Self Harm and Suicidal Behaviour

REGULATIONS AND STANDARDS

The Positive Relationships Standard

The Protection of Children Standard

Note: This chapter should be read in conjunction with the West Yorkshire Consortium Safeguarding and Child Protection Procedures.

RELATED INFORMATION AND GUIDANCE

NHS Choices – Self Harm

NHS Choices – Suicide

RELEVANT CHAPTER

Nursing Care and Medication Policy for Children in Residential Care (2016) Procedure

Recognising Abuse and Neglect Guidance

Procedure for Children Missing from Local Authority Care

Notification of Serious Events Procedure

AMENDMENT

Section 2, Planning and Prevention was updated in April 2018 to provide additional guidance for staff on how to respond to young people who are feeling suicidal or who are self harming. A note was also added on the importance of offering appropriate support to staff members and other young people living in the home when incidents of self harm have taken place.


Contents

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


1. Introduction

Many children and young people who come into the ‘looked after’ system will have experienced significant trauma in their lives. Many of 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 high risk situations.


2. Planning and Prevention

As part of Placement Planning, information concerning any previous self harm or suicidal feelings should be gathered, and appropriate risk assessments put in place alongside relevant intervention strategies. See Placements and Admissions Procedure.

The risk assessment and associated strategies should be regularly reviewed and monitored.

In situations where staff are involved with a child 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 aim of reducing or preventing the continuation of the behaviour. These measures 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 the home, as well as staff and family members.

If there are any concerns that a child is self harming or having suicidal thoughts, their 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 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 inform the child’s 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 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 Safeguarding Referral should be made, if so, see 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.

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 staff in residential units 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.

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