Self-injury is distinct from suicidal thoughts as self-injury is designed to help one to feel better while suicide helps one to feel not at all.
Self-inflicted cutting, burning, hitting, scratching, and any other behaviours that cause harm to a person’s body is serious within itself but is also an indicator for suicide.
An estimated 7.5 to 46.5 per cent of adolescents have engaged in self-injury at least once and self-injury is prevalent among males and females.
A growing body of research suggests that the physical pain and relief that follows self-injury essentially tricks the brain into perceiving relief from emotional pain.
Self-injury can also be contagious, youth adopt the practice after observing it in other people.
Contagion of self-injury in schools can be stopped in a number of ways, first, deliberately showing wounds and scars should not be permitted by students at school.
Discussing self-injury and telling students that all maladaptive behaviours (including self-injury) require help from an adult and identifying which adult they can speak to if they suspect or know of a peer that has self-injured or if they have self-injured are essential.
School staff need training around how to compassionately speak to students about displaying wounds, while also not increasing the student’s sense of shame or excluding students from school or school activities.
Adopting a low key, dispassionate demeanour and asking questions based on respectful curiosity is the central pillar of student-staff interactions related to self-injury.
School staff should not move directly into attempting to fix or otherwise solve student problems and should not deny student feelings. Self-injury implements (e.g., blade or lighter) should be removed using a calm and compassionate manner, and the staff member should stay with the student until another member of school staff (preferably a school nurse or mental health worker/point person) can attend to the student.
If there are open wounds that need attention, the first contact staff member may escort the student to the school nurse/point person/crisis team for treatment.
It’s often left to teaching staff to notice that a child has been self-harming and there are some telltale signs. Unexplained scars and wounds which may include cuts, burns, scratches, or bruises should be looked into.
Students wearing clothing with long sleeves and pant legs is particularly concerning when the weather is warmer.
Students engaging in secretive behaviour and withdrawing from other people, searching online or writing and drawing about self-injury in school essays, journals, and artwork are other indications to look for.
A student showing disregard for their own physical safety and health, their hygiene, or their personal appearance are also cause for concern.
Students who have a history of self-injury should be monitored for changes in their behaviour, warning signs may be used to monitor these students and self-injury tends to reoccur.
Offering support and advice to parents and carers about the risks associated with self-injury, the facts about self-injury, and how parents can respond to their self-injuring child is the role of the school nurse, school mental health staff member, school crisis team or point people, and members of the school leadership.
Support and feedback should be provided to the referring teacher or school staff team member, as long as the cofidentiality of the student is maintained.
Adapted from Dr Emily Berger, Monash University and Dr Janis Whitlock, Cornell University, ‘Self-injury response and intervention policy’, in Building Better Schools with Evidence-based Policy.
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