Lived experiences of primary caregivers supporting adolescents with non-suicidal self-injury: a qualitative systematic review protocol

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NSSI among adolescents is a growing concern; primary caregivers experience emotional distress, psychological strain and disrupted family dynamics, underscoring need for family centred interventions.
Systematic review of qualitative studies will synthesise caregivers' lived experiences across English and Chinese literature using meta aggregation and ConQual to assess confidence.
No ethical approval required for this secondary data review; findings will be published and presented; registered on PROSPERO CRD420251113508.

BMJ Open. 2026 May 20;16(5):e112342. doi: 10.1136/bmjopen-2025-112342.

ABSTRACT

INTRODUCTION: Non-suicidal self-injury (NSSI) is a growing mental health concern among adolescents. While not intended as a suicidal act, it has significant implications for individuals and families. Primary caregivers, often the frontline support, face emotional distress, psychological strain and disrupted family dynamics. However, most research has centred on adolescents leaving a critical gap in understanding caregivers’ perspectives. Addressing this gap is essential for developing effective, family-centred interventions.

METHODS AND ANALYSIS: This review will include original qualitative studies examining the lived experiences of primary caregivers supporting adolescents who engage in NSSI. Studies must address caregivers’ emotional responses, psychological impacts, changes in family relationships and their perspectives on mental health service needs. There will be no restrictions on settings, geographic locations or sample sizes. Research published in both English and Chinese will be included with no restrictions on the starting year up to 31 December 2025. Systematic searches will be conducted across several databases, including PubMed, Embase, CINAHL, PsycINFO, Web of Science, CNKI, Wanfang Data and CBM and reference lists and grey literature will also be reviewed. Two independent reviewers will screen studies, assess their methodological quality, and extract relevant data. The data will be synthesised using meta-aggregation, and the ConQual approach will be used to evaluate the confidence in the synthesised findings.

ETHICS AND DISSEMINATION: This systematic review will not require ethical approval, as it will only include secondary data from previously published studies. The findings will be disseminated through publication in a peer-reviewed journal and presented at relevant academic conferences to inform both research and clinical practice.

PROSPERO REGISTRATION NUMBER: CRD420251113508.

PMID:42161539 | DOI:10.1136/bmjopen-2025-112342

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