How can school staff respond to student incidents of self-injurious thoughts and behaviours? A systematic scoping...

Self-harm risk is highest between ages 12-19, making it essential for schools to have clear, evidence-based practices for identifying and responding to self-injurious thoughts and behaviours (SITBs). This scoping review summarises best-practice responses in primary and high school settings, focusing on non-clinical staff. It provides a foundation for developing consistent, evidence-based whole-school guidelines.

PubMed, CINAHL and Embase were systematically searched (1 January 2000-31 March 2024) for English-language, peer-reviewed studies examining school staff responses to student SITBs. Studies reporting only prevalence or trends were excluded. Final studies were selected through a blinded, multistage screening process by paired reviewers. Data were analysed using narrative synthesis.

Forty-one articles met inclusion criteria. Most were published after 2005, conducted in the USA (n = 17), used qualitative designs (n = 15), involved mixed school staff (n = 14) and were based in high schools (n = 23). Overall study quality was fair to low. Findings indicated that effective school responses rely on whole-school approaches, strong leadership support, clearly defined roles and procedures, crisis response teams, and regular staff training.

Despite gaps in the evidence, this review consolidates current best practice and can inform future guidelines to strengthen school staff capacity and confidence in supporting students experiencing SITBs.