Self Harm

Contents

1. Introduction
2. Planning and Prevention
3. Notifications, Recording and Review
   
   Further Information

1. Introduction

Many children and young people who come into the ‘looked after’ system will have experienced significant trauma in their lives. It is likely that these children will have multiple and complex needs and behavioural and emotional difficulties, which can lead to them acting in ways that place themselves in situations of high risk.

2. Planning and Prevention

Broadly defined, self-harm refers to the deliberate attempt to physically injure oneself without causing death. This can include self-mutilation (e.g. cutting behaviours), self-poisoning, burning, scalding, banging, and hair-pulling.

Although clearly damaging, alcohol and drugs misuse, eating disorders, unsafe sex and other excessively risky behaviour, such as dangerous driving, are not generally classified as self-harm. If a child is suspected or found to be self harming, the Strategies that should be taken are those determined by any existing plan, for example, in the child's Individual Care and Placement Plan.

I If no strategy or plan exists, all reasonable measures should be taken to reduce or prevent continuation of the behaviour.

This may include providing additional supervision and support, referral to specialist agencies, confiscation of materials that may be used to self harm or, as a last resort, use of physical intervention or calling for assistance from the Emergency Services.

A plan should also be developed to manage any impact that an incident of self-harm or suicide may have on other children and young people in home, as well as staff and family members.

If there are any concerns that a child is self harming, the social worker must be informed and a risk assessment undertaken (if it does not already exist) with a view to deciding whether a strategy should be adopted to reduce or prevent the behaviour. That strategy should be included in the child's Individual Care and Placement Plan.

Specialist advice or support (for example from CAMHS) should be sought.

3. Notifications, Recording and Review

3.1 Notifications of Minor or Non Persistent Self Harming

Minor or non persistent self-harming should be notified to the manager at the first opportunity; the manager will decide whether to inform the relevant social worker.

3.2 Notifications of Serious or Persistent Self Harming

Serious or persistent self harming must be notified immediately to the home's manager and the relevant social worker notified within 1 working day - the social worker should be consulted and consideration given to whether a Child Protection Referral should be made, if so, see Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

The home’s allocated Child Protection Manager should also be notified, and consideration should be given as to whether the incident is a Notifiable Event, see Notification of Serious Events Procedure.

3.3 Recording and Review

All self harming must be recorded in the Home's Daily Log and relevant child's Daily Record.

An Incident Report must also be completed.

If First Aid is administered, details must be recorded.

The child's Individual Care and Placement Plan and Safe Care Plan (risk assessment) should be reviewed with a view to incorporating strategies to reduce or prevent future incidents.

A serious incident of self harm is likely to constitute a notifiable event (see Section 3.2, Notifications of Serious or Persistent Self Harming or Attempted Suicide). However, it is important that staff in children’s homes consider the frequency of any self harm incidents and judge whether their cumulative effect makes notification appropriate even if in isolation each event would not warrant this. In particular staff should be alert to any patterns of behaviour or unusual behaviour which may indicate an increased risk to the child.

3.4 Debrief for Staff

Understandably witnessing and dealing with self-harming behaviour can be traumatic for staff. It is important that staff are supported and receive a de-brief, following incidents of self harm, from managers to off load. This should also be discussed in supervision, reflective practice sessions and within professionals meetings.

It is important that strategies are discussed in how best to support the young person as a whole team as well as an individual worker.

Safe Care Plans/Risk Assessments should be updated regularly to take account of any changes of behaviours and positive interactions that work well.

Further Information

Statutory Guidance and Government Non-Statutory Guidance

Suicide Prevention Strategy for England

Suicide Prevention: Resources and Guidance

Good Practice Guidance

Self-harm: Assessment, Management and Preventing Recurrence NICE Guidance

Useful Websites

Mind

The Mix - Essential Support for Under 25s

National Self Harm Network

Papyrus

Young Minds

NHS Choices – Self Harm

NHS Choices – Suicide

Self Harm in Young People: For Parents and Carers