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Non-suicidal self-injury (NSSI) is distinguishable from suicide attempts (SAs) on a number of psychological and motivational factors. However, in corrective services settings, NSSI and SA are not clearly distinguished in assessment impacting on intervention. The purpose of this paper is to examine if any attributes differentiate lifetime history of SA+NSSI, NSSI and SA presentations in inmates who had recently been assessed in custody by a risk intervention team.

A comprehensive clinical assessment and file review was conducted with 87 male inmates (including a no self-injury control group) in two large correctional centres in New South Wales, Australia, to determine if three self-injury groups differ from the control group and if the three self-injury groups differ from each other across a range of static, trait, environmental and clinical characteristics.

The SA+NSSI group was most different from the control group (27/59 variables), and from the SA group (10/59 variables), predominantly across trait and clinical correlates. The SA group was least different from the control group (2/59 variables: suicide ideation, childhood physical abuse).

It was found that the presence of SA+NSSI history is an indicator of increased psychopathology. A history of SA only appears not readily associated with psychopathology. The self-injury subgroups reflected different clinical profiles with implications for risk assessment and treatment planning.

Non-suicidal self-injury (NSSI) is reasonably common, particularly among young people with prevalence rates of up to 25 per cent reported. Many factors contribute towards NSSI, including depression, anxiety and history of abuse and NSSI is a risk factor for suicide. Many people who engage in NSSI do not seek help, potentially due to concern about sigmatising attitudes. The purpose of this paper is to investigate the impact of gender and disclosure on stigmatising attitudes towards individuals who engage in NSSI.

Participants were 384 first-year university students (77.4 per cent female; mean age 19.50 years (SD=3.53)) who completed measures of stigmatising attitudes in response to vignettes featuring individuals who engaged in self-harming behaviour. Vignettes varied in the gender of the individual as well as whether the NSSI was disclosed or not.

The results support the attribution model of public discrimination in relation to NSSI stigma. Perceptions of higher personal responsibility for NSSI behaviour and higher levels of danger and manipulation were positively associated with stigmatizing attitudes and behaviours. Male research participants reported significantly higher levels of stigmatizing attitudes and behaviours than females.

The level of stigmatising attitudes towards individuals who engage in NSSI is significant and may impact on help-seeking behaviour.

Between 10 and 25 per cent of adolescents engage in some form of NSSI, but only a minority seek help to address this behaviour. This study suggests that attitudes by peers may influence help-seeking. Further research is required outside of tertiary education settings.

Non-suicidal self-injury (NSSI) is associated with psychological disorders and suicidal thoughts and behaviours; disclosure of NSSI can serve as a catalyst for help-seeking and self-advocacy amongst people who have self-injured. This study aims to identify the socio-demographic, NSSI-related, socio-cognitive and socio-emotional correlates of NSSI disclosure. Given elevated rates of NSSI amongst university students, this study aimed to investigate these factors amongst this population.

Australian university students (n = 573) completed online surveys; 80.2% had previously disclosed self-injury.

NSSI disclosure was associated with having a mental illness diagnosis, intrapersonal NSSI functions, specifically marking distress and anti-dissociation, having physical scars from NSSI, greater perceived impact of NSSI, less expectation that NSSI would result in communication and greater social support from friends and significant others.

Expanding on previous works in the area, this study incorporated cognitions about NSSI. The ways in which individuals think about the noticeability and impact of their NSSI, and the potential to gain support, are associated with the decision to disclose self-injury. Addressing the way individuals with lived experience consolidate these considerations could facilitate their agency in whether to disclose their NSSI and highlight considerations for health-care professionals working with clients who have lived experience of NSSI.

What is happening in the perceived world of young people who have non-suicidal self-injury? The answer to this question explains many quantitative research findings in the field of NSSI. The current qualitative research design is Husserl's descriptive phenomenology.

The participants included 17–29-year-old youths with self-injury and were selected with a targeted sampling approach and a conspicuous sampling method based on the theoretical saturation criterion of 21 people. Data were collected in a semi-structured interview and analyzed in the MAXQDA2022 software using the Attride-Stirling (2001) method. Validation of data was done by the method of simultaneous review of colleagues and simultaneous review of participants.

The themes emerging from the analysis of the findings are the three organizing themes of “vulnerable temperament” which includes height and head, high pain sensitivity threshold and desire for nothingness, “traumatic family” which includes disorganization, crisis and devaluation in the family and “developmental injuries” that are associated with physical, sexual and emotional abuse and neglect. The content of these themes seriously harms a person's self-perception through the emotions of fear, shame, anger and despair and is integrated into the overarching theme of “damaged self”.

“Damaged Self” provides causal explanations related to the formation of self-injurious behaviors and these behaviors are in harmony with the damage that a person observes in his perception of himself.

The purpose of this paper is to call on researchers and clinicians to carefully consider the terminology used when discussing non-suicidal self-injury (NSSI), and specifically the use of the term “maladaptive” coping.

Drawing on literature regarding stigma, language and self-injury to support the argument that the term maladaptive is inappropriate to describe self-injury.

