Maximising the management of self-harm in schools: A collaborative, implementation science approach by secondary schools and child and adolescent mental health services

Abstract

Background

Self-harm among young people is a complex global problem. Schools could facilitate young people who self-harm to access multilevel interventions. However, schools require support and collaboration from support services such as specialist mental health to implement evidence-based best practices for self-harm. Objectives: This study in Aotearoa New Zealand sought to identify the barriers and solutions to responding to youth self-harm in schools. Methods: We utilised a co-design methodology, with schools and child and youth mental health services and examined barriers and solutions within the Consolidated Framework for Implementation Research (CFIR).

Results

Key stakeholders identified multiple systemic barriers including lack of guidelines and mental health service criterion, lack of trust between schools and mental health services and poor previous experiences. Within the CFIR framework, systemic failure rather than individual people and/or individual attributes were identified driving these barriers.

Conclusion

The need for standardised best practice guidelines that are implemented consistently in schools, reassurance, strong community networks and communication to deliver localised, culturally safe responses to self-harm is urgently required. Cross-government leadership and nationally mandated roles and responsibilities are needed to help schools implement best practices for youth who self-harm in schools. The innovative combination of co-design and implementation science could advance solutions for the prevention of self-harm.