Cutting/ Non-Suicidal Self-Injury (NSSI)

Non-suicidal self-injury (NSSI) is defined as deliberately injuring oneself without suicidal intent. The most common form of NSSI is self-cutting, but other forms include burning, scratching, hitting, intentionally preventing wounds from healing, and other similar behaviors. Tattoos and body piercings are not considered NSSI, unless they are created with the specific intention to self-harm. NSSI is often inflicted on the hands, wrists, stomach, or thighs, but it can occur anywhere on the body.

Rates of NSSI are highest among adolescents and young adults. Although estimates vary, approximately 12%-24% of adolescents and young adults have self-injured, and 6%-8% report current, chronic self-injury. Some individuals continue to engage in these behaviors well into adulthood, especially when they do not receive treatment. Source

Risk Factors

  • Knowledge that friends or acquaintances are cutting
  • Difficulty expressing feelings
  • Extreme emotional reactions to minor occurrences (anger or sorrow)
  • Stressful family events (divorce, death, conflict)
  • Loss of a friend, boyfriend/girlfriend, or social status
  • Negative body image
  • Lack of coping skills
  • Depression


  • Wearing long sleeves during warm weather
  • Wearing thick wristbands that are never removed
  • Unexplained marks on body
  • Secretive or elusive behavior
  • Spending lengthy periods of time alone
  • Items that could be used for cutting (knives, scissors, safety pins, razors) are missing

What should you do?
If you become aware that your child is engaging in self-injurious acts, remember that it is fairly common. Though it is often frightening for parents, the majority of teens who cut themselves do not intend to inflict serious injury or cause death. If the injury appears to pose potential medical risks, contact emergency medical services immediately. If the injury doesn’t appear to pose immediate medical risks, remain calm and nonjudgmental, contact your child’s pediatrician to discuss the concerns, and ask for a referral to a trained mental health professional who has experience in this area. Source

Overview for school staff:

Educators & Self Injury How to recognize, understand, and respond to nonsuicidal self-injury.

Quick reference protocol in steps to intervene at school.  Helps remind staff of steps in intervening with a student who has been cutting.

Parent Notification Form– Please involve parents by informing them by phone prior to sending the form home this parent notification.

Parent Fact Sheet– to go home with Parent Notification Form.

Suicide Risk Assessment Summary Sheet  This is a very good tool.

Safety Contract for Adolescents

Further reading:

Non-Suicidal Self-Injury in Schools: Developing & Implementing School Protocol

PPT Self-Injury Interventions for School Psychologists

Why Teenagers Cut, and How to Help

Need help for self-harm?

If you’re not sure where to turn, call the S.A.F.E. Alternatives information line in the U.S. at (800) 366-8288 for referrals and support for cutting and self-harm. For helplines in other countries, see Resources and References below.

In the middle of a crisis?

If you’re feeling suicidal and need help right now, call the National Suicide Prevention Lifeline in the U.S. at (800) 273-8255. For a suicide helpline outside the U.S., visit Befrienders Worldwide.

Exploring feelings with your kids


20 minute fun activities for parents and children that promote resilience by encouraging flexible thinking.

Emotional Intelligence Activities for Kids

Navigating Your Child’s Emotional Ups and Downs


Amygdala Hijack & Emotional Intelligence

How can we build flexibility into every day parenting?

  • Involve children in making decisions when possible.
  • Inventory the current needs to make a decision based on the present moment.
  • don’t get stuck on musts and should’s if something is not working don’t be afraid to change it.
  • Trust children to do things for themselves, even if it doesn’t turn out perfectly or quite how you wished it would.
  • Have routines for predictability not as a means to reward, punish or control.
  • Plan on extra time whenever possible so that special moments don’t have to be lost or abandoned all the time.
  • Ask questions and welcome cooperation instead of making demands.
  • Take time to care for yourself – you can only give as much love and care to others as you have for yourself! (That’s the elastic thing again – when we give too much we SNAP!)
  • Accept your child’s feelings as authentic expression, not something you must control or squash.
  • Dare to do things differently, be ridiculous and cultivate laughter – this will help you relax and let go!
  • Say YES when you can and say NO with kindness.



Improving Family Communications

Parent/Child Communication

Boys and feelings 

Wanting to be a good father, I try to keep my awareness about my kids’ feelings in the forefront of my thoughts. My son had a tantrum the other day and we started talking about how he felt to work through why he was upset. Afterward I started thinking about different experiences I had growing up with feelings. How I might have benefited more from a better coping skills in difficult situations with a more indepth understanding of feelings and what to do when adversity strikes.

Quote by: Malcolm Knowles

Here is a good Washington Post article: Here’s how (and why) to help boys feel all the feels.

The Harvard University Gazette article: Boys Struggle to be Boys

The Fuller Youth Institute article: Feelings not Allowed

Coping skills for managing emotions: Kids Matter Coping Skills
Boys Town: 99 coping strategies