School staff have a unique opportunity to detect and respond to mental health issues including self-harm and suicidal behaviour in adolescents. There is limited knowledge about how these incidents are managed in schools. This study aims to understand the incidence rates, perceived severity and management of self-harm and suicidal behaviour incidents by schools. A total of 1525 school incidents were analysed for rate, severity and response. Pearson’s χ² test was used to understand incident rates of self-harm and suicidal behaviours compared to all other incidents, and if incident category was related to emergency service involvement. A Kruskal–Wallis ANOVA analysed differences in severity ratings for incidents, and relative risk ratios determined the probability that first responder services will be engaged in self-harm and suicidal behaviour incidents. Self-harm and suicidal behaviour incidents (n = 77) accounted for 5.05% of all incidents and were more likely to be rated highly severe compared to other incidents. Incidents of self-harm and suicidal behaviours were 1.43 times more likely to have police involvement and 8.37 times more likely to have ambulance involvement compared to other incidents that caused harm to students, staff or property including welfare and violence incidents. The findings highlight the severity of reportable self-harm and suicidal behaviour incidents as they required an emergency response. We discuss the potential missed opportunity for early intervention by school staff and services, which may hinder future disclosure or help-seeking by at-risk young people. Training of school staff may provide knowledge and confidence to respond appropriately to self-harm and suicidal behaviour incidents and prevent escalation requiring emergency intervention.

学校工作人员有独特的机会来发现和应对青少年的心理健康问题，包括自我伤害和自杀行为。关于在学校如何处理这些事件的知识很少。这项研究的目的是了解学校的自残和自杀行为事件的发生率，感知的严重性和处理。总共分析了1525起学校事件的发生率，严重性和响应。Pearson的χ ²测试用于了解与所有其他事件相比的自残和自杀行为的发生率，以及事件类别是否与紧急服务部门有关。Kruskal-Wallis方差分析分析了事件严重性等级的差异，并且相对风险比确定了第一响应者服务将从事自残和自杀行为事件的可能性。自我伤害和自杀行为的事件（ñ = 77）占所有事件的5.05％，与其他事件相比，该事件被定为高度严重。与其他对学生，教职员工或财产造成伤害的事件（包括福利和暴力事件）相比，发生自残和自杀行为的警察参与警察的可能性高1.43倍，参与救护车的可能性高8.37倍。这些发现突出了可报告的自我伤害和自杀行为事件的严重性，因为它们需要紧急响应。我们讨论了学校工作人员和服务人员可能错过的早期干预的潜在机会，这可能会阻止将来有风险的年轻人公开或寻求帮助。