Perceptions of School Staff Related to Non-Suicidal Self-Injury (NSSI) Research: Implications for Promoting School Mental Health

Ana Radanović; Isidora Micić; Marija Trajković; Marina Kovačević Lepojević; Jelica Milojčić

doi:10.23947/2334-8496-2026-14-1-037-047

Authors

Ana Radanović Institute for Educational Research, Belgrade, Serbia https://orcid.org/0000-0002-6322-5165
Isidora Micić Institute for Educational Research, Belgrade, Serbia https://orcid.org/0000-0002-7266-7248
Marija Trajković Institute for Educational Research, Belgrade, Serbia https://orcid.org/0000-0001-5555-1780
Marina Kovačević Lepojević Institute for Educational Research, Belgrade, Serbia https://orcid.org/0000-0002-4780-1716
Jelica Milojčić Institute for Educational Research, Belgrade, Serbia https://orcid.org/0000-0001-6088-8417

DOI:

https://doi.org/10.23947/2334-8496-2026-14-1-037-047

Keywords:

non-suicidal self-injury (NSSI), school staff, researchers, Serbia

Abstract

Although non-suicidal self-injury (NSSI) is recognized as a significant concern among adolescents worldwide, research on school-based responses remains limited, particularly in developing countries such as Serbia. Schools often lack mental health resources, clear protocols, and support for staff, leaving teachers feeling isolated and unprepared to manage NSSI. Collaboration between researchers and practitioners in improving conditions for adequate response is highly important. Therefore, it is essential to examine how practitioners perceive it. This study aimed to explore school staff perceptions about the role of the research in addressing NSSI within school context. Sample consisted of 556 school staff members (84.2% female; Mage = 45.51 years) in Serbia who were asked why researchers should explore school staff experiences with students who engage in NSSI. Responses were analyzed using qualitative content analysis. Four main categories emerged: NSSI knowledge, Prevention, Identification and early intervention, and Treatment. NSSI Knowledge captures teachers’ understanding of the need for exploring prevalence, key factors and causes of NSSI, while Prevention points to the need for training and increased NSSI awareness in schools. Identification and early intervention emphasize participants’ role in recognizing signs, mobilizing resources, and following clear protocols. Treatment refers to ways of supporting students who engage in NSSI. Overall, school staff recognize NSSI as a significant issue and perceive themselves as frontline responders but highlight the need for greater support in fostering their competencies, getting wider access to the resources, and institutional support for effective prevention and intervention.

Downloads

Download data is not yet available.

References

Adelman, H. S., & Taylor, L. (1999). Mental health in schools and system restructuring. Clinical Psychology Review, 19(2), 137-163. https://doi.org/10.1016/S0272-7358(98)00071-3 DOI: https://doi.org/10.1016/S0272-7358(98)00071-3

Adelman, H. S., & Taylor, L. (2006). Mental health in schools and public health. Public health reports, 121(3), 294-298. https://doi.org/10.1177/003335490612100312 DOI: https://doi.org/10.1177/003335490612100312

Andrews, A., McCabe, M., & Wideman-Johnston, T. (2014). Mental health issues in the schools: Are educators prepared?. The Journal of Mental Health Training, Education and Practice,9(4), 261-272.https://doi.org/10.1108/JMHTEP-11-2013-0034 DOI: https://doi.org/10.1108/JMHTEP-11-2013-0034

Aspeqvist, E., Korhonen, L., Dahlström, Ö., Andersson, H., Baetens, I., Plener, P. & Zetterquist, M. (2025). Effects of a wholeschool prevention program targeting mental health and nonsuicidal self-injury in Swedish adolescents: A cluster-randomized experimental study with longitudinal follow-up. Journal of Youth and Adolescence, Advance online publication. https://link.springer.com/article/10.1007/s10964-025-02251-3 DOI: https://doi.org/10.1007/s10964-025-02251-3

Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health and Mental Health Services Research, 37, 40-47. https://doi.org/10.1007/s10488-010-0299-7 DOI: https://doi.org/10.1007/s10488-010-0299-7

