Development of performance measures for identification of adolescent deliberate self-harm

Investigators: Amy Finlay-Jones, Donna Cross, Francis Mitrou, Kevin Runions, Rena Vithiatharan

External collaborators: Penelope Haskings (Curtin University of Technology), Carla Sharp (University of Houston), Matthew Ruggiero (Curtin University of Technology), Marie Yap (Monash University), Giulia Pace (Child and Adolescent Mental Health Service), Pradeep Rao (Child and Adolescent Mental Health Service), Pauline Kotselas (Department of Education NSW), Ivan Salmin (Child and Adolescent Mental Health Service)

Suicide is the leading cause of death for Australian teenagers. Rates are rising despite increased public health attention to the problem. Teenagers who deliberately self-harm (DSH), even without suicidal intent, are at greater risk of suicide. Such non-suicidal self-injury (NSSI) can also be a sign of mental health problems such as depression or more severe problems such as borderline personality disorder (BPD).

Schools are affected by these behaviours but may also play a valuable role in detection and response. But school staff are rarely trained to work with students engaging in DSH. The range and diversity of DSH – which can be suicidal or not, and can co-occur with different mental health challenges – makes this even harder. The challenge of accurately identifying these problems is essential to providing or recruiting the right kind of support and is central to improving mental health literacy around DSH. But currently, there are not good means of testing the capability of school staff to identify the range of DSH they may encounter.

We propose to develop a set of ‘vignettes’ (brief stories about hypothetical but realistic situations) that provide examples of young people who are engaging in DSH. We aim to develop these in collaboration with mental health clinicians and consumers, including young people who have been treated for DSH. We will then test these vignettes with a group of mental health workers to ensure instances of DSH can be identified by trained professionals and to gather ideas about how best to respond. Finally, we will test the vignettes with school staff members who are in the ‘front line’ of school mental health work (i.e., school psychologists; pastoral care workers; school nurses).

The aim is to develop and trial vignettes to test capacity of school staff to (a) accurately recognise DSH, (b) recognise signs of other mental health problems, and (c) see what sorts of help they believe would be helpful. This will provide a key tool to evaluate future school-based DSH intervention.