First to Respond, Last to be Trained: Staff Competence for Managing Nonsuicidal Self-injury in Child Care Settings
U. P. Mohammed Shamil Hussain, Kavita Vishwanath Jangam, Priyanka Pavithran Nambiar, K. M. RajendraAbstract
Background:
Nonsuicidal self-injury (NSSI) is a growing concern among children in child care institutions (CCIs), yet staff often lack adequate training to address it. This study aimed to assess the knowledge, experiences, and training needs of CCI staff regarding NSSI.
Materials and Methods:
A mixed-methods approach was used with 25 staff members from seven CCIs. Data were collected through an interview schedule developed by the researcher and a survey questionnaire and analyzed using descriptive statistics and thematic analysis.
Results:
Knowledge assessment revealed significant misconceptions about NSSI. Five items reflected poor understanding, including beliefs that NSSI is a failed suicide attempt (80%) or that it helps individuals stay in control (76%). Eleven items showed problematic understanding, such as viewing NSSI as a release of anger (64%), a sign of mental illness (52%), or NSSI is a woman’s problem (48%). Although 84% had worked with children who self-injure in their current institutions, 56% reported low confidence in managing NSSI. Qualitative analysis generated three themes: Decoding Frontline Experiences, Gaps in Emotional Care, and Training for Transformation, highlighting emotional triggers, limited access to interventions, and the need for targeted training and mental health support.
Conclusions:
CCI Staff demonstrated limited knowledge and confidence, despite frequent exposure to NSSI in CCIs, and expressed a need for targeted training. Strengthening staff capacity may enable earlier recognition and more supportive intervention for institutionalized children.