School-level differences in self-harm and psychosocial problems associated with self-harm in adolescents

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dc.contributor.authorMcEvoy, David
dc.contributor.authorBrannigan, Ross
dc.contributor.authorHealy, Colm
dc.contributor.authorDooley, Niamh
dc.contributor.authorArensman, E.
dc.contributor.authorClarke, Mary
dc.contributor.funderHealth Research Board
dc.date.accessioned2026-05-22T08:50:15Z
dc.date.available2026-05-22T08:50:15Z
dc.date.issued2026
dc.description.abstractBackground: The school environment plays a key role in adolescents’ emotional development and well-being, yet little research has compared self-harm and related psychosocial problems across different secondary school types. Methods: Using data from the Growing Up in Ireland (GUI) longitudinal cohort, this study examined differences in the prevalence of self-harm and psychosocial risk factors across different school types: single-sex versus coeducational, fee-paying versus non-fee-paying, disadvantaged versus non-disadvantaged, and schools with different religious ethos. Multilevel regression models distinguished school-level from individual-level effects. Results: Almost all variance in self-harm and most of the variance in psychosocial problems associated with self-harm occurred at the individual level. Higher self-harm prevalence in single-sex girls’ schools was accounted for by the greater concentration of girls, who had over twice the odds of self-harm compared with boys (OR 2.1, 95% CI 1.71–2.69). No significant differences in self-harm were found by school socio-economic status or religious ethos. Disadvantaged schools showed higher prevalence in seven of nine psychosocial problems, although only internalising problems and truancy/absenteeism remained significantly associated with disadvantaged schools in the fully adjusted models. Adolescents whose parents reported having a religion were less likely to self-harm (OR 0.62, 95% CI 0.50–0.75). Discussion: Although schools are important settings for self-harm prevention, findings indicate that interventions should primarily target individuals and high-risk groups. Girls, in particular, may benefit from supports addressing self-harm. Disadvantaged schools, where well-established psychosocial risk factors for self-harm are more common, may benefit from well-being programmes targeting internalising problems and truancy/absenteeism. © The Author(s), 2026. Published by Cambridge University Press.en
dc.description.sponsorshipThis was funded by the Health Research Board (HRB) Ireland as part of the SPHeRE Programme (Structured Population and Health services Research Education): https://www.sphereprogramme.ie.
dc.description.versionPublished Version
dc.format.extent12
dc.format.mimetypeapplication/pdfen
dc.identifier.authororcidMcEvoy, David
dc.identifier.authororcidBrannigan, Ross
dc.identifier.authororcidHealy, Colm
dc.identifier.authororcidDooley, Niamh
dc.identifier.authororcidArensman, E.§0000-0003-0376-1203
dc.identifier.authororcidClarke, Mary
dc.identifier.citationMcEvoy, D, Brannigan, R, Healy, C, Dooley, N, Arensman, E & Clarke, M 2026, 'School-level differences in self-harm and psychosocial problems associated with self-harm in adolescents', Irish Journal of Psychological Medicine, pp. 1-12. https://doi.org/10.1017/ipm.2026.10192
dc.identifier.doi10.1017/ipm.2026.10192
dc.identifier.endpage12
dc.identifier.issn0790-9667
dc.identifier.journaltitleIrish Journal of Psychological Medicine
dc.identifier.otherRIS: urn:D49D6504D34A60FB968160FE6A73CB5C
dc.identifier.otherORCID: /0000-0003-0376-1203/work/215518219
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/18820
dc.language.isoen
dc.publisherCambridge University Press
dc.relation.urihttps://www.scopus.com/pages/publications/105037062440
dc.relation.urihttps://www.scopus.com/pages/publications/105037062440?origin=resultslist
dc.rights© 2026, theAuthors. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
dc.rights.accessrightsopen access
dc.rights.licensenameAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.statusPeer reviewed
dc.subjectAdolescents
dc.subjectPsychosocial problem
dc.subjectSchools
dc.subjectSelf-harm
dc.subjectSelf-injury
dc.subject[PublicHealth]
dc.titleSchool-level differences in self-harm and psychosocial problems associated with self-harm in adolescentsen
dc.typeArticle (peer-reviewed)
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