Nonsuicidal Self-Injury among Adolescents: A Training Priority for Primary Care Providers


  • We would like to thank Jessica Barnes from the Children, Youth, and Family Consortium, University of Minnesota Extension for her help administering the survey and managing responses.
  • This study was funded in part through contracts from the Minnesota Department of Human Services. The first author's time was partially supported through funds from the Healthy Youth Development Prevention Research Center, University of Minnesota, Cooperative Agreement Number 5U48DP001939 from the Centers for Disease Control and Prevention (PI: Resnick). The findings and conclusions in the article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Address correspondence to Lindsay Taliaferro, Department of Health Sciences, School of Health Professions, 505 Clark Hall, University of Missouri, Columbia, MO 65211; E-mail:


Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self-injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians (n = 260), pediatricians (n = 127), family nurse practitioners (n = 96), and pediatric nurse practitioners (n = 54). Almost 50% felt unprepared to address NSSI, and over 70% wanted training in this area. Overall, relative to other areas of mental health care, clinicians felt least prepared to address and wanted more training on NSSI. Just 27% reported they routinely inquired about NSSI during health supervision. Factors associated with routinely asking about NSSI were identifying as female (OR = 2.37; 95% CI = 1.25–4.49), feeling better prepared to address NSSI (OR = 1.51; 95% CI = 1.04–2.20), and more frequently using a psychosocial interview to identify adolescents in distress (OR = 1.23; 95% CI = 1.02–1.48). Teaching clinicians to assess NSSI within a psychosocial interview may increase screening for and identification of the behavior among adolescents in primary care.