Background Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among individuals seeking treatment. Objective This protocol paper presents the DAILY project’s aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior; (2) the transition from NSSI thoughts and urges to NSSI behavior; and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of individuals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life. Methods The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals. Results We will recruit approximately 120 individuals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023. Conclusions The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among individuals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time. International Registered Report Identifier (IRRID) DERR1-10.2196/46244

Background: Non-suicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence or severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-harming behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The Detection of Acute rIsk of seLf-injurY (DAILY) project will address these gaps among treatment-seeking individuals.Objectives: This protocol paper presents the DAILY project's aims, design, and materials. The objectives are to advance understanding of (1) the short-term course and contexts of elevated risk of NSSI thoughts, urges, and behavior, (2) the transition from NSSI thoughts/urges to NSSI behavior, (3) and the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of treatment-seeking individuals and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life.Methods: The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves three phases, including a baseline assessment (Phase 1), 28 days of Ecological Momentary Assessment (EMA) followed by a clinical session and feedback survey (Phase 2), two follow-up surveys and an optional interview (Phase 3). The EMA protocol consists of regular EMA surveys (six times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (three times within 30 minutes), and event registrations of NSSI behavior. Primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, purging), substance use (binge drinking, smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. Assessed predictors include emotions, cognitions, contextual information, and social appraisals.Results: We will recruit approximately 120 treatment-seeking individuals aged 15-39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and is anticipated to conclude in spring 2023.Conclusions: The findings of the DAILY project will provide a detailed characterization of the short-term course of NSSI and advance understanding of how, why, and when NSSI and other self-harming behaviors unfold among treatment-seeking individuals. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside the therapy room that support people who self-injure in real-time.