Self Harm and Suicidal Behaviour

Contents

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

1. 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, the misuse of alcohol and drugs, self neglect, eating disorders, unsafe sexual behaviour and other forms of risk taking, such as dangerous driving, are not generally classified as self-harm.

If a child is self harming, this should be addressed according to the strategies set out in any existing plan, for example, in the child's Placement Plan.

If no plan or strategy exists, staff in the unit should take measures to reduce or prevent continuation of the behaviour. This may include providing additional supervision, 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.

The child / young person’s social worker must be informed, and a risk assessment undertaken with a view to deciding whether a Strategy should be adopted to reduce or prevent the behaviour. Any such strategy should be included in the child's Placement Plan.

If necessary, specialist advice or support should be sought.

2. Notifications, Recording and Review

2.1 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.

2.2 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 Designated Manager (Self Harming) should also be notified and consideration given to whether the incident is a Notifiable Event, see Notifications of Serious Events Procedure.

2.3 Recording and Review

All self harming must be recorded in the Home's Daily Log and relevant child's Daily Record. If First Aid is administered, details must be recorded.

A serious incident of self harm is likely to constitute a notifiable event (see Section 2.2, Notifications of Serious or Persistent Self Harming). 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 and, where necessary, strategies to reduce or prevent future incidents should be detailed.

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