Supporting students who self-injure: understanding the perceptions of school staff and students

Non-suicidal self-injury (NSSI), the deliberate destruction of body tissue without suicidal intent, among adolescents is a growing concern, especially for school staff. Although NSSI is a significant risk factor for further self-injury and suicide, many adolescents who self-injure do not seek professional help, and hide their behaviour from adults. Teachers and other school staff are in a prime position to identify and intervene with these youth. However, while teachers and other school staff are likely to encounter youth who self-injure, school staff are uncertain and lack training when responding to these students. Understanding the knowledge and training needs of school staff regarding NSSI, and exploring adolescents’ views about strategies to help young people who self-injure, will inform the development of prevention and early intervention initiatives to address NSSI in the school environment. Therefore, the primary aims of this thesis were to: 1) evaluate adolescents’ perspectives on how to help youth who self-injure; 2) establish the level of knowledge, confidence, and training needs of school staff and pre-service teachers; and 3) understand how school staff currently respond, and perceived barriers to effectively responding, to NSSI in schools. To achieve these aims, self-report data were collected from 2637 students, and thematic analysis used to explore what adolescents believe teachers, parents, peers, and online friends could do to help young people who self-injure. Quantitative and qualitative data were also collected from 267 pre-service teachers and 501 school staff (including school leaders, teachers, psychologists, and counsellors), and multivariate statistics used to explore the relationships between attitudes, knowledge, and confidence towards NSSI, exposure to student self-injury, prior training, and actual responses to students who self-injure. Finally, 48 teachers and other school staff reviewed a new school policy for addressing NSSI in schools and provided written feedback on the strengths and suitability of the policy for responding to students who self-injure in the school setting. Adolescents suggested that youth who self-injure could be helped by talking to them about the behaviour and referring them to mental health professionals. However, adolescents with a history of NSSI, or with friends who had engaged in NSSI, were unsure how teachers could help young people who self-injure. Although pre-service teachers and school staff were concerned about and willing to help students who self-injure, they were unsure how to respond and acknowledged their lack of training regarding NSSI. School staff with training regarding NSSI had greater knowledge and confidence to address self-injury in schools, while those with greater perceived knowledge and confidence were more likely to communicate with students who self-injure. Collectively, although students would like access to non-judgmental teachers to talk to about NSSI, teachers feel ill-equipped to discuss self-injury with students. These results have implications for education programs to encourage adolescents to access help for peers or themselves. Additionally, the results can inform the development of training programs and school policies for school staff to enhance their knowledge and confidence, and prepare them to identify, safely communicate with, and refer students who self-injure.