Florida School Toolkit for K-12 Educators to Prevent Suicide

More information and resources can be found at sprc.org . Remember, Florida school personnel who know a student is involved in bullying should not hesitate to ask the student about hopelessness, revenge, violent thoughts, and thoughts of suicide. Suicide and Non-Suicidal Self-Injury Non-suicidal self-injury (NSSI) is a behavior that has caught school personnel by surprise with its frequency and complexity. The behavior is most common in adolescents but has also increased with upper-elementary students. This section will answer the following questions: • What exactly is non-suicidal self-injury? • How many students engage in it? • Why do students engage in it? • What is the school’s role with NSSI? • Do parents need to be notified? • What is the relationship between NSSI and suicide? • What is the best treatment for NSSI? NSSI is defined as the purposeful harming of one’s body without suicidal intent. The most common forms are cutting, burning, scratching, or not letting wounds heal. This behavior fulfills a multitude of complex needs for the student engaging in it and often is addictive. The most common theories for NSSI are the following: • The act has a biological basis as endorphins are released (much like those released in exercise). • The act provides a psychological regulation of emotions as students concentrate on the injury and are able to shut out the conflict they are having at the moment (an argument or a disappointment). Estimates are that NSSI is engaged in at least once by 14–18 percent of adolescents. A common denominator found with students who self-injure repeatedly is a trauma history of loss or abuse. Most young people engaging in NSSI cleverly hide the behavior from adults. The most commonly injured parts of the body are the arms, thighs, and stomach. Students often wear long-sleeved shirts or sweaters even in the summer or wear many bracelets to hide the signs of NSSI. NSSI is also associated with mental illness such as anxiety, depression, and a borderline personality disorder. School personnel need to know the incidence of NSSI and be alert to the warning signs such as frequent or unexplained bruises, scars, cuts, or burns, and the wearing of inappropriate clothing designed to conceal wounds. Secretive behaviors, such as spending unusual amounts of time in the school bathrooms or isolated areas on campus, may also be warning signs. Students might also show evidence of the behavior in work samples, journals, or art projects. Students might also possess sharp instruments such as razor blades, shards of glass, or thumb tacks. Schools need to develop a protocol to respond to a student engaging in NSSI, and the school counselor and school nurse should be involved. A staff member who suspects the behavior should approach the student in a confidential manner or go with the student to see a counselor or nurse. A typical adult response to NSSI is to be horrified and demand that the student stop the behavior. It is not that simple. The behavior is complex and is helping the student cope with the issues in their life. Educators need to respond with compassion and empathy and recognize the struggle the student is experiencing. The focus should be on the underlying issues the student is experiencing. Helping the student gain control over NSSI and diminish the behavior is the goal. Interventions with NSSI need to be done individually, and SMHPs and nurses need to work together to help students learn substitute behaviors that will distract the student when they are having the urge to cut or burn their skin. A few substitute behaviors include scratching clothing, standing on tiptoes, scribbling with a red marker, tearing paper, or playing with clay. Extensive information and school policies for NSSI and treatment procedures are available at the Cornell Self-Injury Center ( selfinjury.bctr.cornell.edu ) . Florida S.T.E.P.S.