Baetens, I., Greene, D., Van Hove, L., Van Leeuwen, K., Wiersema, J. R., Desoete, A., & Roelants, M. (2021). Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors. Journal of Adolescence, 90, 100-108. https://doi.org/10.1016/j.adolescence.2021.06.005 DOI: https://doi.org/10.1016/j.adolescence.2021.06.005

Baetens, I., Decruy C., Vatandoost, S., Vanderhaegen, B., and Kiekens, G. (2020) School-Based Prevention Targeting NonSuicidal Self-injury: A Pilot Study. Frontiers in Psychiatry 11, 437. https://doi.org/10.3389/fpsyt.2020.00437 DOI: https://doi.org/10.3389/fpsyt.2020.00437

Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. (2012). Rates of nonsuicidal self-injury in youth: age, sex, and behavioral methods in a community sample. Pediatrics, 130(1), 39-45. https://doi.org/10.1542/peds.2011-2094 DOI: https://doi.org/10.1542/peds.2011-2094

Berger, E., Hasking, P., & Reupert, A. (2014). “We’re working in the dark here”: Education needs of teachers and school staff regarding student self-injury. School Mental Health, 6, 201-212. https://doi.org/10.1007/s12310-013-9114-4 DOI: https://doi.org/10.1007/s12310-013-9114-4

Berger, E., Hasking, P., & Martin, G. (2014a). Adolescents’ Perspectives of Youth Non-Suicidal Self-Injury Prevention. Youth & Society, 49(1), 3-22. https://doi.org/10.1177/0044118X13520561 (Original work published 2017) DOI: https://doi.org/10.1177/0044118X13520561

Berger, E., Hasking, P., & Reupert, A. (2015). Developing a policy to address nonsuicidal self-injury in schools. Journal of School Health, 85(9), 629-647. https://doi.org/10.1111/josh.12292 DOI: https://doi.org/10.1111/josh.12292

Bowden, L., Mulqueen, M., Williams, A., Swannell, S., & Fortune, S. (2025). Maximising the management of self-harm in schools: A collaborative, implementation science approach by secondary schools and child and adolescent mental health services. The Lancet Regional Health – Western Pacific, 46, 101001. https://doi.org/10.1016/j.lanwpc.2025.101001 DOI: https://doi.org/10.1016/j.mhp.2025.200391

Braun, V., & Clarke, V. (2021). Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counselling and Psychotherapy Research, 21(1), 37-47. https://doi.org/10.1002/capr.12360 DOI: https://doi.org/10.1002/capr.12360

Burn, A. M., McDonnell, S., Ryder, C., Kelly, C., & O’Connor, R. C. (2025). A self-harm awareness training module for school staff. School Mental Health. Advance online publication. https://doi.org/10.2196/69309 DOI: https://doi.org/10.2196/69309

Cain, T. (2015). Teachers’ engagement with research texts: Beyond instrumental, conceptual or strategic use. Journal of Education for Teaching, 41(5), 478-492.https://doi.org/10.1080/02607476.2015.1105536 DOI: https://doi.org/10.1080/02607476.2015.1105536

Castelpietra, G., Knudsen, A. K. S., Agardh, E. E., Armocida, B., Beghi, M., Iburg, K. M., Logroscino, G., Ma, R., Starace, F., Steel, N., Addolorato, G., Andrei, C. L., Andrei, T., Ayuso-Mateos, J. L., Banach, M., Bärnighausen, T. W., BaroneAdesi, F., Bhagavathula, A. S., Carvalho, F., … Monasta, L. (2022). The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Disease Study 2019. The Lancet Regional Health–Europe, 16. http://dx.doi.org/10.1016/j.lanepe.2022.100364 DOI: https://doi.org/10.1016/j.lanepe.2022.100364

Cipriano A, Aprea C, Bellone L, Cotrufo P, Cella S. (2022). Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic. Front Psychiatry. 13, 12:737544. https://doi.org/10.3389/fpsyt.2021.737544 DOI: https://doi.org/10.3389/fpsyt.2021.737544

