Non-suicidal self-injury and suicidal behaviours among children and adolescents: The role of adverse childhood experiences and bullying victimization.

This three-paper dissertation examined non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings in Ontario, and the association between suicidal behaviours and referral for mental health services among children involved in the child welfare system in Ontario. The first paper examined the effect of adverse childhood experiences on non-suicidal self-injury. The results of this paper indicated that children and
adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts.

The second paper examined the effect of bullying victimization on non-suicidal self-injury and the mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self injury among adolescents. The results indicated that the effect of bullying victimization on nonsuicidal self-injury was partially mediated by depressive symptoms after adjusting for the effect of demographic characteristics, number of childhood abuse, social support, and mental health diagnoses.

The third paper examined the association between suicidal behaviours and referral for mental health services among children involved in the Child Welfare System in Ontario. Data for this paper were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. Results indicated that children who expressed suicidal thoughts had more than twice the odds of being referred for mental health services and children who engaged in self-harm behaviour had 44% higher odds of being referred for mental health services. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of maltreatment, should also take into account non-suicidal self-injury. The dissertation concludes by summarizing the results and implications for social work and children‘s mental health research.