Early interventions for self-harm among children and young people in educational and primary-care settings: A scoping review.

Abstract

Self-harm among children and young people is a major public-health concern associated with substantially elevated risk of adverse outcomes including suicide. Educational and primary-care settings are frequent points of contact, prompting diverse prevention and early-intervention efforts, yet the scope and effectiveness of these remain unclear. This scoping review mapped and synthesised empirical studies evaluating interventions designed to prevent or reduce self-harm in individuals aged 25 years or younger within educational or general-practice contexts. Following JBI and PRISMA-ScR guidance, seven databases and grey-literature sources were searched to July 2025. Twenty-two studies met inclusion criteria: five randomised controlled trials, five other quantitative evaluations, four mixed-methods studies, seven qualitative enquiries, and one implementation report. Most were delivered in educational settings; primary care remained under-represented. Psycho-educational programmes were most common, followed by screening or early-identification approaches, mindfulness or expressive-therapeutic interventions, an integrated service model, professional training, and a digital self-help app. Of twelve studies with quantitative outcomes, four reported significant reductions in self-harm thoughts or behaviours, although most were small-scale and short-term. Adverse-event reporting and harm monitoring were limited. Evidence indicates potential benefits of psycho-educational and brief psychotherapeutic interventions in schools, but further multi-site trials with longer follow-up and robust harm-monitoring protocols are needed, particularly within primary care.