The rationale for a novel non-suicidal self-injury prevention program for youth

Non-suicidal self-injury (NSSI) is self-inflicted physical harm that is associated with suicidality, although it is not an expression of suicidal intent. NSSI behaviours range from minor skin scratching to injury requiring medical attention, and in extreme cases, death. NSSI is understood as an effort to modulate emotion in times of crisis and distress. Causal models have been developed for self-harming individuals with mental health concerns. Ongoing research continues to examine the efficacy of various interventions targeted to specific self-harming populations with co-occurring mental health concerns. Prevalence estimates of NSSI in school-attending youth in Sweden reported that more than 40% had engaged in NSSI, but that a smaller subgroup of approximately 5% engaged in repetitive self-harm. Although engaging in NSSI on a single occasion is not associated with poor mental health and increased risk of suicide, repetitive NSSI does share a relationship with these outcomes. Timely interventions for self-harming youth have a role in decreasing morbidity and mortality associated with repetitive NSSI. However, the role of prevention for youth is unique and possibly transformative with respect to reducing uptake of NSSI in the first place. This theoretical review examines mental health prevention initiatives for youth, and presents a new adolescent NSSI prevention program.