Educators of all kinds are in a unique position to notice and support students in meaningful ways. While parents and caregivers play a vital role, there are times when a student’s basic needs may not be fully recognized or met at home. By staying attentive and responsive, educators can serve as an additional layer of care and advocacy, helping to ensure that students feel seen, supported, and safe.
Follow up on your instincts
There are two key principles to keep in mind when working with a student you know or suspect may be self-injuring. First, do not ignore concerning signs. If your instincts tell you something may be wrong, take the time to follow up. It is natural to want to minimize what you see, accept surface-level explanations, or assume someone else is already helping. However, you may be the only adult who has noticed, and your willingness to listen and respond could be the critical first step in connecting the student with support and intervention.
Extend an attitude of calm understanding
The second principle is to approach the student with empathy and understanding. While self-injury may feel incomprehensible to you, for many students it functions as a coping mechanism that helps them manage overwhelming emotions and continue living. It is important to remember that, although unhealthy, self-injury is different from a suicide attempt. Stay calm, listen openly, and allow the student to describe their behavior in their own words, including whether or not it was intended as a suicide attempt. Your role is to respond without judgment and then take appropriate action based on what the student shares, ensuring they are connected with the support they need.
Any educator who encounters NSSI should keep the two above principles in mind. Other important principles include:
Link the student, family, onsite mental health staff, and offsite mental health professionals
School sites may need to exercise flexibility in allowing a self-injuring student to access the school counselor or school psychologist by means of a simple signal or short statement of request. Many students will feel uncomfortable if they are required to give a lengthy explanation for why they need to leave a classroom or other school activity. Onsite and offsite mental health professionals* should work together whenever possible to make plans** for the student to follow at school when they are feeling dysregulated and may possibly self-injure.
*With a Release of Information signed by the parent.
**Documented in a 504 or incorporated into an IEP
Develop a list of outside referrals.
It is outside the scope of this website to suggest professionals in areas throughout the United States and beyond. Mental health staff at school sites should have a list of information about counselors and therapists in the area who feel comfortable addressing self-injury in children and adolescents.
Refer out
While school psychologists and school counselors can provide meaningful support to students who self-injure (see section below), it is beyond the expertise of school-based staff to fully treat self-injury within the educational setting. Cases of NSSI should be handled with the same seriousness as expressed suicidal ideation or intent, and three principles apply:
- In almost all cases, parents/guardians must be informed.
- The student and their family should be referred to professional help outside of school.
- Follow up—create reminders to check in with the family and ensure the student is receiving appropriate care.
It is also important that students are reminded of the limits of confidentiality at the beginning of counseling sessions. They must understand that school staff are required to break confidentiality when there is a risk of “harm to self.” In short, school-based professionals can play a valuable role, but outside clinical care is essential for addressing self-injury in a comprehensive and lasting way.
Promptly refer students who self-injure to the school nurse and school based mental health staff for assessment
Teachers and other non-mental health staff play an important role in supporting the well-being of students who self-injure by noticing concerns and listening when students choose to share. However, they should never attempt to manage the situation on their own. Students must be referred to the school nurse and to a school counselor or school psychologist, who can assess the situation and connect families with outside resources. This assessment includes evaluating the student’s level of risk by considering potential for suicide, the severity of physical injury, and the presence of co-occurring risk factors such as mental health disorders.
Note: Always call 911 immediately for serious injuries. If you are not sure, call.
Follow a planned protocol for dealing with cases of self-injury.
- Click here for a suggested step-by-step protocol (or download the PDF).
- Click here to download a parent notification form (PDF).
- Click here to download a parent fact sheet (PDF).
- Click here for a detailed protocol from Cornell Research (or download here)
Guidance for School Psychologists and School Counselors:
School Based Mental Health Support for Students who Self-Harm