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

Abstract Background 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. Methods 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). Results 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. Conclusion 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-based principles of practice for UK schools, drawing on the perspectives of staff and young people to inform a whole-school approach.