Fig. 2

Overarching Staff and Student Themes and Meta-themes. Concepts, vernacular and metaphors were mapped and compared across study to develop over-arching thematic descriptions of the data presented within and between individual studies. These themes retained the distinction between staff and student data sources. Presented staff-level themes are: lack of staff awareness; absence from curriculum; definitions, understandings and judgements around self-harm and suicide; staff reactions during intervention; confidence and competence to intervene; and challenging peer relationships. Presented student-level themes are: lack of staff awareness; absence from curriculum; student-staff relationships; stress and anxiety; challenging peer relationships. Meta-themes were generated through the process of reciprocal translation in order to generate more rounded and nuanced themes that integrated both staff and student data. Presented meta-themes are: a hidden health harm; the intersection of discourses around schooling and self-harm; school management strategies; the pressure to perform; and tension and negotiations within peer relationships