<![CDATA[Self-harm is an emerging public mental health concern among university students, particularly those enrolled in health science programs who are exposed to academic and clinical stressors. Although several international studies have examined the stress–self-harm relationship, empirical evidence from Indonesian health polytechnic students remains limited, especially regarding gender-imbalanced cohorts and early clinical-placement semesters. This study aimed to analyze the relationship between stress levels and self-harm behavior among Nursing and Midwifery students at the Polytechnic of the Ministry of Health, East Kalimantan. A quantitative cross-sectional design with a correlational approach was employed. Respondents were selected through proportionate stratified random sampling from 1,148 active students; 186 respondents met the inclusion criteria and completed the questionnaire. Stress levels were measured using the Indonesian-adapted 14-item stress subscale of the Depression Anxiety Stress Scales (DASS-42; Cronbach's α = 0.87 in the study sample), and self-harm behavior was measured using the Self-Harm Inventory (SHI; 22 items; Cronbach's α = 0.82). Data were analyzed using univariate frequency distribution and bivariate Chi-Square test (α = 0.05), supplemented by the prevalence ratio (PR) to quantify the strength of association. The results showed that 24.2% of respondents experienced severe stress, and 38.2% reported self-harm behavior. Among students with severe stress, 66.7% engaged in self-harm, compared with 24.1% among those with normal stress (PR = 2.77; 95% CI = 1.82–4.21). The Chi-Square test revealed a significant association between stress level and self-harm behavior (p = 0.001). These findings underscore the urgent need for institutionally embedded mental health screening, structured clinical-placement orientation, and cognitive-behavioral coping training to mitigate maladaptive coping among future health professionals.]]>
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