Child and Adolescent Health Measurement Initiative. (2021–2022). National Survey of Children’s Health. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved May 23, 2025, from https://nschdata.org/browse/survey?s=2&y=51&r=1#home

Ching, B.C.F., Foster, A., Schlief, M., Lewis, G., & Rajyaguru, P. (2024). Co-producing school-based mental health interventions with young people, teachers, and schools: a case study. Res Involv Engagem, 10(109), 1-8. https://doi.org/10.1186/s40900-024-00636-5 DOI: https://doi.org/10.1186/s40900-024-00636-5

Costa, L. C. R., Gabriel, I. M., Lopes, D. G., Oliveira, W. A. D., Silva, J. L. D., & Carlos, D. M. (2020). Non-suicidal self-injury and school context: perspectives of adolescents and education professionals. SMAD, Rev Eletrônica Saúde Mental Álcool Drog, 16(4), 39-48. https://doi.org/10.11606/issn.1806-6976.smad.2020.168295 DOI: https://doi.org/10.11606/issn.1806-6976.smad.2020.168295

De Riggi, M. E., Moumne, S., Heath, N. L., & Lewis, S. P. (2017). Non-suicidal self-injury in our schools: A review and researchinformed guidelines for school mental health professionals. Canadian Journal of School Psychology, 32(2), 122-143. https://doi.org/10.1177/0829573516645563 DOI: https://doi.org/10.1177/0829573516645563

Elyoseph, Z., & Levkovich, I. (2024). Beyond the Surface: Teachers’ Perceptions and Experiences in Cases of Non-Suicidal Self-Injury among High School Students. OMEGA-Journal of Death and Dying, 00302228231223275. https://doi.org/10.1177/00302228231223275 DOI: https://doi.org/10.1177/00302228231223275

Fortier, A., Lalonde, G., Venesoen, P., Legwegoh, A. F., & Short, K. H. (2017). Educator mental health literacy to scale: from theory to practice. Advances in School Mental Health Promotion, 10(1), 65-84. https://doi.org/10.1080/175473X.2016.1252276 DOI: https://doi.org/10.1080/1754730X.2016.1252276

Foulkes, L., & Andrews, J. L. (2023). Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. New Ideas in Psychology, 69, 101010. https://doi.org/10.1016/j.newideapsych.2023.101010 DOI: https://doi.org/10.1016/j.newideapsych.2023.101010

Giles-Kaye A., Quach J., Oberklaid F., O’Connor M., Darling S., Dawson G., Connolly A.S. (2022). Supporting children’s mental health in primary schools: a qualitative exploration of educator perspectives. Australian Education Research, 18, 1-21. https://doi.org/10.1007/s13384-022-00558-9 DOI: https://doi.org/10.1007/s13384-022-00558-9

Hamza, C.A., & Heath, N.L. (2018). Nonsuicidal Self-Injury: What Schools Can Do. In: Leschied, A., Saklofske, D., Flett, G. (Eds.), Handbook of School-Based Mental Health Promotion. The Springer Series on Human Exceptionality. Springer, Cham. https://doi.org/10.1007/978-3-319-89842-1_14 DOI: https://doi.org/10.1007/978-3-319-89842-1_14

Harris, L. M., & Ribeiro, J. D. (2021). Does fearlessness about death mediate the association between NSSI and suicide attempts? A longitudinal study of over 1,000 high-risk individuals. Journal of Consulting and Clinical Psychology, 89(3), https://doi.org/10.1037/ccp0000626 DOI: https://doi.org/10.1037/ccp0000626

Hasking, P., Baetens, I., Bloom, E., Heath, N., Lewis, S. P., Lloyd-Richardson, E., & Robinson, K. (2019). Addressing and responding to nonsuicidal self-injury in the school context. In J. J. Washburn (Ed.), Nonsuicidal Self-Injury, 175-194. Routledge. DOI: https://doi.org/10.4324/9781315164182-11

Hasking, P., Lewis, S. P., Bloom, E., Brausch, A., Kaess, M., & Robinson, K. (2021). Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources. School Psychology International, 42(1), 57-78. https://doi.org/10.1177/0143034320974414 DOI: https://doi.org/10.1177/0143034320974414

Heath, N. L., Toste, J. R., & Beettam, E. L. (2006). “I am not well-equipped” high school teachers’ perceptions of self-injury. Canadian Journal of School Psychology, 21(1-2), 73-92. https://doi.org/10.1177/0829573506298471 DOI: https://doi.org/10.1177/0829573506298471

Heath, N. L., Bastien, L., Mettler, J., Bloom, E., & Hamza, C. (2020). School response to non-suicidal self-injury. Consultation and mental health interventions in school settings: A scientist-practitioner’s guide.

