Self-harm and suicidal behaviors in children: perspectives of mental health clinicians.

Objective: Presentations for self-harm and suicidal behaviors are increasing in children and young people, although less is known about these presentations in children aged 12 years and under. This study aims to understand how mental health clinicians in public health services conceptualize, identify and respond to self-harm and suicidal behaviors in children.

Methods: 26 mental health clinicians provided their perspectives through interviews or focus groups. Participant responses were analyzed using reflexive thematic analysis.

Results: Mental health clinicians described how self-harm and suicidal behaviors may present differently in children compared with adolescents, particularly with the methods used. Using developmentally appropriate language and including parents or carers when screening for self-harm and suicidal behaviors was recommended by clinicians. The inclusion of parents or carers throughout the treatment process was important for clinicians, including helping parents understand their child's behavior and manage their own distress. Clinicians also highlighted the benefit of collaborating with schools to support children, yet noted primary school staff require training in responding to child self-harm and suicidal behavior. The limited services available for children 12 years and under including emergency care services, was identified as a problem.

Conclusions: Findings highlight the importance of timely assessment and interventions which include mental health and medical clinicians, parents, carers, and school staff to support children with self-harm and suicidal behaviors.