Non-Suicidal Self Injury (NSSI) Among Students Seeking Mental Health Services at an Urban, Public University

Background: Non-suicidal Self Injury (NSSI) occurs when an individual intentionally harms their body without overt suicidal intent, for reasons that are not socially sanctioned, and frequently entails behaviors such as cutting, burning, scratching, and self-battery (Walsh, 2014; Whitlock et al., 2011). NSSI is markedly prevalent among young adults with rates ranging from 12-47% among various samples.  Associations between NSSI and psychological distress, disordered eating, and other mental health disorders are well documented (Walsh, 2014). Increased understanding of risks and protective factors for NSSI among youth may help improve intervention and prevention efforts. The purpose of the current study was to examine rates and correlates of recent (past month) and lifetime NSSI among socially and demographically-diverse college students seeking help at a public university-based counseling center.

Methods: Data were drawn from counseling center records of students who sought assistance from the Counseling and Psychological Services Department of an urban, public university from 2016-2018. Students (N=2,141) completed the Center for Collegiate Mental Health’s Standardized Data Set Questionnaire (2015; 2017), a self-report measure designed to assess mental health, demographic information, and treatment history in college students, for both clinical and research purposes. Multinomial logistic regression was used to compare students with no history of NSSI to those with recent (past month) or past history of NSSI (lifetime but not past month).

Results: In this sample, 6.5% of students reported engaging in NSSI during the past month, while 25.2% reported lifetime histories of NSSI, but not in the past month. Transgender students (OR=8.73), students who reported more frequent binge drinking (OR=1.28, p=.009), had a history of sexual victimization (OR=1.71, p=.010) and those with a past suicide attempt (6.54, p<.001) had greater odds of past-month NSSI. Older age was associated with lower odds of past-month NSSI (OR=0.87, p<.001). Females (OR=1.41, p=.010), LGB students (OR=1.85 p<.001), students reporting histories of sexual victimization (OR=2.50, p<.001), a past suicide attempt (OR=5.41, p<.001) and more frequent marijuana use (OR=1.11, p=.008) had greater odds of lifetime NSSI.  Students who identified as African American (OR=0.55, p<.001), reported higher levels of religious importance (OR=0.86, p=.003), and were international students (OR=0.36, p=.003), had lower odds of lifetime NSSI.

 Conclusion: This study identified associations between reported engagement in NSSI, and gender and sexual minority identification, substance use behaviors, sexual victimization, and history of suicide attempts. We also identified demographic/background characteristics (e.g. older age, African American race, and importance of religion) associated with lower odds of NSSI.  This study is unique in that it explored correlates of NSSI among students on an urban college campus with a diverse population of students from multiple ethnic groups. Specifically, the sample included a large population of students who identified as Muslim and 22.6% who identified as LGB.  Findings may contribute to the development of more sophisticated assessment tools for the identification of university students who may be at risk for NSSI. Future research should further examine risk and protective factors for NSSI among diverse college students.