青少年非自杀性自伤披露后的照护路径：一项二元质性研究

ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Adolescent and Young Adult Psychiatry

• Shaoxing Seventh People's Hospital, Shaoxing, China

Abstract

Introduction: Adolescents with non-suicidal self-injury (NSSI) often move between family, school, and mental health services after disclosure, but the care pathways shaping psychiatric service engagement and continuity remain poorly understood. Methods: We conducted a dyadic qualitative study using semi-structured interviews with 20 adolescents (14-17 years) with a history of NSSI and 20 caregivers in Shaoxing, China. Reflexive thematic analysis was combined with socioecological journey mapping to reconstruct post-disclosure care trajectories across individual, family, school, and health-system contexts. Results: Analysis identified a six-stage care pathway from accumulated distress and concealed NSSI to discovery, multi-system service entry, treatment engagement, and continuing care needs. The key transition was the point at which NSSI became visible to others. Participants described post-disclosure responses as important contexts associated with more stabilising or fragmented care trajectories. Adolescents emphasised shame, exposure, and uncertainty, whereas caregivers described fear, guilt, and difficulty identifying appropriate help. Continuity depended on emotional safety, caregiver reframing, school referral, clear service navigation, and follow-up planning. Discussion: Disclosure or discovery of adolescent NSSI is a clinically important transition that shapes subsequent psychiatric service engagement and continuity of care. Coordinated responses across families, schools, and mental health services may help transform disclosure from a crisis event into a pathway toward sustained support.

Keywords

Adolescent, Caregivers, continuity of care, Help-seeking, Non-suicidal self-injury, Psychiatric services, qualitative research

Received

10 July 2026

Accepted

20 September 2026

Copyright

© 2026 Fang, Xu, Qian, Qian and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence:

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