Hoover, S., & Bostic, J. (2021). Schools as a vital component of the child and adolescent mental health system. Psychiatric Services, 72(1), 37-48. https://doi.org/10.1176/appi.ps.201900575 DOI: https://doi.org/10.1176/appi.ps.201900575

IBM (2022). SPSS statistics for Windows. Version 29.0. Armonk, NY: IBM International Society for the Study of Self-Injury. (2024). What is Non-suicidal Self-Injury?. Retrieved July 2, 2024, from https://www.itriples.org/aboutnssi

Kallitsoglou, A., & Mahmud, A. (2023). Teacher attitudes towards evidence-based practices for social, emotional and mental health difficulties in school and association with teacher academic research engagement. Emotional and Behavioural Difficulties, 28(4), 263-281. https://doi.org/10.1080/13632752.2023.2276024 DOI: https://doi.org/10.1080/13632752.2023.2276024

Leiner, D. J. (2020). SoSci Survey (3.2. 21)[Computer software].

Marshall, L., Wishart, R., Dunatchik, A., & Smith, N. (2017). Supporting mental health in schools and colleges: Quantitative survey (Research Report RR697). NatCen Social Research & National Children’s Bureau.

McLaughlin, C., & Black-Hawkins, K. (2007). School–university partnerships for educational research—distinctions, dilemmas and challenges. The Curriculum Journal, 18(3), 327-341. https://doi.org/10.1080/09585170701589967 DOI: https://doi.org/10.1080/09585170701589967

Owens, M., Stevenson, J., Hadwin, J. A., & Norgate, R. (2012). Anxiety and depression in academic performance: An exploration of the mediating factors of worry and working memory. School Psychology International, 33(4), 433-449. https://doi.org/10.1177/0143034311427433 DOI: https://doi.org/10.1177/0143034311427433

Patalay, P., Giese, L., Stanković, M., Curtin, C., Moltrecht, B., & Gondek, D. (2016). Mental health provision in schools: priority, facilitators and barriers in 10 European countries. Child and Adolescent Mental Health, 21(3), 139-147. https://doi.org/10.1111/camh.12160 DOI: https://doi.org/10.1111/camh.12160

Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345-365. https://doi.org/10.1111/jcpp.12381 DOI: https://doi.org/10.1111/jcpp.12381

Price, C., Satherley, R. M., Jones, C. J., & John, M. (2022). Development and Evaluation of an eLearning Training Module to Improve United Kingdom Secondary School Teachers’ Knowledge and Confidence in Supporting Young People Who Self-Harm. Frontiers in Education, 7, 889659. https://doi.org/10.3389/feduc.2022.889659 DOI: https://doi.org/10.3389/feduc.2022.889659

Radanović, A. (2025). Understanding and addressing youth mental health issues within the school context in Serbia. In M. Kovačević Lepojević & S. Kanjevac (Eds.), Book of Abstract, 33rd International Scientific Conference Educational Research and School Practice From Positive Youth Development to Positive Youth Justice (pp. 8). Belgrade: Institute for Educational Research.

