Although nonsuicidal self-injury (NSSI) and suicidal behavior have different intentions, they share many of the same risk factors. These include a history of trauma, abuse, or chronic stress; high emotional sensitivity; few effective coping strategies; feelings of isolation; substance use; depression or anxiety; and feelings of worthlessness. Because of these shared vulnerabilities, the presence of NSSI is considered a risk factor in itself for suicide thoughts and behaviors.
Research shows that a significant number of individuals who self-injure also experience suicidality. In the general population, 35–40% of people who engage in NSSI report suicidal thoughts or behaviors, while in clinical populations this figure rises to 65% or more. Suicidality may emerge in the same general period as NSSI or afterward, though in about 20% of individuals it appears before NSSI begins. Importantly, more than half of youth and young adults who self-injure in non-clinical populations do not report suicidal thoughts, so the presence of NSSI does not automatically mean the student is suicidal.
That said, certain patterns increase risk. More severe or chronic forms of NSSI (e.g., cutting, carving, burning, or using multiple methods) are linked to higher likelihood of suicidality, particularly when combined with over 20 lifetime incidents, recent psychological distress, trauma history, hopelessness, family conflict, impulsivity, substance use, or diagnoses such as depression or PTSD. While NSSI does not cause suicidal behavior, it can lower a person’s natural inhibition against harming themselves, making it easier to act on suicidal urges if they emerge. For educators, this means that NSSI should always be taken seriously as a marker of vulnerability, with prompt referral to mental health professionals and ongoing monitoring for signs of escalating risk.
Source: “The Relationship between Non-Suicidal Self-Injury and Suicide” by Janis Whitlock, Rachel Minton, Pamela Babington & Carrie Ernhout – Cornell University (link to full resource)
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