Clinical Care: What is NSSI All About??

Understanding Non-Suicidal Self Injury (NSSI) Behavior of Young People

Wolverine Human Services has been working avidly to remain innovative and informed about each generation of young people that we serve. Since the national financial crisis of 2008, our population of clients and the challenges they are presented with have changed significantly. The young people being referred to the residential care programs have demonstrated more severe levels and frequency of mental health challenges and disorders. The methods of coping and the behavioral responses of young people struggling with mental health challenges have changed presentation as well.

One of the most challenging and equally heart breaking trends that our clinicians and staff are combatting is an increase in Non-Suicidal Self Injury (NSSI). Previously and more commonly referred to as ‘self-mutilation’, ‘self-harm’, and ‘cutting’, NSSI comes in many forms and extremes. Even more frighteningly, there are now a plethora of online and social media venues where adolescent are signing on to support, teach and share unhealthy information about the benefits and ways to engage in and hide self-injurious behaviors. Parents and guardians need to be aware of this trend and influences guiding the increasing number of young people engaging in NSSI to cope with painful feelings. Studies indicate that approximately 40% of people who engage in NSSI have seriously thought about suicide as well.

NSSI involves a person intentionally causing physical and extreme emotional harm to themselves in effort to manage overwhelming, painful or overflowing emotions. There is no intention to suicide, though this is a serious ‘red flag’ or a sign of mental distress. These include, but are certainly not limited to: cutting, burning, hair-pulling, biting, head-banging, punching or hitting oneself, punching objects causing injury to the hand such as fractures, using erasers to cause damage to the skin, scratching the skin, carving words or images into skin, breaking bones, piercing with sharp objects (outside norms of fashion or culture), pinching, poisoning self, swallowing harmful objects and re-opening healing wounds. Believe it or not—all of these are just young people trying to cope with and manage feelings that are overwhelming and distressing. NSSI can become an addictive behavior and as the young people will tell you…”it works” to help bring them back to reality, back to baseline and back under control. Conversely, it can help a person experiencing numbness and emptiness to feel something, even if just physical sensation. The goal is to simply change how they feel in the moment. It can provide a temporary sense of release and relief from intensely painful or uncomfortably numbing emotions.

WHS’ residential care programs have stepped up to learn effective ways to manage this risky behavior in a number of ways. We have integrated use of sensory grounding equipment into our work with young people. These include items like weighted blankets, kinetic sand, use of ice and intense exercise, focal objects, and other sensory items. Therapists are using evidence based treatment curriculums and teaching clients alternative, healthy grounding and soothing skills to better manage distress. We continue educating our staffing teams on trauma informed care and safe management of NSSI. WHS has joined the national movement to certify our personnel as “Youth Mental Health First Aiders”. We have partnered with the Beck Institute of Philadelphia and University of Indiana to implement effective and evidence based Cognitive-behavioral therapy (CBT) models into our residential programs.

For more information on this alarming and ‘trending’ topic, you can simply search a web browser for Non-Suicidal Self-injury. Sources ranging from Wiki and Psychology Today to the APA (American Psychiatric Association), NCBH (National Council for Behavioral Health) and NIMH (National Institute of Mental Health).


Katrina Brock, LMSW, CAADC, CCS, is Director of Clinical & Quality Services at Wolverine Human Services. Katrina has over 16 years of direct clinical as well as administrative experience. She leads WHS’ Quality & Performance Improvement Department and is the agency lead consultant for accreditation with the Council on Accreditation. She is very proud of WHS’ new programs and evidence-based practice initiatives. On the side, Katrina enjoys doing outpatient therapy directly with clients and working with diverse populations of clients.