School children and self-harm: Staff perspectives and concerns

Purpose: The aim of this study was to describe the experiences, understandings and concerns elementary school staff have of self-harm among Norwegian elementary school children (6-13 years). This is an independent research project which received no funding. Method: Data were collected through face-to-face interviews using a semi-structured interview guide and through an online survey designed by the authors. Data analysis was informed by both the thematic approach and Interpretative Phenomenological Analysis (IPA). Participants: Elementary school staff in Norway. 63 staff members responded to the survey and 15 additional staff members were interviewed. All interview participants had some prior experience or knowledge of children who self-harmed. Results: Three themes resulted from the analysis: 1. Participants’ understandings of self-harm, 2. social learning of self-harm, and 3. a call for more knowledge. Staff tend to dichotomize between what is serious and what is not and express uncertainty about what behaviors should be labeled self-harm. Self-harm is frequently understood as an emotion regulation strategy or as a “cry for help” where the self-harm is seen as a clear signal of a child in distress. Staff expressed concern of social learning effects if self-harm is introduced as a topic for children. Staff appraisals of their own competence to manage children who self-harm were low, and many expressed a desire to receive outside help and to gain more knowledge of self-harm. Findings were supported by survey data. Conclusion: School staff are in a privileged position to uncover self-harm among children and provide help and early intervention. The authors suggest that staff must be provided with more knowledge on self-harm to increase visibility and understanding, and that all children who display warning signs must be spoken to individually. Increased knowledge will help staff feel more secure in dealing with children who self-harm and may increase their efficacy and promote positive attitudes. A counselor should be available at all elementary schools to provide an alternative to the external helping system which is generally less available