Chen S, Lam T, Lam K, Lo T, Chao D, Mak K, Lam E, Tang W, Chan H, Yip P. The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study. J Med Internet Res 2022;24(10):e37695 DOI: 10.2196/37695
This study examined youths’ private social media use via a new Instagram feature, Close Friends, and its relationship with online and offline help-seeking willingness and suicidality. The Close Friends Instagram feature allows private online interaction by permitting invited users only to view private posts. Forty youth participants aged 15-19 years old residing in Hong Kong were recruited. The motivations for using Close Friends and concerns regarding online expression were addressed in focus groups and individual interviews. A quantitative survey was also conducted among a larger sample of 1,676 students aged 15-19 years old in Hong Kong to examine the prevalence of Close Friends usage, online and offline help-seeking willingness, and suicide-related experiences. Focus group and interview data revealed common motives for using Close Friends to include interaction and seeking help from friends, release of negative emotions, and venting and self-expression. Survey results found 71% of youth use Close Friends and 46% use frequently. Overall, seeking help online was associated with higher risk of suicidality (Odds Ratio=1.50, 95% CI 1.04-2.15) and seeking help offline was associated with decreased suicidality (Odds Ratio=0.55, 95% CI 0.39-0.75). Close Friends users were significantly more likely to seek offline support than non-users, but frequent Close Friends users were more likely to seek help online and to be at higher risk of suicidality than non-users. Prevalent use of Close Friends represents an emerging trend for online expression and private conversation among youth. Excessive use of this feature may indicate more limited offline support or less desirable offline support for youth experiencing suicidality. Authors recommend future steps in determining the causal relationship between use of Close Friends and willingness to seek help.