Identifying and managing nonsuicidal self-injurious behavior in the primary care setting

To provide an overview of nonsuicidal self-injurious behavior (NSSIB) for nurse practitioners (NPs) who see patients with this complex phenomenon in primary care settings.

Selected research and clinical reviews.

NSSIB is characterized as a low-lethality, repetitive act that can alter or cause damage to the body tissue. Among researchers and those who work directly with young people, there is a general consensus that NSSIB is increasing in prevalence. Unfortunately, NPs often view self-injuring patients negatively, likely because of a lack of knowledge as to how to help this special patient population.

Appropriate treatment can be initiated in the primary care setting; however, NPs must be aware of how and when to refer to specialty mental health services. Those with psychiatric comorbidities such as mood lability, anxiety, chronic emptiness or depersonalization, dysphoria, loneliness, anhedonia, or borderline personality disorder require management by mental health specialists. Patients experiencing NSSIB in response to command auditory hallucinations need immediate medical attention.