Adolescent self‐harm prevention and intervention in secondary schools: a survey of staff in England and Wales

Abstract

Background Adolescent self‐harm is a major public health concern. To date there is a limited evidence‐base for prevention or intervention, particularly within the school setting. To develop effective approaches, it is important to first understand the school context, including existing provision, barriers to implementation, and the acceptability of different approaches. Methods A convenience sample of 222 secondary schools in England and Wales were invited to participate in a survey, with a 68.9% (n = 153) response rate. One member of staff completed the survey on behalf of each school. Participants responded to questions on the existing provision of adolescent self‐harm prevention and intervention, barriers to delivery, and future needs. Results Adolescent self‐harm is an important concern for senior management and teachers. However, emotional health and well‐being is the primary health priority for schools. Health services, such as Child and Adolescent Mental Health Services, and on‐site counselling are the main approaches schools currently use to address adolescent self‐harm, with counselling cited as the most useful provision. Fifty‐two per cent of schools have received some staff training on adolescent self‐harm, although only 22% rated the adequacy of this training as high. Where schools do not have existing provision, respondents stated that they would like staff training, specialist student training, external speakers, posters and assemblies, although the latter four options were infrequently ranked as the most useful approaches. Key barriers to addressing adolescent self‐harm were: lack of time in the curriculum; lack of resources; lack of staff training and time; and fear of encouraging self‐harm amongst adolescents. Conclusions Adolescent self‐harm is a priority for schools. Intervention might focus on increasing the availability of training to teaching staff.

Acceptability and Feasibility of Early Identification of Mental Health Difficulties in Primary Schools: A Qualitative Exploration of UK School Staff and Parents’ Perceptions

“…Our study's findings corroborated with others around concerns of the age appropriateness of topics such as self-harm (Evans et al, 2019), indicating that delivery by professionals could be beneficial. The Green Paper on transforming children's mental health services (DOH & DFE, 2017) advised that all schools are allocated funding to develop Mental Health Support Teams as well as a designated senior lead for mental health.…”

Adolescents at risk of self-harm in Ghana: a qualitative interview study exploring the views and experiences of key adult informants

“…Thus, as expected, the school staff and social workers in the present study suggested the inclusion of adolescent mental health issues in the social work and teacher training curricula and as part of social workers' and teachers' continuing professional development training programmes. Among other things, such in-service and preservice staff training should address the fear related to the misconception that talking about self-harm or suicide 'places the idea to try out the behaviour into the heads of young people' [45], and the need to avoid separating self-harm neatly into 'suicidal' and 'non-suicidal' [46][47][48][49]. This suggestion of stakeholder training is imperative, as studies have shown that the training of key stakeholders and adult gatekeepers is critical to the supportive roles these adults play towards improving the mental health of children and adolescents [50][51][52][53].…”

School absenteeism as a risk factor for self-harm and suicidal ideation in children and adolescents: a systematic review and meta-analysis

“…Both education professionals and young people suggest that self-harm should be a priority issue to address in schools [ 32 , 33 ]. However, education professionals feel ill-equipped to address it [ 34 ]. The recent UK government Green Paper ‘Transforming Children and Young People’s Mental Health Provision’ [ 35 ] has laid out plans to develop a system of greater integration between the health and education sectors in the provision of mental health support for young people.…”