# Principles of practice for a whole school approach to self-harm: a qualitative study

## TL;DR

This study explores how schools can better address self-harm among adolescents by developing practical guidelines based on input from students and staff.

## Contribution

The study introduces evidence-based principles of practice for schools to address self-harm through a whole-school approach.

## Key findings

- School staff and students agree on the need to understand self-harm's nature and scope in schools.
- Building school capacity and creating a supportive environment are key to addressing self-harm.
- Principles of practice were developed to guide schools in responding to self-harm effectively.

## Abstract

Self-harm is common among adolescents and recognised as a significant public health issue. This study aimed to explore the perspectives of young people and school staff about how schools should respond to self-harm and subsequently develop principles of practice.

Seven focus groups were carried out with school staff and young people. Qualitative data were thematically analysed using the Framework Method to generate themes [1, 2]. The findings were translated into actionable items by applying the Implementation in Schools Framework [3].

Staff and students had overlapping views about how schools should address self-harm. These were captured in three themes (1) Understanding the nature and scope of self-harm in schools, (2) Building whole school capacity to respond to self-harm, (3) Creating a supportive school environment. Principles of practice were generated to guide schools in their approach to self-harm.

For many young people, schools are a key setting for early intervention in self-harm; however, staff often feel ill-equipped to respond and clear guidance is lacking. This study has developed evidence-informed principles of practice for UK schools, drawing on the perspectives of staff and young people to inform a whole school approach.

The online version contains supplementary material available at 10.1186/s12889-025-25538-3.