Student Self-Harm: Awareness & Procedures for Teachers

Instructor: Della McGuire

Della has been teaching secondary and adult education for over 20 years. She holds a BS in Sociology, MEd in Reading, and is ABD on the MComm in Storytelling.

In this lesson, we will discuss some methods for understanding and recognizing self-harm in students, as well as procedures teachers and school staff can take to address this common issue among youth.

What is NSSI?

Cornell Research Program on Self-Injurious Behavior defines non-suicidal self-injury (NSSI) as the 'deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned'. Basically, this means that some people, especially young people, will do physical harm to their bodies intentionally without any intentions of killing themselves. Some examples of NSSI behaviors include cutting or branding the skin, pulling out hairs, picking at skin, excessive nail biting, consuming toxic substances, or other kinds of injurious behavior. In order to accommodate injuries like tattoos, piercing, scarification, dieting, or various modern beauty routines that involve deliberate injury, the definition necessarily includes a disclaimer that the purposes are 'not socially sanctioned'.

Why NSSI?

NSSI is a highly stigmatized behavior that is judged harshly by most members of society. Much of this is due to a deep misunderstanding of the function and goal of someone using NSSI as a coping mechanism. NSSI can release powerful endorphins and have a neurologically calming effect, so it's effective at controlling other uncomfortable emotions. By learning better coping skills, students engaging in NSSI can learn to reduce the dangerous practice and replace it with safer responses to stress and anxiety. It is critical that teachers and school staff avoid passing judgment on students who suffer with NSSI, as this kind of stigma can make things harder.

Answering the question of why someone may use NSSI can be handled with courtesy and respect to avoid adding excess anxiety or judgment. Questions that display genuine curiosity in a respectful tone can help understand an individual's motivation. Such questions may include: 'How does cutting make you feel better?'; 'What things or situations happen that make you want to cut?'; 'How old were you when you first started cutting?'; 'What was happening in your life then?'; 'What role do these carvings play in your life right now?' Frank and compassionate questions like these show that you are not afraid to talk openly and nonjudgmentally about a difficult topic and show that you can be trusted to care, without showing alarm or disgust.

NSSI Procedures

Now that we have some awareness of NSSI, let's look at some helpful tips on developing effective procedures for addressing this issue among students. The first step is educating staff and students about self-injury to increase awareness and reduce stigma.

Identifying self-injury

Teachers and school staff need to be aware of the signs, such as wearing long sleeves or pants in warm weather to hide marks, or not participating in activities that show skin like dressing out for gym or swimming. Elevated levels of stress, anxiety, or depression may also be a sign. The most telling sign is seeing bandages, wounds, scars, or even paraphernalia like knives, razors, thumbtacks, or anything else that may be used to self-injure.

Assessing self-injury

Assessment for severity should be done by trained crisis staff, such as a nurse or counselor to determine if the injuries need medical attention or referral to outside therapeutic assistance. Students may be triaged as low or high risk based on the severity and frequency of injury.

Designating Point Persons

Some individuals in the school should serve as the point person or people for managing self-injury cases as they appear and take the lead for the next steps to getting help for the student. These trained staff should be able to have a deep understanding of the dynamics of NSSI.

Parent Contact

Schools should develop a protocol for determining under what circumstances parents should be contacted. Each state varies about student confidentiality and the school's obligation to withhold information and retain confidentiality. Encourage students to reach out to loved ones they can talk to at home.

Managing Active NSSI

For those students engaging in ongoing self-injury, establish a team that includes the self-injurious student, peers, parents, and external referrals like counseling professionals. The emphasis should be on finding healthier coping skills and stress management strategies to replace the injurious behavior, rather than trying to force them to quit cold turkey.

Making Referrals

A critical step in the school's protocols should include a guideline for determining when and how to issue outside referrals to therapy or counseling as well as any necessary medical treatment like stitches. Identifying external referral sources and contact information is necessary to have prepared as there is sometimes difficulty finding professionals who are trained to address NSSI. Teachers should be prepared with various internet resources to provide to students. Some of these helpful organizations are listed with the Cornell Research Program on Self-Injurious Behavior.

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