Development of guidelines for school staff on supporting students who self-harm: a Delphi study

Abstract

Objective Self-harm is a major public health issue that significantly impacts communities, making early intervention and prevention paramount in addressing this public health issue. This study aimed to develop evidence-based, culturally responsive, safe, and practical guidelines to assist school staff in effectively supporting students who self-harm. Methods This Delphi study comprised of a five-step process, oversighted by a Rōpū Mātanga Māori (Māori clinical and cultural governance group), and drawing on the expertise and knowledge gained from existing literature, interviews with stakeholders, and two panels of experts (youth and stakeholders). The Rōpū Mātanga Māori ensured accountability to the principles of Te Tiriti o Waitangi (Treaty of Waitangi) and kept Māori processes central to the research aims. The panels completed two rounds of questionnaires, rating their endorsement of each statement. Statements rated as important or essential by 80% or more of both panels and Māori participants were included in the final guidelines. The Rōpū Mātanga Māori reviewed any remaining statements to determine inclusion. Results Following the five-step process, 305 statements were included in the guidelines. These statements provided guiding actions that endorsed communication, collaborative responsibility, and wellbeing and a student-centred approach. Conclusion The guidelines provide guidance to all school staff that is culturally responsive and safe, consensus-based, and evidence-based. It is informed by the voices and experiences of young people and those who support them.

Lived experience codesign of self-harm interventions: a scoping review

“…Four interventions were for non-suicidal self-harm,40 47 54 61 while eight interventions did not discriminate based on suicidal intent 43–46 48 50 51 60. The remaining sources did not define self-harm or the definition did not reference intent.…”

“…Of the 12 interventions designed by and for children and young people, 4 were mobile health technologies 42–45. Four were resources to support care providers—primary care practitioners,40 general hospital children’s nurses,41 parents and teachers,49 and school staff 48. In educational settings, young people codesigned and co-ran a self-injury group47 and codesigned outcomes for self-harm interventions, which informed a Cochrane review 50.…”

“…App design ideas,42 guidelines,51 handbook training61 and findings60 were (or planned to be) codisseminated. Only one paper explicitly stated those with lived experience were acknowledged as contributors on final guidelines 48. Continued dialogue was rare, though people with lived experience not only codesigned the BEACON intervention but were coinvestigators in a subsequent randomised controlled trial 52…”

“…This varied from a certificate48 to travel reimbursement and food provision,54 vouchers,41 48 50 hourly pay42 53 and unspecified payment for involvement 51 57. More attractive incentives were proposed to encourage recruitment 41.…”

“…Most work included individuals with personal self-harm experience recruited via services,41 46 existing team networks,42 48 53 young people’s organisations,49 50 advertisements,54 social media51 or college mental health organisations 47. Snowball sampling was common 40 42 52.…”