Understanding Nonsuicidal Self-Injury in Youth

In this article we summarize what is known about nonsuicidal self-injury (NSSI) in youth. First, we describe basic demographic trends, prevalence, and function. Then we turn our attention to the implications of NSSI for schools, schoolrelated policies, and school guidelines. Having provided an overview of the field, we conclude that even in the absence of academic and clinical consensus of the definition, measurement, and NSSI function, schools are uniquely poised to raise awareness about NSSI and about mental health issues in general among their students and their staff. By taking proactive approaches to building awareness and skills, schools are well positioned to assist in equipping young people with the skills they need to better cope with the inevitable vicissitudes of life including but not limited to NSSI. Despite its contemporary ubiquity, understanding of nonsuicidal self-injury (NSSI) is nascent. Its seemingly sudden appearance on the map of youth risk behavior just over a decade ago gave rise to a flurry of research on its epidemiological composition. And, as the case examples below portray, NSSI is both common among youth who otherwise function normally and is found in schools, colleges, youth serving organizations, and families of every type. In many ways, however, practical approaches for detecting, responding to, and intervening with NSSI in the everyday settings where youth are found, like schools, lag even further behind than our basic understanding of what it is and why people do it. In light of the instinctive confusion it seems to generate for onlookers, it is easy to understand why NSSI is not only hard to talk about but is a topic easier to avoid than to engage. Its very nature defies deep instinctual human drives for self-preservation as well strong social taboos related to self-inflicted injury. It is, after all, quite puzzling. Why would someone choose to cut or otherwise hurt his or her body? Why would someone do this in way that looks like a suicide attempt but then insists that it actually has nothing to do with suicide at all? How do we understand this, let alone effectively respond to it? Those of us who study NSSI are very familiar with the instinctive avoidance reaction to this topic, and some of us have had to overcome it in ourselves and all of us have encountered it in others. Such avoidance is natural, but it is also something schools and other youth-serving professionals will need to actively counter to help the high numbers of today’s youth who use NSSI as a path to School Psychology Forum: Research in Practice b.Whitlock.PP.3d 5/11/13 18:44:11 The Charlesworth Group, Wakefield +44(0)1924 369598 Rev 7.51n/W (Jan 2