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Hiew Y, Powell NL, Wong QY, Fong ZH, Fong YJ, Chee TT. Factors associated with informal and formal help-seeking among Asian adolescents with nonsuicidal self-injury. Clin Child Psychol Psychiatry 2024; 29:1296-1317. [PMID: 38565258 DOI: 10.1177/13591045241241109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking - specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents (Mage = 16.2 years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI.
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Affiliation(s)
- Yvette Hiew
- Department of Psychology, National University of Singapore, Singapore
| | | | - Qiu Yan Wong
- Department of Psychology, National University of Singapore, Singapore
| | - Zhi Hui Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Ying Jie Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Tji Tjian Chee
- Department of Psychological Medicine, National University Health System, Singapore
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Waller G, Newbury-Birch D, Simpson D, Armstrong E, James B, Chapman L, Ahmed F, Ferguson J. The barriers and facilitators to the reporting and recording of self-harm in young people aged 18 and under: a systematic review. BMC Public Health 2023; 23:158. [PMID: 36694149 PMCID: PMC9871435 DOI: 10.1186/s12889-023-15046-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND AIMS This systematic review sought to identify, explain and interpret the prominent or recurring themes relating to the barriers and facilitators of reporting and recording of self-harm in young people across different settings, such as the healthcare setting, schools and the criminal justice setting. METHODS A search strategy was developed to ensure all relevant literature around the reporting and recording of self-harm in young people was obtained. Literature searches were conducted in six databases and a grey literature search of policy documents and relevant material was also conducted. Due to the range of available literature, both quantitative and qualitative methodologies were considered for inclusion. RESULTS Following the completion of the literature searches and sifting, nineteen papers were eligible for inclusion. Facilitators to reporting self-harm across the different settings were found to be recognising self-harm behaviours, using passive screening, training and experience, positive communication, and safe, private information sharing. Barriers to reporting self-harm included confidentiality concerns, negative perceptions of young people, communication difficulties, stigma, staff lacking knowledge around self-harm, and a lack of time, money and resources. Facilitators to recording self-harm across the different settings included being open to discussing what is recorded, services working together and co-ordinated help. Barriers to recording self-harm were mainly around stigma, the information being recorded and the ability of staff being able to do so, and their length of professional experience. CONCLUSION Following the review of the current evidence, it was apparent that there was still progress to be made to improve the reporting and recording of self-harm in young people, across the different settings. Future work should concentrate on better understanding the facilitators, whilst aiming to ameliorate the barriers.
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Affiliation(s)
- Gillian Waller
- NHS Business Services Authority, Stella House, Newburn, Newcastle, NE15 8NY, UK.
| | - Dorothy Newbury-Birch
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Diane Simpson
- grid.7110.70000000105559901Faculty of Education and Society, University of Sunderland, Sunderland, SR6 0DD UK
| | - Emma Armstrong
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Becky James
- Department of Health and Social Care, Office for Health Improvement & Disparities, Newburn, Newcastle, NE15 8NY UK
| | - Lucy Chapman
- grid.433912.e0000 0001 0150 9675Durham County Council, County Hall, Durham, DH1 5UJ UK
| | - Farhin Ahmed
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Jennifer Ferguson
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
