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

Signs

• 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.