Community-Based Strategy to Prevent Deliberate Self-Harm in Adolescence: An Inquiry to Find Risk Factors at School

BACKGROUND: Self-harm behaviors consist of parasuicidal behaviors, which represent “a deliberate destruction of body tissue, with or without suicidal intent”. A theoretical model is the Experiential Avoidance Model. The most frequent risk factors are school distress, poor social integration, poor social and family support, drugs use, sexual abuse, altered sense of life and death, bad relationship with the body and unsolved body mentalization process. OBJECTIVES: The objective of the present study was to perform an analysis of risk factors for self-harm behaviors, to help plan preventive actions. PATIENTS AND METHODS: One questionnaire with specific scales was employed for students, whereas three semi-structured interviews were employed for teachers, all on distress perception and self-harm in school. RESULTS: Data analysis confirms an association between self- cutting and alcohol use, sexual harassments, school dropout, threatening people, incommunicability with family members and negative relationship with the body and suicide attempts, with a clear tendency for males. In the interviews, teachers highlight self-injury as a dysfunctional relationship with the body and observe several risk markers of psychological distress. CONCLUSIONS: The results confirm the available literature data, while noting that self-harming is a preponderantly male behavior. The results also signal the need to create opportunities to instruct teachers to combat the resistances and stereotypes of psychological distress.