Self Harm and Suicidal Behaviour


Contents

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


1. Introduction

Many children and young people who are Looked After will have experienced significant trauma in their lives. Some of these will have multiple and complex needs, as well as behavioural and emotional difficulties.

Integrated Treatment Model (ITM) Homes

Within the ITM Homes, we have a specific protocol on how to respond to self-harm that adheres to the DBT program. This will be followed in situations where self-harm has occurred, we ensure other professionals are aware of this to reduce the likelihood of reinforcing this behaviour.


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 and Risk Assessment Proformas.

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 home, as well as staff and family members.

If there are any concerns that a child 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.


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 Children’s Homes 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 or Attempted Suicide

Serious or persistent self-harming or attempted suicide must be notified immediately to the Registered Children’s Homes 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.

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 children’s homes also 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.

All residential staff should undertake the Ligature training provided by our workforce development team.