Bowden, LindaFortune, SarahHetrick, Sarah ElisabethMeinhardt, IngeDonkin, Liesje2026-05-212026-05-212026-04-30School Mental Health, ISSN: 1866-2625 (Print); 1866-2633 (Online), Springer Science and Business Media LLC, 1-34. doi: 10.1007/s12310-026-09871-51866-26251866-2633http://hdl.handle.net/10292/21169Self-harm rates among adolescents continue to increase globally, placing an increased demand on schools to respond to and manage young people who engage in self-harm. Schools in developed countries report being ill-equipped to manage self-harm, and unsure of how to use the evidence available to guide them. The methods used in this systematic review are based on Cochrane methodology. We conducted a search of peer-reviewed publications from three databases; PsycINFO, (OVID) MEDLINE and EMBASE published in English from 1990 until 30 September 2022 and completed a grey literature search via Google. Two authors (LB and SH) extracted data from publications that provides guidance, actions and/or recommendations to school-based professionals (any school staff including school pastoral care) on the management of self-harm. The breadth of recommendations made to schools are discussed. Studies suggest schools need specific advice about role and responsibility to effectively respond to and manage self-harm in school settings. Evidenced based, action-oriented guidelines for schools to respond to self-harm is required.Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.https://creativecommons.org/licenses/by/4.0/5201 Applied and Developmental Psychology5203 Clinical and Health Psychology39 Education3904 Specialist Studies In Education52 PsychologyPediatric Research Initiative3904 Specialist studies in educationSelf-harmSuicide preventionSchoolPracticeGuidelinesYouthJournal ArticleOpenAccess10.1007/s12310-026-09871-5