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The Journal of School Nursing
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Feature Article

Self-Mutilation in Adolescents

Catherine McDonald, CCRN, MSN

Catherine McDonald, CCRN, MSN, is a school nurse in the West Morris Regional High School District, Chester, NJ. This article has been adapted from a paper submitted for the MSN degree at Monmouth University, West Long Branch, NJ

Self-mutilation is not a new trend or phenomenon in adolescents. Self-mutilation can be divided into three categories: major, stereotypic, and moderate/superficial. Moderate/superficial self-mutilation is the most common type in adolescents and includes cutting, burning, and carving. School nurses are positioned to identify, to assist, and to educate adolescents who are self-mutilating, as well as those who may be at risk. A crucial intervention by school nurses is referral of students who are self-mutilating, because it is a gateway to treatment. Treatment, which includes therapy and medication, may be a difficult and lengthy process. The adolescent who self-mutilates may find the school environment difficult during treatment. School nurses must become educated about adolescent self-mutilation in order to care for those who engage in this behavior. Prevention of self-mutilation should focus on increasing coping mechanisms, facilitating decision-making strategies, encouraging positive relationships, and cultivating self-esteem.

Key Words: coping • cutting • mental health • self-esteem • self-mutilation

The Journal of School Nursing, Vol. 22, No. 4, 193-200 (2006)
DOI: 10.1177/10598405050220040201
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