Navigating Suicide-Related Online Content in Individuals With Lived Experience of Suicidality: Cross-Sectional Survey.

Background: Engagement with suicide-related content online is often assumed to be harmful, yet many individuals with lived experience describe such content as supportive or even life-preserving. Despite policy and clinical concerns, little is known about how people intentionally or unintentionally encounter this content, how they interpret it, and how these experiences shape perceived harm or benefit. Objective: This study aims to explore how intent and context influence the ways in which individuals with lived experience of suicidality encounter, interpret, and respond to suicide-related online content, and to identify factors associated with perceived harm and benefit. Methods: An exploratory cross-sectional survey was conducted with a convenience sample of 713 UK-based participants aged 16 to 60 years and older, 95.9% (n=684) of whom reported having lived experience of suicidality. Quantitative data were analyzed using descriptive and inferential statistics, including chi-square tests, to examine associations between engagement patterns, intent, and suicidality. Free-text responses were coded using content analysis to identify categories relating to motivations for engagement, emotional responses, and perceived impact. Results: Participants reported a broad range of experiences. While 30.0% (214/713) described suicide-related content as contributing to suicidal thoughts or attempts, others reported relief, validation, or reduced feelings of isolation, with 21.0% (150/713) attributing content to preventing an attempt. Clear differences emerged between participants who actively sought out content ("seekers") and those who encountered it unintentionally ("stumblers"). Seekers more frequently reported positive or understanding responses, often in the context of unmet offline support needs, whereas stumblers were more likely to report shock or distress. Approximately 39.9% (151/378) of participants described their engagement as neither intentional nor accidental, potentially reflecting a blurred boundary between passive exposure and active seeking, as well as the difficulty individuals face in accurately identifying and articulating their own motivations in relation to suicidality. Conclusions: Engagement with suicide-related online content cannot be characterized as uniformly harmful. Outcomes depend on user intent, emotional state, and the context of engagement, and they may change over time. Clinical, regulatory, and policy approaches should move beyond risk-only frameworks to account for the nuanced and sometimes supportive roles such content plays in how individuals make sense of suicidal thoughts, while still protecting those at risk.