Suicidal Ideation and Influencing Factors in Adolescents With Non‐Suicidal Self‐Injury

Background Adolescents who engage in non‐suicidal self‐injury (NSSI) are at heightened risk for suicidal ideation. Nevertheless, there is a scarcity of population‐level evidence in China to guide school‐based health initiatives. This study aimed to explore the prevalence and correlates of suicidal ideation among adolescents with NSSI in central China. Methods A multicenter study in central China assessed 3730 adolescents with NSSI using standardized measures of depression, anxiety, family functioning, and suicidal ideation. Multiple linear regression identified associated factors ( p < 0.05). Results A total of 74.05% reported suicidal ideation in the past year, and 68.2% were at elevated suicide risk. Higher suicidal ideation was associated with female sex, only‐child status, higher parental education, greater depressive/anxiety symptoms, and poorer family functioning. Implications for School Health Policy, Practice, and Equity Findings emphasize the need for school‐based mental health screening, early intervention, and family‐school collaboration, alongside equitable policies to ensure psychosocial support across diverse socioeconomic and regional contexts. Conclusions Suicidal ideation is highly prevalent among adolescents with NSSI and is closely linked to emotional distress and family functioning, highlighting the importance of school‐centered prevention strategies.