Open Access Open Badges Research article

Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study

Claire M Kelly*, Anthony F Jorm, Betty A Kitchener and Robyn L Langlands

Author Affiliations

ORYGEN Research Centre, University of Melbourne, Australia

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BMC Psychiatry 2008, 8:62  doi:10.1186/1471-244X-8-62

Published: 23 July 2008



It is estimated that around 4% of the population engages, or has engaged, in deliberate non-suicidal self-injury. In clinical samples, the figures rise as high as 21%. There is also evidence to suggest that these figures may be increasing. A family member or friend may suspect that a person is injuring themselves, but very few people know how to respond if this is the case. Simple first aid guidelines may help members of the public assist people to seek and receive the professional help they require to overcome self-injury.


This research was conducted using the Delphi methodology, a method of reaching consensus in a panel of experts. Experts recruited to the panels included 26 professionals, 16 people who had engaged in self-injurious behaviour in the past and 3 carers of people who had engaged in self-injurious behaviour in the past. Statements about providing first aid to a person engaged in self-injurious behaviour were sought from the medical and lay literature, but little was found. Panel members were asked to respond to general questions about first aid for NSSI in a variety of domains and statements were extracted from their responses. The guidelines were written using the items most consistently endorsed by the consumer and professional panels.


Of 79 statements rated by the panels, 18 were accepted. These statements were used to develop the guidelines appended to this paper.


There are a number of actions which are considered to be useful for members of the public when they encounter someone who is engaging in deliberate, non-suicidal self-injury. These guidelines will be useful in revising curricula for mental health first aid and NSSI first aid training programs. They can also be used by members of the public who want immediate information about how to assist a person who is engaging in such behaviour.