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Ammerman BA, Park Y, O'Loughlin CM. Disclosure of suicidal thoughts and behaviors: The impact of suicide event type. J Clin Psychol 2022; 78:2456-2469. [PMID: 35466401 DOI: 10.1002/jclp.23357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Despite its importance, limited work has investigated the nuances of suicidal thoughts and behavior self-disclosure. The present study aimed to examine potential differences in self-disclosure based on whether an individual has disclosed suicidal thinking versus behavior. METHODS Two hundred and four participants having disclosed their suicidal thoughts or behaviors completed a battery of online questionnaires assessing several key aspects of disclosure (i.e., disclosure recipient, perceived helpfulness of disclosure, impact on treatment seeking), as it pertained to both one's first and overall disclosure experiences. RESULTS Individuals who disclosed a suicide attempt, versus ideation, were more likely to have disclosed to a formal support (i.e., health professional) and to seek professional help following disclosure. No significant group differences in perceived helpfulness of experiences were found. CONCLUSION It may be beneficial to increase opportunities for disclosure of suicidal thinking. Overall, disclosures were perceived as helpful and may not impede future help-seeking behavior.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Yeonsoo Park
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
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Uncovering the Mystery of Non-Suicidal Self-Injury Among Selected Filipino Adolescents: A Grounded Theory Approach. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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Ammerman BA, Wilcox KT, O'Loughlin CM, McCloskey MS. Characterizing the choice to disclose nonsuicidal self-injury. J Clin Psychol 2020; 77:683-700. [PMID: 32869874 DOI: 10.1002/jclp.23045] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Despite nonsuicidal self-injury (NSSI) being a prevalent and problematic behavior, only approximately half of those who engage in NSSI disclose their behavior. Yet, limited research has explored the choice to disclose. This study sought to identify if NSSI characteristics, emotional distress, and perceived interpersonal obstacles discriminated between NSSI disclosure status. Exploratory aims also investigated reasons for one's disclosure decision and disclosure contextual factors. METHOD Participants included 977 undergraduate students (83% female) with a lifetime history of NSSI. RESULTS Greater NSSI intrapersonal functions, suicide risk, and significant other support, and lower depression symptoms were associated with NSSI disclosure. Exploratory results highlight perceptions of one's NSSI severity and desire to receive support in disclosure choice; intrapersonal functions and peer support were associated with the timing of disclosure. CONCLUSIONS Findings underscore the potential importance of individual attitudes toward NSSI, in addition to traditionally measured risk factors, as potential drivers in NSSI disclosure.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Kenneth T Wilcox
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | | | - Michael S McCloskey
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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Gargiulo A. Narratives of Self-Harm at School: Identifying Trajectories of Intervention in Educational Contexts. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:95-111. [PMID: 33680172 PMCID: PMC7913034 DOI: 10.5964/ejop.v16i1.1883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022]
Abstract
Recent studies have shown that self-harming behaviour is increasingly widespread among adolescents, in particular at school. However, educational institutions perceive themselves unable to cope with the phenomenon, searching for protocols and guidelines to improve its management. Considering schools as useful contexts for intercepting the young malaise, this study aims at exploring the main meanings of self-harming behaviours made within the educational cultural contexts starting from the student’s narrations, in order to understand the possible trajectories of practice. In two high schools we have collected 96 narratives of self-harm written by adolescents (mean age 14; 74% females), who have been engaged in non-suicidal self-injury once in their life. The analysis of the narratives, produced with the help of a software for the automatic qualitative analysis of texts, has allowed to identify four prevalent themes organized into three sense vectors. The findings highlighted significant gender differences in the representation of the experience of self-harm between males and females, as well as the importance of meaningful relationships developed in familiar and educational contexts, which may allow the help seeking process. The emerging of culturally-shared meanings among adolescents within the investigated contexts may allow to think about possible protocols of preventive and clinical practices in schools.
