Guidelines for a Trauma-Informed Approach to Non-Suicidal-Injury for Crisis Evaluators

Non-suicidal self-injury, or NSSI, is increasing across the globe, especially among adolescents and young adults (Muehlenkamp et al., in Chil and Adol Psy and Ment Heal, 6, 2012). Trauma-informed assessment practices have been absent from many behavioral health crisis settings. Some crisis clinicians respond with personal bias about NSSI (Thomas et al., in Admini and Pol in Ment Heal and Ment Heal Ser Res, 45(4), 611–622, 2018). The principles of trauma-informed care applied in behavioral health crisis settings include promoting awareness of trauma, ensuring safety for the client, trustworthiness and transparency in service delivery, collaboration and empowerment of the client, humility and responsiveness to client needs, honoring peer support and mutual self-help efforts, and sensitivity to cultural considerations (Adams et al., in J Pro Coun.: Pra Theo & Res, 49(2), 91–107, 2022). With education, clinicians are more likely to provide trauma-informed, effective care for patients who engage in NSSI. A review of current research about non-suicidal self-injury or NSSI may add to an improved understanding of the prevalence, functions, and best practice guidelines for responding to this growing problem. A detailed search of peer-reviewed literature has identified multiple research studies employing various methodologies. NSSI has no global definition, contributing to risk assessment clinicians’ confusion. There is an association between NSSI and suicide when the individual engages in NSSI repetitively. While more clinicians are encountering NSSI, limited studies have established prevalence rates because of the secrecy and stigma associated with these behaviors. Common risk factors include early trauma, isolation, and poor management of strong emotions. Some studies have identified the importance of peer support as an essential component of mitigating the risk in youth who engage in NSSI. Cultural differences require creating culturally sensitive approaches to this serious public health issue.