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Not all online communities are completely safe, and some discuss potentially triggering or distressing topics. This case study examines when and how to refer to a self-harm online community.

This case study will help you:

  • assess the risk of referring someone to an online community
  • make sure a young person is prepared for the potential of distressing content
  • make a supported referral to an online community.
Boy in office with tablet talking to teacher


Bodies Under Siege (BUS) was the name of the first psychiatry book on non-suicidal self-injury. In 1996 the BUSList was conceived by and for people participating in self-injury to support each other towards recovery in the form of an electronic mailing list. It has had several incarnations and is and is now in the form of a phpBB [5] board (forum community) and a live chat.

Before recommending a BUS channel to a young person, I would talk through the potential risks and how they might manage those. If the young person does decide to give it a go – it could be beneficial to sign them up together and go through the guidelines, and have discussions about each point. You might also want to make sure you schedule in time to chat through their BUS experiences in your sessions or discussions over time.

- Community Manager working with an online mental health service

This case study includes suggested practice questions that will help you guide positive interaction with a community that has a higher potential for risk.