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Affiliation(s)
- Anna Gargiulo
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Kostić J, Žikić O, Stankovic M, Nikolić G. Nonsuicidal self-injury among adolescents in south-east Serbia. Int J Pediatr Adolesc Med 2019; 6:131-134. [PMID: 31890837 PMCID: PMC6926179 DOI: 10.1016/j.ijpam.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/13/2019] [Indexed: 12/05/2022]
Abstract
Background Nonsuicidal self-injury (NSSI) refers to the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned. The aim of this study was to explore the variety of self-injury behaviors as well as the function of NSSI among adolescents in South-East Serbia. Methods The study included 50 adolescents of both sexes, aged 13–18 years, who had deliberately engaged in self-injury at least once. A general socio-demographic questionnaire and the Inventory of Statements About Self-Injury (ISAS) were used in the study. Results The average age of the respondents was 15 (1.17); the most common NSSI methods were cutting (60%), followed by biting and severe scratching (14%); the average age of onset was 14.12 (0.77); the majority confirmed experiencing pain during self-injury (42%); the respondents more commonly performed NSSI when they were alone (68,0%); in 90% of the cases, the time elapsed between sensing the urge to self-injury and acting on it was less than 1 h; the majority of the respondents stated that they did not want to stop self-injuring (56%). In terms of the NSSI function, the obtained scores were the highest for affect regulation 3.36 (1.47), self-punishment 1.90 (1.39) and marking distress 1.72 (1.26). In terms of gender, there was a statistically significant difference for the antidissociation (P = .043), interpersonal influence (P = .004) and revenge (P = .019). Conclusion The results may have practical implications when it comes to taking preventive and therapeutic measures in the vulnerable adolescent population.
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Affiliation(s)
- Jelena Kostić
- Department of Psychiatry, School of Medicine, University of Niš, Serbia.,Clinic for Mental Health Protection, Department for Child and Adolescent Psychiatry, Clinical Center Niš, Serbia
| | - Olivera Žikić
- Department of Psychiatry, School of Medicine, University of Niš, Serbia.,Clinic for Mental Health Protection, Department for Diagnose and Treatment, Clinical Center Niš, Serbia
| | - Miodrag Stankovic
- Department of Psychiatry, School of Medicine, University of Niš, Serbia.,Clinic for Mental Health Protection, Department for Child and Adolescent Psychiatry, Clinical Center Niš, Serbia
| | - Gordana Nikolić
- Department of Psychiatry, School of Medicine, University of Niš, Serbia.,Clinic for Mental Health Protection, Department for Diagnose and Treatment, Clinical Center Niš, Serbia
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Tillman KS, Prazak M, Obert ML. Understanding the experiences of middle school girls who have received help for non-suicidal self-injury. Clin Child Psychol Psychiatry 2018; 23:514-527. [PMID: 29228788 DOI: 10.1177/1359104517743784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to understand the experiences of middle school girls who have engaged in non-suicidal self-injury (NSSI) and have received professional help for these behaviors. Participants described engaging in NSSI in response to uncomfortable feelings and invasive negative thoughts. They reported that engaging in NSSI decreased their uncomfortable feelings. While each participant had at least one person in her life who knew about her NSSI, participants did not feel supported or validated by these people. Participants were not completely honest with their therapists because they were afraid of being misunderstood, dismissed, or getting others into trouble. Despite these things, participants wanted support and understanding about who they are as unique individuals, why they are struggling, and why they self-injure. They also wanted to be in a transparent therapeutic relationship where they felt respected and accepted. Unfortunately, they did not describe relationships with their therapists as possessing these qualities. Professionals would better meet the need of adolescents by clearly discussing confidentiality, boundaries, conveying respect and acceptance, and recognizing the uniqueness of their clients. Assessing for self-harm and treatment reluctance should be done in the context of resistance to therapy and a sensitivity to judgment.
