Non-suicidal self-injury: Suicide risk or social activity?

Abstract

Deliberate self-harm (DSH) has been conceptualised as indicative of mental illness, on a continuum ending with suicide. Recently our understanding of DSH has become more nuanced, with distinctions made between suicidal behaviour and non-suicidal self-injury (NSSI). Indeed, there is some evidence that NSSI may be consciously countersuicidal. Moreover, NSSI appears to have recently increased markedly among young women. This research explores the motivations, meanings and functions of NSSI in young New Zealand women through 19 in-depth interviews. The results show that precursors range from serious anguish including suicidality, to purely social, with functions from the alleviation of distress to participation in a social activity. Often minimal physical or psychological harm is involved, either preceding NSSI, or as a result. Previous beliefs about the dynamics and the social contexts in which NSSI occurs are thus problematic, as are assumptions about the appropriate support. Though a potential indicator of mental ill-health, NSSI may be a harm-reduction technique, or a relatively normalised teenage activity within the peer group.