Bridge to Better: Preventing self-harm in NSW primary schools

The Challenge

Self-harm is a significant risk factor for suicide and affects around 17% of adolescents aged 12–18 years. In NSW, adolescents aged 13–17 are presenting to hospitals at disproportionately high rates, highlighting the need for prevention during late childhood/early adolescence (ages 8–12).

Universal prevention, targeting all children regardless of risk, is most effective because it is difficult to predict who will go on to self-harm. Prevention strategies focus on strengthening emotion regulation and social connectedness across the two settings children spend most of their time - school and home.

Schools provide an ideal setting to deliver prevention programs at scale, as socio-emotional learning is embedded in the Australian curriculum. Parental involvement is also crucial, as parental support is the leading protective factor for self-harm risk. Despite growing demand from educators and parents, few evidence-based programs exist, and none take a multimodal approach involving students, teachers, and parents. 

To address this gap, the Black Dog Institute (BDI) partnered with Orygen Youth Mental Health to co-design and trial a novel, multimodal self-harm prevention program, Bridge to Better (B2B). To involve parents in the prevention effort, BDI is co-developing a complementary web-based intervention, Parenting 2 Prevent (P2P), in parallel. 

Program Overview 

B2B is an evidence-based self-harm prevention program for children aged 8–12 (Years 3–6) in NSW primary schools. The hybrid intervention combines skills training, video animations, and interactive activities in the classroom to build emotion regulation ability and strengthen school connectedness. Its multimodal design engages children, teachers, and parents to provide wraparound support and build protective factors, early.

To support delivery of the program, teachers complete 14 self-directed online training modules and receive comprehensive print and digital resources. Parents access P2P, a web-based platform with information and training modules, to reinforce child emotion regulation strategies and support connectedness at home.

The aim is to deliver a universal, evidence-based solution to prevent self-harm in childhood, reducing the risk of suicide and mental illness across the life course.

Measuring Impact

Hearts & Minds measures its impact across six core categories as developed by the Association of Australian Medical Research Institutes. This project demonstrates excellence across multiple areas:

• Advancing knowledge: B2B will contribute robust evidence on multimodal, universal self-harm prevention for primary school-aged children.
• Health impacts: By targeting emotion regulation and social connectedness early, the program will address key risk factors for self-harm and build long-term protective skills.
• Informing decisions: The trial provides actionable insights for schools, educators, and policymakers on delivering effective, scalable self-harm prevention programs.
• Economic and social impact: A universal, evidence-based program has the potential to reduce future mental health service use and improve wellbeing across communities.

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Bridge to Better represents a significant step forward in child and adolescent mental health and suicide prevention. By combining evidence-based strategies with a multimodal design, the program is improving children’s emotional skills, supporting parents and teachers, and generating actionable insights that can shape future self-harm prevention efforts across Australia.

Funding support from Hearts and Minds Investments, as nominated by Core Fund Manager, Tribeca Investment Partners.  

This content was last updated in August 2025. For further information and updates, visit Black Dog Institute.