School-level differences in self-harm and psychosocial problems associated with self-harm in adolescents
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Date
2026
Authors
McEvoy, David
Brannigan, Ross
Healy, Colm
Dooley, Niamh
Arensman, E.
Clarke, Mary
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Abstract
Background: 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.
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© 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.
Keywords
SDG 4 - Quality Education , Adolescents , Psychosocial problem , Schools , Self-harm , Self-injury , [PublicHealth]
Citation
McEvoy, 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
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