When the Environment Is the Risk Factor: A Narrative Review of Nonsuicidal Self-Injury in Juvenile Detention

Adolescents in juvenile detention facilities self-harm at rates two to three times those documented in community samples, yet the research literature on this population remains sparse, methodologically heterogeneous, and theoretically underdeveloped. This narrative review synthesises current evidence on the prevalence, risk factors, functional correlates, detection practices, and intervention landscape for nonsuicidal self-injury (NSSI) in juvenile detention, with the dual aim of mapping what is known and identifying what the field has not yet asked. Drawing on the first systematic review and meta-analysis in this area (Barker et al., 2024), along with epidemiological, clinical, and qualitative literature, the review describes a population characterised by near-universal adverse childhood experience exposure, high psychiatric comorbidity, and institutional conditions that are themselves risk-amplifying. Emotional dysregulation is the mechanism most consistently documented; the functional model of NSSI (Nock & Prinstein, 2004) provides useful organising concepts but has been applied to detention populations without empirical validation. Five gaps are identified as most consequential for advancing both theory and practice: the absence of validated functional assessment data in this population, the lack of ecological momentary assessment, the absence of longitudinal within-detention trajectory data, insufficient sex-stratified functional analysis, and the theoretical failure to account for how institutional conditions specifically, rather than merely statistically, modify the functions of NSSI.