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Young people and adult stakeholders' reflections on how school staff should support students who self-harm: A qualitative study.

INTRODUCTION
Self-harm is a significant public health issue affecting school communities, students, and families. The school is an ideal environment for early intervention and prevention. This study aimed to explore the views of young people and stakeholders on how school staff should support students who self-harm in the context of developing accessible and acceptable guidelines.


METHODS
The study was nested within a larger Delphi study conducted in New Zealand. Two panels were asked to provide reflection in open text boxes in two questionnaires on how school staff can support students who self-harm. The youth panel included 22 participants between 16 and 25 years, and 81.8% identified as female and 18.3% as male. The stakeholder panel (e.g., school staff) included 27 participants over 25 years, and 63.0% identified as female, and 37.0% as male. The data were analyzed using thematic analysis to identify key themes.


RESULTS
Eight themes were identified; (1) an approach that prioritizes trust, (2) an approach that recognizes students' agency, (3) an individually tailored approach, (4) a whole-school approach, (5) an approach that recognizes role boundaries, (6) an approach that prioritizes safety, (7) a nonpunitive approach, and (8) an appropriately-resourced approach.


CONCLUSION
The eight themes identified highlighted ineffective practices in response to self-harm in schools. The eight themes provide solutions to these practices. Our findings highlighted four recommendations that address ineffective management approaches in response to students who self-harm. These recommendations included using a student-centered approach, a whole-school approach, avoiding punitive approaches, and providing adequate resourcing to schools.