Non-suicidal self-injury (NSSI)

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A Resource for Teachers. Defining non-suicidal self-injury (NSSI) . Deliberate self-inflicted injury to one’s own body tissues without conscious intent to die. Not . considered a socially approved practice within one’s . ID: 578162 Download Presentation

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Non-suicidal self-injury (NSSI)

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Non-suicidal self-injury (NSSI)

A Resource for Teachers


Defining non-suicidal self-injury (NSSI)

Deliberate self-inflicted injury to one’s own body tissues without conscious intent to dieNot considered a socially approved practice within one’s cultureExcludes ear piercing, tattooing, circumcision, or cultural healing rituals


Prevalence rates

15% to 20% of middle and high school students engage in NSSIBPrevalence rates are much higher in clinical samples of adolescents (between 12-65%)Typical age of onset occurs during middle school, roughly between the ages of 12 to 15 yearsIn adolescent samples, females are more likely to report having self-injured but by late adolescence, young males and females report similar ratesThe most commonly found risk factors for NSSI is having difficulties with regulating emotions


Common forms of NSSI

scraping or scratching skincutting skin self-hitting or banging (to break or bruise) burning pinching

interfering with a healing wound self-biting picking or ripping skin


NSSI vs. Suicidal Behaviour

Non-suicidal self-injury Suicidal behaviour IntentTo get immediate relief from negative emotionsTo die in order to permanently escape emotional painRepetitionMore frequentLess frequentLethalityOften involves less lethal methods but with a potential for lethalityTends to involve more lethal methodsPsychological consequencesOften used to relieve psychological painOften aggravates psychological painGenderMay or may not occur often in women, depending on sampleOccurs more often in women but men are more likely to die by suicide


Why do people engage in NSSI?

To reduce negative emotions


and thoughts

NSSI involves the body’s natural pain killers. This can result in the release of pleasant feelings

To stop themselves from acting on

suicidal thoughts and urges


punish one-self

To reconnect with one-self and others


complex and is often the result of many converging factors. The explanations are equally complex.


How can School Personnel help at the time of disclosure?


Respond in a calm and caring manner.

Don't be afraid to state, "I've noticed injuries that appear to be self-inflicted, I care about why you might be doing that" or, "it appears you have hurt yourself, do you want to talk about it?”

Understand that this is the student’s way of coping with pain.

Have a non-judgemental compassion for the student’s experience.

Offer to be a caring adult for the student while they are seeking mental health support.

Acknowledge their feelings; offer to listen


be available.

Encourage participation in extracurricular activities and outreach in the community (e.g. volunteering with animals, nursing homes, tutoring or mentoring).

Discover the student’s strengths.


How can School Personnel help at the time of disclosure?


Be overly reactive as this could alienate the student and damage the developing alliance.

Show excessive interest in the NSSI behavior.

Permit the student to relive the experiences of NSSI in detail, as this can be triggering.

Try to stop the behaviour with threats or ultimatums.

Discourage self‐injury; threaten hospitalization, use punishment or negative consequences.

Act shocked, overreact, say or do anything to cause guilt or shame.

Publicly humiliate the student .

Talk about the student’s NSSI in front of class or peers.

Agree to hold NSSI behaviour confidential.

Make deals or promises you can’t keep in an effort to stop NSSI.


School response protocol

Wounds are severe or life-threatening or the student is attempting suicide

Provide first aid and assess lethality of injurySend someone to call 911 and to communicate with the principal or designate. Listen empathically and carefully to the student’s message. The principal or designate will call the parent(s) or guardian(s).

Wounds are not life-threatening

Report all concerns related NSSI to the school principal or designate. A suicide risk review will be conducted by an ASIST trained staffThe ASIST trained staff and principal or designate, will identify the level of NSSI risk

Should the student be identified as potentially suicidal,

DSB Ontario North East Youth Suicide Prevention, Intervention and Response Protocols

are followed.



Ontario North East Protocol Flowchart

If the student is suicidal, follow suicide protocols





Be cautious about telling the student that you won’t tell anyone about their self-injury. There could be a risk of suicide a health risk a self-injuring group of peers, and/or

As per our protocol,

staff shall report all concerns related to potential self-harm to the school principal, vice-principal or designate




Circles of

vulnerability for contagion of NSSI

Population at risk


Contagion in Schools


Trends have been suggested whereby multiple students who self-injure, communicate frequently about NSSI, and trigger the behaviour in each other.


may self-injure in front of each other, share the same tools, implement or take turns injuring the body parts of others in the group.


adolescents will pick up self-injuring behaviour from siblings or peer group leaders.


Managing contagion in the school

When discussing NSSI with students, the following guidelines will help in preventing contagion:



allow students to share detailed information regarding NSSI, reveal their scars, or share NSSI

related images





use school-wide assemblies, newsletters, school newspapers to address an “outbreak” of


Do not


media that glamorize NSSI [as part of classroom curriculum].


educating youth about NSSI, discuss the behavior in its broader context; that is, as a maladaptive

coping strategy

among several others (such as substance abuse, or risk-taking



the need for students who are engaging in the behavior to seek support.



We hope that you found this a useful introduction to NSSI.

For more information, please refer to pp. 121 – 125 of Supporting Minds: An Educator’s Guide to Promoting Students’ Mental Health

and Well-being:


Should you have questions,

your Mental Health Leader is available

to provide ongoing support and

leadership to your team.

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