Use of the term maladaptive conflates short-term effectiveness with long-term outcomes and ignores context in which the behaviour occurs.

Use of the term maladaptive to describe self-injury can invalidate the person with a history of NSSI, impacting stigma and potentially help-seeking. An alternate framing focussed on specific coping strategies is offered.

Language is a powerful medium of communication that has significant influence in how society shapes ideas around mental health. In proposing a change in the way the authors’ talk about self-injury there is potential to significantly improve the wellbeing of people with lived experience of self-injury.

Non-suicidal self-injury (NSSI) is a growing public health concern. Continued NSSI is often associated with negative outcomes, yet the behaviour usually serves a purpose for individuals who self-injure (e.g. emotional relief). As such, individuals who self-injure often experience ambivalence about the behaviour. The purpose of this paper is to highlight the importance of recognising ambivalence as a natural and expected part of the recovery process.

This paper draws on literature regarding NSSI recovery, ambivalence towards stopping the behaviour and challenges for both clients and health professionals.

This paper argues that ambivalence towards self-injury can be challenging for both clients and health professionals. Clients may feel shame and sense of failure if they experience a setback; health professionals may experience frustration towards clients who continue to self-injure despite treatment.

Validation of the clients’ experience can have significant positive outcomes in treatment and help-seeking behaviours. Acknowledgement of client ambivalence during the recovery process will serve to validate clients’ experience and facilitate rapport. Health professionals who accept ambivalence as a natural part of the recovery process may experience less frustration with clients who continue to self-injure.

This paper deals with services provided within an organization, outlining a model to measure internal customer satisfaction and perceptions of internal quality. Adapting the concept of the service profit chain which is used still frequently to illustrate the relationship between external customer satisfaction and economic success, this article proposes that the external service quality can be attained only after internal performance prerequisites have been investigated and optimized. Additionally, it introduces the concept of an internal service barometer, and presents the results of an empirical study to evaluate the relationships between internal service quality, internal customer satisfaction and internal customer retention.

This study aims to identify and critically appraise literature exploring the effectiveness of psychological interventions in improving borderline personality disorder (BPD) symptomatology for individuals who misuse substances.

Systematic searches across six databases (PsycINFO, Embase, Scopus, Medline, CINAHL and ProQuest), hand searching and citation chaining were conducted between June and August 2021. Key search terms included BPD, substance use, therapy and effect. Study and sample characteristics, interventions, outcome measures and key findings were extracted. Quality assessment and a narrative synthesis approach were used to explore strengths, limitations and relationships between and within studies.

Seven eligible reports were included and showed mostly adequate quality. Mixed samples, designs, outcomes, definitions and implementation varied. Treatment completion did not differ significantly between those who did and did not misuse substances. Interventions demonstrated effectiveness in relation to psychiatric symptoms, hospital admissions, self-efficacy and impulsive and self-mutilating (cutting, burning, etc.) behaviours. No effects were found for suicidal or parasuicidal (threats, preparation and attempts) behaviours.

This review only considers individuals with diagnoses of BPD who are not accessing substance misuse treatment. Radically open dialectical behaviour therapy (DBT), therapeutic communities and other interventions are available as interventions for substance misuse (Beaulieu et al., 2021). Based on the findings of this review, it should not be assumed that such interventions affect substance misuse rather than BPD symptomatology. Therefore, future research might explore the effectiveness of these interventions on BPD symptomatology despite this not being the primary target for intervention.

Despite McCrone et al. (2008) noting the cost of this population’s difficulties to both themselves and services, the limited number of studies in this area is astonishing. Despite a lack of quality in the data available, there i some evidence to support the use of DBT and general psychiatric management (GPM) interventions for those with BPD and concurrent substance misuse. It is therefore of principal importance that health and social care services action Public Health England’s (2017) recommendations. Individuals with coexisting BPD and substance misuse would then receive support from any professional they see, who could then refer for psychological therapies.

Although the reports appear to show that DBT, integrated therapies and GPM may be effective for this population, conclusions cannot be drawn with high levels of confidence due to heterogeneity among studies. The findings indicate that future, high-quality research is needed to test the effects of interventions on BPD symptomatology for those who misuse substances. Randomised controlled trials with sufficient statistical power, homogeneous outcomes and standardised methodological approaches are needed.

The management of public health risks is a key focus for the European Union. One of the key factors that has been shown to pose a public health risk is that of the management of needles from healthcare facilities. The paper aims to discuss this issue.

Using audits of two case study hospitals based in northern Italy, this study sought to examine the key factors that resulted in needle stick injuries amongst staff and suggest measures to minimise these risks.

The number of needle stick injuries was influenced by various key factors including the time period during the year, the length of time employed, the location within the site, staff category and working hours.

Suggestions for overcoming the risk factors, including redesigning working patterns, staff training and awareness building, and the use of safety-engineered devices are outlined.

This study examined the incidence of needle stick injuries amongst healthcare staff in two Italian hospitals, which was lower than in other countries due to various factors, including recapping of needles not being allowed, the introduction of self-retractable needles and awareness campaigns about the correct disposal procedures of potentially infectious waste.

Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients.

All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+).

In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients.

More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self.

Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.