Review: Interventions to prevent or manage self‐harm among students in educational settings – a systematic review

Abstract

Background: At least half of all young people who die by suicide have previously self-harmed and most of those who self-harm will not seek help from health services for self-harming behaviours. By default, schools, colleges and universities necessarily play a key role in identifying those who self-harm and supporting them to access help. Methods: We conducted a systematic review (PROSPERO ID: CRD42021243692) of five databases (Medline, PsycINFO, ASSIA, ERIC and BEI) for quantitative studies evaluating interventions to reduce self-harm among students in schools, colleges and universities. Results: We identified six eligible studies that reported interventions. Two interventions used mindfulness-based approaches and the remaining four interventions focused on in-classroom education. Three interventions reported a significant reduction in self-harm, all three used in-classroom education. Of the six studies, one study was rated methodologically moderate, while the remaining five were weak. Conclusion: In summary, the evidence base is limited in size and quality. Most current interventions to address self-harm in schools focus on training staff in awareness, with a significant gap in direct support for students. Key Practitioner Message• At least half of all young people who die by suicide have previously self-harmed and most of those who selfharm will not seek help from health services for self-harming behaviours. • By default, schools, colleges and universities necessarily play a key role in identifying those who self-harm and supporting them to access help. • The evidence base is limited in size and quality. Most current interventions to address self-harm in schools focus on training staff in awareness, with a significant gap in direct support for students. • Future research needs a much improved theoretical and empirical basis to develop, evaluate and implement direct interventions with young people who self-harm.

Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study

“… 20 This suggests that BlueIce could be a useful tool that is scalable, able to offer ‘out of hours’ support, can help students cope in difficult moments and reach more students who may be struggling with self-harm and feel unable to directly ask for help. Research into self-harm interventions in university settings is very limited, for example, Nawaz et al 55 found only two studies meeting this criteria, neither of which were found to be effective in reducing self-harm. More research is needed to establish the effectiveness of BlueIce, nevertheless, the current study identifies it as a valuable and acceptable tool for students.…”

Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors

“…This is an issue implying that universities should be creating mechanisms to assess suicidal ideation and intervene early, preventing suicide. A systematic review of the literature highlighted the gap that exists in the development of support programs for university students with self-harm behaviors [47].…”

Editorial: The need for more effective school‐based youth mental health interventions

“…This picture corroborates a review by Nawaz and colleagues, also in the current issue of this journal, on interventions focused on the prevention of self‐harm within educational settings. Only six studies were identified, mostly with severe methodological shortcomings, leading to the conclusion that the evidence base for school‐based interventions for self‐harm is limited (Nawaz, Anderson, Colville, Fraser‐Andrews, & Ford, 2023). This message was echoed by a broader meta‐analysis concluding that there is little evidence for school‐based interventions to prevent internalizing problems (Caldwell et al., 2019).…”