The COVID-19 pandemic, with its social isolation and school closures, has impacted the mental health of countless young people and may elevate the risk of non-suicidal self-injury (NSSI) among students, according to a new University of Guelph report.
The challenges of the COVID-19 pandemic – lowered peer support and social interaction, reduced access to medical and mental health services, and increased stress and uncertainty – are continuing for all students, especially given the most recent school closures.
Students who self-injure or who are at risk of NSSI may be especially vulnerable, said a lead on the paper, Dr. Stephen Lewis, a professor in the Department of Psychology and an NSSI expert.
Lewis and his colleagues wrote a report on the potential impact of the pandemic on students who self-injure and how schools can support them. Entitled “Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources,” the paper was published in the journal School Psychology International.
The report was covered by the Waterloo Region Record.
During the global COVID-19 pandemic, Lewis said, many schools have been closed and students sent home to learn online. These changes may exacerbate existing mental health difficulties and pose several new stressors that can increase the risk of NSSI. School closures – including a second round of closures in Ontario – perpetuate the isolation, uncertainty and distress that can play a role in self-injury.
NSSI involves deliberate damage to body tissue without suicidal intent. It is often done in response to overwhelming emotions, acting as a temporary relief from them.
It is a significant mental health concern for many young people and is linked to suicidal thoughts and behaviours. Research cited in the report shows that NSSI can play a role in the transition from suicidal ideation to suicidal attempts among adolescents.
According to research, 17 per cent of adolescents worldwide engage in NSSI.
The risk of NSSI may be higher during the COVID-19 pandemic, especially in the absence of support, Lewis said.
“We know that how individuals manage distress, anxiety, depression and other difficult emotions plays a key role in self-injury engagement,” said Lewis. “When young people’s coping resources are impacted and become depleted, their capacity to cope with stress and overwhelming emotion becomes more difficult. Given the many and ongoing stresses of the pandemic, this may put these youth at greater risk of self-injury.”
The report highlights that schools can play a vital role in supporting students who self-injure and in fostering a climate in which all students feel safe enough to reach out for support. This is especially important given the stigma associated with self-injury, Lewis said.
During the pandemic, schools have been providing mental health supports, Lewis said. These efforts should ensure resources specific to self-injury are readily available, he added.
The published report is intended as a practical guide to help schools support students in these challenging times. This includes sharing research-informed resources. For instance, Lewis is co-founder and co-director of Self-injury Outreach and Support, which provides coping strategies for self-injury as well as resources for schools and families.
The report condenses existing research on self-injury among students and offers creative ways schools can support youth, including what can help them cope as the pandemic drags on and schools remain closed, said Lewis.
He co-authored the study with his colleagues as part of the International Consortium on Self-injury in Educational Settings. According to the paper, secondary schools are an ideal setting in which to identify and refer students who self-injure, given that NSSI typically begins during early to mid-adolescence. Schools are best able to implement evidence-based prevention and early intervention programs.
But pandemic conditions have complicated the delivery of those programs. The ongoing spread of COVID-19 has disrupted structure, routines and peer interactions, and has limited the mental health resources usually available to youth through their school.
“The provision of online supports and resources is critical for all students in the context of the pandemic,” Lewis said.
Lewis said that well before the pandemic began, many students preferred to use the internet to access mental health resources. In response, many schools have provided some of those resources on their websites and other secure online platforms to help students cope with mental health difficulties, including depression and anxiety, self-injury, and to provide resources for crisis support and coping.
Lewis said supporting all students during the pandemic is about ensuring they have ongoing social support, a sense of school community and access to mental health supports and resources, even if provided virtually. Providers need to implement sustained support using online platforms to help youth who engage in or are at risk for NSSI.
“Students may not have the opportunities to regularly engage in social interaction and see their peers and teachers in the same way, but it’s important for them to continue to engage in social connection, and for us to ensure they have access to support and research-informed resources so that we can limit the mental health consequences of the pandemic on those youth,” he said.