Empirical Research

Journal of Youth and Adolescence

, Volume 39, Issue 3, pp 259-269

First online:

Characteristics and Co-occurrence of Adolescent Non-Suicidal Self-Injury and Suicidal Behaviours in Pediatric Emergency Crisis Services

  • Paula CloutierAffiliated withMental Health Patient Service Unit, Children’s Hospital of Eastern Ontario Email author 
  • , Jodi MartinAffiliated withDepartment of Psychology, University of Ottawa
  • , Allison KennedyAffiliated withMental Health Patient Service Unit, Children’s Hospital of Eastern Ontario
  • , Mary K. NixonAffiliated withDivision of Medical Sciences, University of VictoriaDepartment of Psychiatry, University of British Columbia
  • , Jennifer J. MuehlenkampAffiliated withDepartment of Psychology, University of Wisconsin-Eau Claire

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During the potentially tumultuous adolescent period, non-suicidal self-injury (NSSI) and suicide attempts are relatively common, particularly amongst youth who present to mental health services. These phenomena frequently co-occur but their relationship is unclear. This study evaluated clinical data from 468 youth between the ages of 12 and 17 years (63.5% female) to determine the incidence of NSSI 24 h prior to presentation at emergency crisis services, evaluated the overlap between NSSI and suicide attempt, and examined the characteristics of different types of self-harm. Half of the adolescents presenting to emergency crisis services had self-harmed within the previous 24 h, with most of these (91%) classified as NSSI only. The percentage of youth with a suicide attempt was 5% and the co-occurrence of these two behaviours was 4%. Group differences in depressive symptoms, suicidal ideation and impulsivity were identified, with the co-occurring NSSI and suicide attempt group presenting with the highest level of psychopathology. This study underscores the necessity of assessing suicidal ideation and NSSI in all youth presenting to mental health services.


Adolescents Non-suicidal self-injury Suicide Emergency crisis services