A Systematic Review of Perceived Risks and Risk Management Strategies in Non-Suicidal Self-Harm

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• Non-suicidal self-harm (NSSH) risks are documented, but understanding and management by individuals with lived experience remain underexplored.
• Existing literature often lacks the perspective of those engaging in NSSH regarding risk perception and mitigation.

Purpose of the Study:

• To systematically review and synthesize the perceived risks of NSSH by individuals who engage in it.
• To identify and analyze the risk management strategies employed by individuals experiencing NSSH.

Main Methods:

• A systematic review of five databases was conducted.
• Meta-synthesis of qualitative findings from 37 eligible studies was performed.
• Quantitative findings from one study were narratively synthesized.

Main Results:

• Three themes emerged: physical risks (injury management), interpersonal risks (impacts and responses), and intrapersonal risks (personal assessment).
• Individuals demonstrated nuanced understanding of risks, employing strategies like damage limitation and scar concealment.
• The perceived utility of these strategies ranged from beneficial to detrimental; online community users reported similar fears of judgment and stigma.

Conclusions:

• Perspectives on NSSH risk management strategies are diverse, with varied perceived effectiveness.
• Integrating lived experience insights is crucial for person-centered care, peer support, and collaborative clinical management plans for NSSH.