Associations between Teachers' Attitudes and Perceived Barriers and their Self-Reported Responses to Students Engaging in NSSI: A Mixed-Methods Analysis

Abstract Non-suicidal self-injury (NSSI) among adolescents, defined as deliberate self-inflicted harm without suicidal intent, is often employed as a coping mechanism for emotional distress. Effectively addressing NSSI requires timely referral to professional support services and the development of strategies for managing the needs of affected students, highlighting the critical role of teachers in fostering a supportive and understandable environment. This study explored the associations between teachers’ attitudes, perceived barriers, and their self-reported responses to students engaging in NSSI. It examined teachers’ responses, including perceived referral confidence to mental health services and perceived competence in managing NSSI, while comparing regular and special education teachers. A mixed-methods design was employed, integrating quantitative data (n = 203) and qualitative insights (n = 35) from secondary school teachers. The quantitative findings revealed that teachers’ positive attitudes and strong role perceptions were associated with higher self-reported perceived competence in managing NSSI and greater likelihood of perceived referral confidence . Special education teachers demonstrated superior perceived competence in managing NSSI, likely due to their specialized training and resources, although perceived referral confidence rates remained consistent across the groups. Qualitative themes underscored the emotional toll on teachers, systemic challenges, and the critical importance of professional and peer support in managing cases of NSSI. The findings emphasize the need for trauma-informed training, clear intervention protocols, and systemic support to empower teachers to address NSSI. This study contributes to the development of targeted professional training programs and promotes the creation of supportive educational environments for students who engage in NSSI.