As Melannie Litscher and her Milwaukee Public Schools colleagues were researching best practices for working with teens who engage in nonsuicidal self-injury, one name kept popping up in the literature — Dr. Jennifer Muehlenkamp.
When Litscher googled the often-published and highly respected international expert, she was surprised to discover that Muehlenkamp was just a few hours away, a psychology professor at UW-Eau Claire.
Even more surprising to her?
Muehlenkamp’s willingness to help MPS staff create evidence-based processes and protocols to guide them as they work with students engaging in NSSI behaviors in their schools.
“I sent her an email thinking a person as busy and renowned as she would not reply,” Litscher, a school psychologist at an MPS high school, says of Muehlenkamp. “She did reply, and she offered her consultation services to us freely.
“Then, at the beginning of the following school year, after we had developed our protocol for the assessment and management of NSSI alongside Jennifer, she presented to nearly 500 pupil services staff in the district about the topic.”
NSSI is a behavior that involves someone — often teens and young adults — purposely cutting, bruising, burning or in some other way injuring themselves without intending to die.
It’s estimated that approximately 20% of middle and high school students engage in some form of NSSI behavior, says Muehlenkamp, noting that the behavior often begins in early adolescence and can continue into young adulthood.
Reasons for engaging in NSSI behaviors vary, but young people, regardless of socioeconomic status, gender or ethnicity, may self-injure to cope with stress or to distract themselves from emotional pain. Teens with low self-esteem or who have issues with depression or anxiety also are thought to be more likely to self-injure.
At MPS — a large district with more than 70,000 students — staff have long interacted with students who engage in NSSI behaviors. While staff always assessed and managed the situations to the best of their abilities, many felt underprepared or unqualified to intervene effectively, Litscher says.
However, with Muehlenkamp’s help, MPS now has a best practices-based protocol in place, helping staff feel more confident as they work with students engaging in these behaviors, Litscher says.
“As a result of Jennifer’s contributions to our district, we have gotten reports from our staff that they feel better equipped to address the issue of NSSI,” Litscher says. “They have knowledge and skills they can and do readily use on a daily basis.”
During the 2018-19 school year, the new protocol was used more than 400 times by MPS staff, Litscher says, noting that she expects that number to grow as additional staff become familiar with it.
“School staff are naturally wary of anything ‘new’ as education best-practices can change so frequently,” Litscher says. “Having Jennifer, a world-renowned expert in the topic, endorse our work and offer her expertise to our staff was essential for getting buy-in.
“I believe that with the consultation and knowledge Jennifer offered MPS, we have set a new standard in the assessment and management of NSSI in school settings.”
The MPS’s NSSI protocol was featured at the 2019 Prevent Suicide Wisconsin conference, helping even more school districts increase their knowledge about best practices for responding to NSSI.
Given that nearly one in four teens engage in NSSI behaviors, interest among school psychologists and other school staff is high.
“It’s definitely on their radar,” says Muehlenkamp, who has consulted with numerous Wisconsin school districts and communities. “There isn’t a school in the U.S. that hasn’t had to deal with NSSI. The extent to which they deal with it varies, but it is in every school.”
Muehlenkamp says friends or siblings often know that a teen is engaging in self-injury behaviors, and many of them alert a teacher or another adult at the school about the behavior.
Since few graduate or other professional training programs adequately address NSSI, most school personnel don’t know how to best assess and support students who engage in self-injury behaviors, Muehlenkamp says.
“Schools are desperate for this information because they know that the sooner they can identify NSSI and intervene, the less likely it is that the behavior will persist and become a chronic problem,” Muehlenkamp says.
There is no one-size-fits-all NSSI protocol because needs and resources vary by district, she says.
After all, one school might have school psychologists, social workers, school nurses and other staff available to provide therapy to students at school, while another district may have only limited support staff available, so on-site therapy isn’t an option, she says.
“I share best practices with them, and then we transfer those to the specific school, so they can practice them in a way that works for them,” Muehlenkamp says.
Her work with school districts is important because it helps to create safe spaces for young people who are struggling with a variety of issues, including NSSI, Muehlenkamp says.
“It’s important for school staff to know what this behavior is and what it is not, so they can help make students feel supported,” Muehlenkamp says. “Schools need to be a safe space for students. Teens are more likely to talk about it and seek help if they know adults will support them and not be judgmental or overreact.”
Best practices include things like assessing a student without being judgmental, ensuring the teen is an equal partner in the problem-solving and decision-making, bringing parents and other allies into the discussion, and only having a medical professional examine any severe wounds that may require medical intervention, Muehlenkamp says.
It’s also critical that adults don’t overreact when they learn of NSSI behaviors, she says. Most NSSI-related injuries are not severe, so teens often are more in need of learning new coping skills than they are of immediate medical attention to treat the wound, she says.
“The goal is to help them find healthier ways to deal with stress,” Muehlenkamp says of addressing NSSI.
Muehlenkamp’s work with MPS and other Wisconsin schools was among her many contributions on and off campus that were noted as she was awarded UW-Eau Claire’s 2019 Excellence in Service Award.
Award nominators described the breadth and depth of Muehlenkamp’s service as “staggering,” noting that she also regularly shares her expertise with law enforcement agencies, health departments and others.
Professionals like Litscher are grateful for Muehlenkamp’s expertise as well as her willingness to share her knowledge in ways that benefit people across Wisconsin and beyond.
“As a graduate of the UW system, it makes me feel very proud of our universities to know that an expert like Jennifer is in our backyard,” Litscher says. “Wisconsin is so fortunate to have her, and our schools and children have benefited from her work and generosity with her expertise.
“It was clear from the beginning that Jennifer only had good intentions with her work — she truly wants to improve the lives of individuals who are experiencing their darkest moments.”
Photo caption: Dr. Jennifer Muehlenkamp is sharing her expertise with school districts across Wisconsin.