Background and Goals:
Non-suicidal self-injury (NSSI) is a common presenting
issue mental health providers experience in all levels of care from outpatient clinics to inpatient
units. It is common among adolescents seen in emergency settings, either as a presenting
problem or as a covert condition that may not be detected unless specifically assessed
for. The presence of NSSI increases the risk of suicide. This article aims to help the clinician
develop a better understanding of NSSI – what it may entail, the prevalence, and the motivations
for why young people engage in it.
Methods:
We review the reasons adolescents injure themselves, the link between NSSI and
psychiatric diagnoses and suicide, the assessment of NSSI, and treatment planning, with emphasis
on ways to screen for NSSI and interventions that can be implemented in the Emergency
Department. We illustrate the complexity of NSSI with the case of a young patient
with a complex psychiatric history and an extensive history of self-injury.
Results and Discussion:
Despite the seeming intractability of NSSI, a number of evidencebased
treatments exist. Treatment primarily involves specialized forms of psychotherapy, but
interventions can be implemented in the ED that will reduce the immediate risk of NSSI
while more definitive intervention is awaited.
Conclusion:
Mental health consultations in the ED should always include screening for
NSSI. Mental health professionals in the ED can play an important role in the detection and
treatment of this condition..
Measurement invariance of the distress tolerance scale among university students with and without a history of non-suicidal self-injury
