{"id":{"repo_id":"auckland-ms","oai_identifier":"oai:researchspace.auckland.ac.nz:2292/75646"},"canonical_url":"https://search.dev.ndltd.org/etd/auckland-ms/oai:researchspace.auckland.ac.nz:2292/75646","repository":{"repo_id":"auckland-ms","name":"University of Auckland","base_url":"https://researchspace.auckland.ac.nz/server/oai/request"},"display":{"title":"Evidence-Based Prevention of Youth Self-Harm in Aotearoa New Zealand","abstract":"Introduction: Self-harm is an important public health issue due to its association with increased suicide risk. In Aotearoa, the increased community prevalence of self-harm and corresponding demands for services expose an urgent need. Despite this, there are important epidemiological gaps regarding hospitalisation for self-harm to prioritise prevention strategies. Self-harm is established during adolescence, and schools are an ideal setting to intervene early; however, schools lack guidance and support to respond. Methods: The programme of work included 1) an epidemiological study of trends in all-age hospitalisation for self-harm between 01 January 1999 and 31 December 2022; 2) a systematic review of guidance provided to schools responding to self-harm; 3) the co-design of how to implement best practice for self-harm in school settings; with this culminating in 4) the development of action-oriented, co-designed guidelines for schools distributed via the Ministry of Education website. Results: The epidemiological study highlighted an upward trend in hospital-presenting self-harm rates, particularly among females and young people. Young people aged 15–19 years had the highest rates of self-harm at 619.4 per 100,000 in 2022. The total proportion of repeated hospitalisation for self-harm was 27.5% and was highest among those under the age of 19 years (59.3%) and among European (30.5%) and Māori (24.7%) ethnic groups. The total population all-cause mortality was 3.1% and was significantly higher among men and people over 65 years. The systematic review of guidance provided to schools recommended policies and procedures for responding to self-harm, but lacked detail on roles, responsibilities, or specific actions schools could take. Additionally, guidance lacked scientific evidence or was based on outdated approaches. Conclusion: Schools are an ideal setting to intervene early in cases of self-harm, but they need to be supported by co-design and implementation science with equity-focused, systemic solutions, which ensure a whole-of-system response to youth self-harm. Co-designed guidelines should be implemented in schools to enable a whole-of-school approach to self-harm","abstract_html":"Introduction: Self-harm is an important public health issue due to its association with increased suicide risk. In Aotearoa, the increased community prevalence of self-harm and corresponding demands for services expose an urgent need. Despite this, there are important epidemiological gaps regarding hospitalisation for self-harm to prioritise prevention strategies. Self-harm is established during adolescence, and schools are an ideal setting to intervene early; however, schools lack guidance and support to respond. Methods: The programme of work included 1) an epidemiological study of trends in all-age hospitalisation for self-harm between 01 January 1999 and 31 December 2022; 2) a systematic review of guidance provided to schools responding to self-harm; 3) the co-design of how to implement best practice for self-harm in school settings; with this culminating in 4) the development of action-oriented, co-designed guidelines for schools distributed via the Ministry of Education website. Results: The epidemiological study highlighted an upward trend in hospital-presenting self-harm rates, particularly among females and young people. Young people aged 15–19 years had the highest rates of self-harm at 619.4 per 100,000 in 2022. The total proportion of repeated hospitalisation for self-harm was 27.5% and was highest among those under the age of 19 years (59.3%) and among European (30.5%) and Māori (24.7%) ethnic groups. The total population all-cause mortality was 3.1% and was significantly higher among men and people over 65 years. The systematic review of guidance provided to schools recommended policies and procedures for responding to self-harm, but lacked detail on roles, responsibilities, or specific actions schools could take. Additionally, guidance lacked scientific evidence or was based on outdated approaches. Conclusion: Schools are an ideal setting to intervene early in cases of self-harm, but they need to be supported by co-design and implementation science with equity-focused, systemic solutions, which ensure a whole-of-system response to youth self-harm. Co-designed guidelines should be implemented in schools to enable a whole-of-school approach to self-harm","abstract_has_math":false,"creators":["Bowden, Linda Maya"],"institution":"ResearchSpace@Auckland","degree_name":"PhD","degree_level":"Doctoral","degree_discipline":"Suicide Prevention","degree_department":null,"school":null,"contributors":[],"advisors":["Hetrick, Sarah","Fortune, Sarah","Clark, Terryann"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-24T01:07:07Z","subjects":["self-harm","suicide","youth","schools","implementation science","Co-design"],"languages":[],"rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"rights_urls":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2292/75646","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Hetrick, Sarah","Fortune, Sarah","Clark, Terryann"]},{"key":"dc:creator","label":"Author","values":["Bowden, Linda Maya"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-05-24T19:51:11Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher","label":"Institution","values":["ResearchSpace@Auckland"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Suicide