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Affiliation(s)
- Kathleen S Tillman
- Department of Counseling Psychology & Community Services, University of North Dakota, USA
| | - Michael Prazak
- Department of Counseling Psychology & Community Services, University of North Dakota, USA
| | - Megan L Obert
- Department of Counseling Psychology & Community Services, University of North Dakota, USA
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Baiden P, Stewart SL, Fallon B. The mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents: Findings from community and inpatient mental health settings in Ontario, Canada. Psychiatry Res 2017; 255:238-247. [PMID: 28587863 DOI: 10.1016/j.psychres.2017.05.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 03/28/2017] [Accepted: 05/11/2017] [Indexed: 12/17/2022]
Abstract
Although bullying victimization has been linked to a number of behavioral and emotional problems among adolescents, few studies have investigate the mechanism through which bullying victimization affect non-suicidal self-injury. The objectives of this study were to examine the effect of bullying victimization on non-suicidal self-injury and the mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents. Data for this study came from the interRAI Child and Youth Mental Health dataset. A total of 1650 adolescents aged 12-18 years (M =14.56; SD =1.79; 54.2% males) were analyzed. Binary logistic and Poisson regression models were conducted to identify the mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury. Of the 1650 adolescents studied, 611 representing 37% engaged in non-suicidal self-injury and 26.7% were victims of bullying. The effect of bullying victimization on non-suicidal self-injury was partially mediated by depressive symptoms after adjusting for the effect of demographic characteristics, history of childhood abuse, social support, and mental health diagnoses. The contribution of bullying victimization and depression to non-suicidal self-injury adds to the case for the development of trauma-focused interventions in reducing the risk of non-suicidal self-injury among adolescents.
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Affiliation(s)
- Philip Baiden
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4.
| | - Shannon L Stewart
- Faculty of Education, Western University, 1137 Western Road, London, ON, Canada N6G 1G7
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4
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Baiden P, Stewart SL, Fallon B. The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. CHILD ABUSE & NEGLECT 2017; 69:163-176. [PMID: 28477476 DOI: 10.1016/j.chiabu.2017.04.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/31/2017] [Accepted: 04/09/2017] [Indexed: 06/07/2023]
Abstract
The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors.
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Affiliation(s)
- Philip Baiden
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
| | - Shannon L Stewart
- Faculty of Education, Western University, 1137 Western Road, London, ON N6G 1G7, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada
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De Riggi ME, Moumne S, Heath NL, Lewis SP. Non-Suicidal Self-Injury in Our Schools: A Review and Research-Informed Guidelines for School Mental Health Professionals. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516645563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Non-suicidal self-injury (NSSI), the immediate and deliberate destruction of one’s own body tissue, without suicidal intent, and not for purposes that are socially accepted, is a critical concern for youth in schools. Despite significant scholarly advances and increasing clinical awareness of NSSI, many school mental health professionals (MHPs) continue to report feeling ill equipped to support students who self-injure, and emphasize a need for formal education about NSSI and its management in schools. Thus, the first part of this article summarizes current NSSI research on prevalence, age of onset, gender differences, functions, risk factors, and associations with suicide. Emerging from this review, the second part offers research-informed recommendations for MHPs managing NSSI in schools, including guidelines for (a) identifying students at elevated risk of self-injury, (b) developing a protocol for school personnel’s initial response to student self-injury, (c) first-level assessment of NSSI, and (d) managing critical issues related to NSSI contagion and online activity.
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Lewis SP, Seko Y. A Double-Edged Sword: A Review of Benefits and Risks of Online Nonsuicidal Self-Injury Activities. J Clin Psychol 2015; 72:249-62. [PMID: 26613372 DOI: 10.1002/jclp.22242] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This review aimed to synthesize current evidence on the perceived benefits and risks of online activity pertinent to nonsuicidal self-injury (NSSI). METHOD A systematic literature search was conducted to identify peer-reviewed articles, which yielded a total of 27 articles published between 2005 and 2015. Following this, a thematic analysis was employed to identify perceived benefits and risks of online NSSI activity. RESULTS Our thematic analysis identified 4 potential benefits (mitigation of social isolation, recovery encouragement, emotional self-disclosure, curbing NSSI urges) and 3 potential risks (NSSI reinforcement, triggering NSSI urges, stigmatization of NSSI) associated with online NSSI activities. CONCLUSION Given the double-edged effect of online NSSI activities, clinicians may benefit from incorporating clients' online NSSI activity in the context of NSSI assessment and treatment. Future research ought to directly examine the link between online NSSI activity and NSSI behavior to better understand the nature of these benefits and risks.
