Journal of Youth and Adolescence

, Volume 39, Issue 3, pp 259–269 | Cite as

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

  • Paula Cloutier
  • Jodi Martin
  • Allison Kennedy
  • Mary K. Nixon
  • Jennifer J. Muehlenkamp
Empirical Research


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 



The authors would like to thank all the crisis intervention workers at the Children’s Hospital of Eastern Ontario (CHEO) for their assistance with data collection. They were instrumental in effectively conducting the research. The authors would also like to acknowledge the Provincial Centre of Excellence for Child and Youth Mental Health at CHEO for their financial assistance.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Paula Cloutier
    • 1
  • Jodi Martin
    • 2
  • Allison Kennedy
    • 1
  • Mary K. Nixon
    • 3
    • 4
  • Jennifer J. Muehlenkamp
    • 5
  1. 1.Mental Health Patient Service UnitChildren’s Hospital of Eastern OntarioOttawaCanada
  2. 2.Department of PsychologyUniversity of OttawaOttawaCanada
  3. 3.Division of Medical SciencesUniversity of VictoriaVictoriaCanada
  4. 4.Department of PsychiatryUniversity of British ColumbiaVancouverCanada
  5. 5.Department of PsychologyUniversity of Wisconsin-Eau ClaireEau ClaireUSA

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