Effect of a nurse-led caring contact program on 90-day recurrence of nonsuicidal self-injury in youth

Nonsuicidal self-injury (NSSI) is highly prevalent among adolescents and is associated with significant emotional dysregulation and elevated suicide risk. The post-discharge period, particularly the first 90 days, represents a high-risk window for relapse. Caring contact - a brief, supportive, nonclinical follow-up after discharge - has shown potential in reducing self-harm among adults, but evidence in adolescents with NSSI remains limited. This study aimed to evaluate the effectiveness of a nurse-led caring contact program in reducing 90-day NSSI recurrence and improving psychological outcomes among adolescents. A retrospective cohort study was conducted including 102 adolescents hospitalized for NSSI between January 2023 and December 2024. Participants were assigned to the intervention group (n = 52; structured caring contact at weeks 1, 2, 4, 8, and 12) or control group (n = 50; routine post-discharge care). Primary outcome was 90-day NSSI recurrence. Secondary outcomes included changes in depression (patient health questionnaire-9 item), anxiety (generalized anxiety disorder 7-item scale), and perceived social support (perceived social support scale). Logistic regression was used to identify independent predictors of recurrence. Nurse-led caring contact substantially reduces short-term NSSI recurrence and improves emotional symptoms and perceived social support in adolescents following psychiatric hospitalization. As a low-cost, scalable intervention, caring contact should be considered for integration into routine post-discharge management to enhance continuity of care and prevent early relapse in this high-risk population. The 90-day recurrence rate was significantly lower in the intervention group compared with controls (21.15% vs 42.00%, χ2 = 5.17, P = .023). The intervention group showed greater reductions in patient health questionnaire-9 item and generalized anxiety disorder 7-item scale scores and a greater increase in perceived social support scale scores (all P < .001). In multivariable analysis, nurse-led caring contact remained an independent protective factor against recurrence (odds ratio = 0.38, 95% confidence interval: 0.16-0.91, P = .031).