Document Type
Manuscript
Submission Date
2025
Abstract
An important public health approach to reducing suicide is supporting healthcare providers in recognizing and responding to risks for non-suicidal self injury (NSSI) and suicidality. While psychiatrists and other mental health professionals are typically trained in identifying NSSI and addressing suicide, other healthcare professionals do not feel as prepared to tackle this responsibility effectively. Given that primary care providers (PCPs) are the front-line providers of psychiatric care for adolescents, this represents a challenge for the health and mental health systems of care.
Recent evidence suggests that for many young people, NSSI is upstream of later suicide attempts. PCPs are well positioned to identify NSSI as they encounter their patients more frequently than other providers and they do routine wellness checks. However, physicians report multiple obstacles regarding screening for NSSI and suicidal ideation, constructing an interventional plan, and following up with at-risk patients. These obstacles include not having enough time in a routine visit (often just 15 minutes) to address NSSI and a lack of focused, easily accessible resources to help them identify risks and then provide evidence-based interventions.
Our e-module, Healthcare Provider Education on the Prevention of Suicide and Self-Harming behaviors in Adolescents, was created to support healthcare providers and trainees in providing evidence-based care for their patients at risk for intentional self-harming behaviors and reduce their risk for negative outcomes, such as future suicide attempts and deaths.
Key elements of the e-module include defining relevant language surrounding suicide and NSSI, epidemiology, risk vs protective factors for suicide and NSSI, methods, warning signs, and reasons adolescents may engage in NSSI. The module also describes tools and approaches for healthcare providers to identify NSSI behaviors, including the Self-Harming Screening Inventory (SHSI, a 10-binary questionnaire that can be used to initially assess if a patient has been engaging in NSSI behaviors), a script to help healthcare providers open a dialogue with their patients about NSSI, and example scenarios with interactive questions and feedback. To support active learning, brief knowledge checks are distributed throughout the e-module. At the end, there is a quiz assessing basic knowledge of suicide and NSSI and an optional survey for participants to provide feedback.
In Spring 2025, we shared our e-module with a sample of medical students (n= 23) who completed the e-module and provided detailed feedback. Overall, 86% of participants found the e-module to be effective in supporting their learning about NSSI and 83% felt more confident in their ability to identify NSSI in adolescent patients after completing the e-module. Additionally, 91% of participants believed that what they learned from the e-module can be applied to their current or future practice, with many participants specifying that they found the script to be a very helpful resource.
Recommended Citation
Moussadek, Khadija and Delaney, Thomas, "Evaluation of a Self-Directed E-Module Supporting Healthcare Provider Education on Adolescent Self-Harm" (2025). Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects. 55.
https://scholarworks.uvm.edu/m4sp/55
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