Prevention"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Auckland"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["self-harm","suicide","youth","schools","implementation science","Co-design"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2292/75646"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Introduction: Self-harm is an important public health issue due to its association with increased suicide risk. In Aotearoa, the increased community prevalence of self-harm and corresponding demands for services expose an urgent need. Despite this, there are important epidemiological gaps regarding hospitalisation for self-harm to prioritise prevention strategies. Self-harm is established during adolescence, and schools are an ideal setting to intervene early; however, schools lack guidance and support to respond. Methods: The programme of work included 1) an epidemiological study of trends in all-age hospitalisation for self-harm between 01 January 1999 and 31 December 2022; 2) a systematic review of guidance provided to schools responding to self-harm; 3) the co-design of how to implement best practice for self-harm in school settings; with this culminating in 4) the development of action-oriented, co-designed guidelines for schools distributed via the Ministry of Education website. Results: The epidemiological study highlighted an upward trend in hospital-presenting self-harm rates, particularly among females and young people. Young people aged 15–19 years had the highest rates of self-harm at 619.4 per 100,000 in 2022. The total proportion of repeated hospitalisation for self-harm was 27.5% and was highest among those under the age of 19 years (59.3%) and among European (30.5%) and Māori (24.7%) ethnic groups. The total population all-cause mortality was 3.1% and was significantly higher among men and people over 65 years. The systematic review of guidance provided to schools recommended policies and procedures for responding to self-harm, but lacked detail on roles, responsibilities, or specific actions schools could take. Additionally, guidance lacked scientific evidence or was based on outdated approaches. Conclusion: Schools are an ideal setting to intervene early in cases of self-harm, but they need to be supported by co-design and implementation science with equity-focused, systemic solutions, which ensure a whole-of-system response to youth self-harm. Co-designed guidelines should be implemented in schools to enable a whole-of-school approach to self-harm"]},{"key":"dc:title","label":"Title","values":["Evidence-Based Prevention of Youth Self-Harm in Aotearoa New Zealand"]}]}],"canonical_facts":{"dc:contributor.advisor":["Hetrick, Sarah","Fortune, Sarah","Clark, Terryann"],"dc:creator":["Bowden, Linda Maya"],"dc:date.accessioned":["2026-05-24T19:51:11Z"],"dc:date.issued":["2025"],"dc:description.abstract":["Introduction: Self-harm is an important public health issue due to its association with increased suicide risk. In Aotearoa, the increased community prevalence of self-harm and corresponding demands for services expose an urgent need. Despite this, there are important epidemiological gaps regarding hospitalisation for self-harm to prioritise prevention strategies. Self-harm is established during adolescence, and schools are an ideal setting to intervene early; however, schools lack guidance and support to respond. Methods: The programme of work included 1) an epidemiological study of trends in all-age hospitalisation for self-harm between 01 January 1999 and 31 December 2022; 2) a systematic review of guidance provided to schools responding to self-harm; 3) the co-design of how to implement best practice for self-harm in school settings; with this culminating in 4) the development of action-oriented, co-designed guidelines for schools distributed via the Ministry of Education website. Results: The epidemiological study highlighted an upward trend in hospital-presenting self-harm rates, particularly among females and young people. Young people aged 15–19 years had the highest rates of self-harm at 619.4 per 100,000 in 2022. The total proportion of repeated hospitalisation for self-harm was 27.5% and was highest among those under the age of 19 years (59.3%) and among European (30.5%) and Māori (24.7%) ethnic groups. The total population all-cause mortality was 3.1% and was significantly higher among men and people over 65 years. The systematic review of guidance provided to schools recommended policies and procedures for responding to self-harm, but lacked detail on roles, responsibilities, or specific actions schools could take. Additionally, guidance lacked scientific evidence or was based on outdated approaches. Conclusion: Schools are an ideal setting to intervene early in cases of self-harm, but they need to be supported by co-design and implementation science with equity-focused, systemic solutions, which ensure a whole-of-system response to youth self-harm. Co-designed guidelines should be implemented in schools to enable a whole-of-school approach to self-harm"],"dc:identifier.uri":["https://hdl.handle.net/2292/75646"],"dc:publisher":["ResearchSpace@Auckland"],"dc:rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"dc:rights.uri":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"dc:subject":["self-harm","suicide","youth","schools","implementation science","Co-design"],"dc:title":["Evidence-Based Prevention of Youth Self-Harm in Aotearoa New Zealand"],"dc:type":["Thesis"],"thesis:degree_discipline":["Suicide Prevention"],"thesis:degree_level":["Doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["The University of Auckland"]},"updated_at":"2026-07-24T01:07:07Z"}