Self Harm and Suicidal Behaviour

1. Introduction

Many children and young people who are in our care will have experienced significant trauma in their lives. It is possible that they will have multiple and complex needs and there may be behavioural and emotional worries about the child/young person

2. Planning and Prevention

As part of Placement Planning, worries about any previous self harm or suicidal feelings should be assessed, considered within the Harm Matrix, and appropriate risk assessments put in place alongside any safety planning for the child/young person. See Placements and Admissions Procedure. The assessment and plan for the child/young person should be regularly reviewed and monitored.

In situations where staff are involved with a child or young person who is actively self-harming or feeling suicidal, they should, in consultation with other members of the team, ensure that all reasonable measures are taken to support the young person with the aim of reducing or preventing the continuation of the behaviour. These measures may include safety planning for the child/young person, 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 attempted 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 or young person is self-harming or having suicidal thoughts, 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 Placement Plan.

Specialist advice or support (for example from CYPMHS) should be sought. Where specialist stakeholders do not engage within expected timescales, the registered manager should employ the Escalation Policy.

The registered manager will ensure that the staff team receive training which explains why a child or young person may self-harm. This would include the theory of transference of psychological and emotional pain and trauma into physical manifestation, so that the child or young person feels more able to cope. Specialist support from health colleagues should be sought to assist with this learning and with the development of care planning including safety planning that helps to manage any prolonged self-harming.

The registered manager should consider additional training for the staff team, including suicide prevention from such as the branch of the MIND charity closest to the home. Ligature training should also be completed at regular intervals. The registered manager should consider any support the staff team require following their care of children and young people during incidents of self-harm.

See also: Mind - Supporting Someone Who Feels Suicidal.

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 registered manager at the first opportunity, who will then decide whether to inform the relevant social worker.

3.2 Notifications of Serious or Persistent Self Harming or Attempted Suicide

Serious or persistent self-harming or attempted suicide must be notified immediately to the registered 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.

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 and the safety plan and risk matrix updated. Consideration should also be given to update of the safety plans of other children and young people who may be affected by the incident.

If First Aid is administered, details must be recorded.

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 children's home staff 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 or young person.

The child or young person's Placement Plan should be reviewed with a view to incorporating strategies to reduce or prevent future incidents.