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Rowe SL, French RS, Henderson C, Ougrin D, Slade M, Moran P. Help-seeking behaviour and adolescent self-harm: a systematic review. Aust N Z J Psychiatry 2014; 48:1083-95. [PMID: 25335872 DOI: 10.1177/0004867414555718] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Self-harm is common in adolescence, but most young people who self-harm do not seek professional help. The aim of this literature review was to determine (a) the sources of support adolescents who self-harm access if they seek help, and (b) the barriers and facilitators to help-seeking for adolescents who self-harm. METHOD Using a pre-defined search strategy we searched databases for terms related to self-harm, adolescents and help-seeking. Studies were included in the review if participants were aged 11-19 years. RESULTS Twenty articles met criteria for inclusion. Between a third and one half of adolescents who self-harm do not seek help for this behaviour. Of those who seek help, results showed adolescents primarily turned to friends and family for support. The Internet may be more commonly used as a tool for self-disclosure rather than asking for help. Barriers to help-seeking included fear of negative reactions from others including stigmatisation, fear of confidentiality being breached and fear of being seen as 'attention-seeking'. Few facilitators of help-seeking were identified. CONCLUSIONS Of the small proportion of adolescents who seek help for their self-harm, informal sources are the most likely support systems accessed. Interpersonal barriers and a lack of knowledge about where to go for help may impede help-seeking. Future research should address the lack of knowledge regarding the facilitators of help-seeking behaviour in order to improve the ability of services to engage with this vulnerable group of young people.
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Affiliation(s)
- Sarah L Rowe
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK
| | - Rebecca S French
- London School of Hygiene and Tropical Medicine, Department of Social and Environmental Health Research, Faculty of Public Health & Policy, London, UK
| | - Claire Henderson
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK
| | - Dennis Ougrin
- King's College London, Child and Adolescent Psychiatry Department, Institute of Psychiatry, London, UK
| | - Mike Slade
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK
| | - Paul Moran
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK
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An Examination of Disclosure of Nonsuicidal Self-injury among University Students. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2014. [DOI: 10.1002/casp.2190] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Lewis SP, Heath NL, Michal NJ, Duggan JM. Non-suicidal self-injury, youth, and the Internet: What mental health professionals need to know. Child Adolesc Psychiatry Ment Health 2012; 6:13. [PMID: 22463379 PMCID: PMC3464157 DOI: 10.1186/1753-2000-6-13] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 02/07/2012] [Indexed: 11/10/2022] Open
Abstract
Non-suicidal self-injury (NSSI) content and related e-communication have proliferated on the Internet in recent years. Research indicates that many youth who self-injure go online to connect with others who self-injure and view others' NSSI experiences and share their own through text and videos platforms. Although there are benefits to this behaviour in terms of receiving peer support, these activities can introduce these young people to risks, such as NSSI reinforcement through the sharing of stories and strategies, as well as, risks for triggering of NSSI urges. Due to the nature of these risks mental health professionals need to know about these risks and how to effectively assess adolescents' online activity in order to adequately monitor the effects of the purported benefits and risks associated with NSSI content. This article offers research informed clinical guidelines for the assessment, intervention, and monitoring of online NSSI activities. To help bridge the gap between youth culture and mental health culture, these essentials include descriptions of Community, Social Networking, and Video/Photo Sharing websites and the terms associated with these websites. Assessment of these behaviours can be facilitated by a basic Functional Assessment approach that is further informed using specific recommended online questions tailored to NSSI online and an assessment of the frequency, duration, and time of day of the online activities. Intervention in this area should initially assess readiness for change and use motivational interviewing to encourage substitution of healthier online activities for the activities that may currently foster harm.
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Affiliation(s)
- Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC H3A 1Y2, Canada
| | - Natalie J Michal
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Jamie M Duggan
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC H3A 1Y2, Canada
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