How can school staff respond to student incidents of self-injurious thoughts and behaviours? A systematic scoping review

Purpose: Self-harm risk is highest between ages 12–19, making it essential for schools to have clear, evidence-based practices for identifying and responding to self-injurious thoughts and behaviours (SITBs). This scoping review summarises best-practice responses in primary and high school settings, focusing on non-clinical staff. It provides a foundation for developing consistent, evidence-based whole-school guidelines. Methods: PubMed, CINAHL and Embase were systematically searched (1 January 2000–31 March 2024) for English-language, peer-reviewed studies examining school staff responses to student SITBs. Studies reporting only prevalence or trends were excluded. Final studies were selected through a blinded, multistage screening process by paired reviewers. Data were analysed using narrative synthesis. Results: Forty-one articles met inclusion criteria. Most were published after 2005, conducted in the USA (n = 17), used qualitative designs (n = 15), involved mixed school staff (n = 14) and were based in high schools (n = 23). Overall study quality was fair to low. Findings indicated that effective school responses rely on whole-school approaches, strong leadership support, clearly defined roles and procedures, crisis response teams, and regular staff training. Conclusions: Despite gaps in the evidence, this review consolidates current best practice and can inform future guidelines to strengthen school staff capacity and confidence in supporting students experiencing SITBs.