Radanović, A., Kostić, M., Pejović-Milovančević, M., Tošković, O., Videnović, M., Mitković-Vončina, M., Radosavljev Kirćanski, J., Mandić Maravić, V., & Lazarević, L. B. (2022). Nonsuicidal Self-Injury (NSSI) in Serbia: Nationally representative sample study. Psychiatry Research Communications, 2(3), 100051. https://doi.org/10.1016/j.psycom.2022.100051 DOI: https://doi.org/10.1016/j.psycom.2022.100051

Radanovic, A., Kovacevic-Lepojevic, M., Micic, I., Trajkovic, M., Grujicic, R., & Pejovic-Milovancevic, M. (2025). Addressing non-suicidal self-injury (NSSI) in Serbian schools: School staff reactions, needs, and protocol development. Zbornik Instituta Za Pedagoska Istrazivanja, 57(2), 293–322. https://doi.org/10.2298/ZIPI2502293R DOI: https://doi.org/10.2298/ZIPI2502293R

Rossen, E., & Cowan, K. C. (2014). Improving mental health in schools. Phi Delta Kappan, 96(4), 8-13. https://doi.org/10.1177/0031721714561438 DOI: https://doi.org/10.1177/0031721714561438

Sacco R., Camilleri N., Eberhardt J., Umla-Runge K., Newbury-Birch D. (2024). A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. European Child Adolescence Psychiatry, (9), 2877-2894. https://doi.org/10.1007/s00787-022-02131-2 DOI: https://doi.org/10.1007/s00787-022-02131-2

Sanchez, A. L., Cornacchio, D., Poznanski, B., Golik, A. M., Chou, T., & Comer, J. S. (2018). The effectiveness of school-based mental health services for elementary-aged children: A meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 57(3), 153-165. https://doi.org/10.1016/j.jaac.2017.11.022 DOI: https://doi.org/10.1016/j.jaac.2017.11.022

Shelemy, L., Harvey, K., & Waite, P. (2019). Supporting students’ mental health in schools: what do teachers want and need?. Emotional and behavioural difficulties, 24(1), 100-116. https://doi.org/10.1080/13632752.2019.1582742 DOI: https://doi.org/10.1080/13632752.2019.1582742

Simundic, A., Hove, L. V., Baetens, I., Bloom, E., & Heath, N. (2024). Nonsuicidal self-injury in elementary schools: School educators’ knowledge and professional development needs. Psychology in the Schools, 61(5), 1868-1880. https://doi.org/10.1002/pits.23142 DOI: https://doi.org/10.1002/pits.23142

Skoric, D., Rakic, J. G., Jovanovic, V., Backovic, D., Soldatovic, I., & Zivojinovic, J. I. (2023). Psychosocial school factors and mental health of first grade secondary school students—Results of the Health Behaviour in School-aged Children Survey in Serbia. PloS One, 18(11), e0293179. DOI: https://doi.org/10.1371/journal.pone.0293179

Schreier, M. (2012). Qualitative content analysis in practice. London: SAGE DOI: https://doi.org/10.4135/9781529682571

Sornberger, M. J., Heath, N. L., Toste, J. R., & McLouth, R. (2012). Nonsuicidal self-injury and gender: Patterns of prevalence, methods, and locations among adolescents. Suicide and Life-Threatening Behavior, 42(3), 266-278. https://doi.org/10.1111/j.1943-278X.2012.0088.x DOI: https://doi.org/10.1111/j.1943-278X.2012.0088.x

Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 44(3), 273-https://doi.org/10.1111/sltb.12070 DOI: https://doi.org/10.1111/sltb.12070

Vanderlinde, R., & Van Braak, J. (2010). The gap between educational research and practice: Views of teachers, school leaders, intermediaries and researchers. British Educational Research Journal, 36(2), 299-316. https://doi.org/10.1080/01411920902919257 DOI: https://doi.org/10.1080/01411920902919257

VERBI Software (2004). MAXQDA 2024. Berlin

Walker, H. M. (2004). Commentary: Use of evidence-based interventions in schools: Where we’ve been, where we are, and where we need to go. School Psychology Review, 33(3), 398-407. https://doi.org/10.1080/02796015.2004.12086256 DOI: https://doi.org/10.1080/02796015.2004.12086256

Wang, Y. J., Li, X., Ng, C. H., Xu, D. W., Hu, S., & Yuan, T. F. (2022). Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. EClinicalMedicine, 46. https://doi.org/10.1016/j.eclinm.2022.101350 DOI: https://doi.org/10.1016/j.eclinm.2022.101350