Introduction: Adolescents who present to emergency departments (ED) following intentional injuries present a challenge in terms of ascertaining their intent and risk for future self-injurious or suicidal behaviour. Our ED has seen an 80% increase in visits for mental health issues over the past ten years. As usage of our Emergency Mental Health and Addictions Services (EMHAS) team continues to rise, it is increasingly important to understand the incidence of NSSI among our youth, explore if NSSI is reported at triage and identify characteristics that may distinguish these adolescents from others presenting for mental health assessment. Methods: This is an exploratory research study using retrospective data. Patients who had an Emergency Mental Health Triage (EMHT) form on their health record from an ED visit between June 1, 2017 and May 31, 2018 were eligible. Trained research assistants, using a structured data collection form in REDCap. abstracted data from the EMHT form, the EMHAS Assessment form, the Assessment of Suicide Risk Inventory and our CHIRPP (Canadian Hospitals Injury Reporting and Prevention Program) database. We calculated kappa values and 95% confidence intervals to describe the extent to which the forms agree with respect to identifying NSSI. We will compare the cohort who reports NSSI with the cohort who does not report NSSI using chi-square statistics depending. We will use descriptive statistics to characterize the NSSI patients. Results: During the one-year study period 955 patients had an EMHT form completed. In preliminary analysis 558 (58.4%) reported a history of NSSI. Patients reported NSSI on both the EMHT form and the EMHAS assessment form 64.7% of the time (kappa 0.56) indicating moderate agreement. In patients with NSSI, 9.5% of patients reported it only at triage and 25.8% of patients reported it only during their EMHAS assessment. Between group comparisons and descriptive analysis is underway. Conclusion: More than half of youth triaged with an emergency mental health complaint in our ED reported a history of NSSI. Screening at triage was moderately effective in identifying adolescents with NSSI compared to an in-depth assessment by the mental health team. Further research is needed to clarify how NSSI relates to risk for suicide.

Conducted with a community sample, this study first tested the hypothesis that the constant association of Non-Suicidal Self Injury (NSSI) with various psychopathological states may be overrepresented because many of the studies reporting these associations used clinical samples. Secondly, the study aimed to test the emotional regulation model of NSSI by exploring the functions, the affective antecedents and consequences of NSSI episodes and to understand this emotion regulation role of NSSI in the light of Attachment Theory by differentiating self-injurers and non-self-injurers on relevant romantic attachment dimensions. A third purpose of this study was to test the hypothesis that individuals currently performing NSSI could be differentiated on these dimensions from those who had ceased engaging in NSSI. Pursuing these purposes, 518 university students (171 males and 347 females), aged 17 to 62 years old completed the Self-Injury Questionnaire – Treatment Related (Claes & Vandereycken, 2007), the Brief Symptom Inventory (Derogatis, 1982) and the Adult Attachment Scale (Collins & Read, 1990). Individuals with NSSI scored significantly higher on all BSI subscales (all p < .001). Results also revealed the existence of significant differences between participants with and without NSSI on Anxiety (Z = –2.92, p < .01) and Comfort with Proximity (Z = –3.18, p < .01), and significant differences between past self-injurers and current self-injurers on Trust in Others (Z = –2.40, p < .05). These results are discussed by linking NSSI and Attachment Theory literatures.