Self Harming and Suicidal Behaviour
Scope of this chapter
Note: This chapter should be read in conjunction with the Local Safeguarding Children Partnership chapter.
Relevant Regulations
Children's Homes Quality Standards 2015: The Positive Relationships Standard
Children's Homes Quality Standards 2015: The Protection of Children Standard
Residential Holiday Schemes for Disabled Children 2013: Events and Notifications; Schedule 5
Related guidance
Many children and young people who come into the 'looked after' system have experienced significant trauma in their lives and are often highly vulnerable. It is likely that these children will sometimes have multiple and complex needs and significant behavioural and emotional difficulties, which can lead to acting in ways that place themselves in situations of high risk.
As part of Placement Planning, relevant information should be gathered and appropriate risk assessments put in place alongside relevant intervention strategies.
This should be regularly reviewed and monitored.
In situation where staff are involved with a child who is actively self-harming or suicidal, they should, in consultation with other members of the team, ensure there is a plan to manage the effects such as distress or grief, that an incident of self-harm or suicide may cause other workers, family members and other children and young people in the setting.
All reasonable measures should be taken to reduce or prevent continuation of the behaviour including confiscation of any item used to execute the self-injury. The most effective preventative approach involves teaching young people alternative coping mechanisms. If there is a risk of self-injury, a risk management plan must always be agreed with the Social Worker (and the parent within the scheme of delegation as set out in the Placement Plan) at the earliest point that the risk is identified. Referral to CYPMHS is a priority action where risk is identified and we will always work closely with CYPMHS adopting a joint risk assessment and management plan approach.
Some young people, in agreement with CYPMHS, the social worker, the parent within the scheme of delegation and within the framework of a joint plan/ risk assessment, may be taught to 'own' their own self injury, provided with a bespoke self-injury care plan, and in some circumstances provided with a safer cutting kit. However this approach must only be practised where agreed by all parties and constantly informed by access to specialist advice and support from CYPMHS.
Where there are serious concerns about the mental health of a child or young person, urgent medical advice will always be sought and a mental health assessment requested under the Mental Health Act 1983.
Residential Family Centres must have arrangements in place with local primary health care services and work in co-operation with health agencies, including specialist services such as mental and sexual health so that parents and children have the services they need. Please note the notification requirement as per Section 4.2, Notifications of Serious or 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.
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 Child Protection Referral should be made, if so, see Referring Safeguarding Concerns Procedure.
The Designated Safeguarding Manager should also be notified and consideration given to whether the incident is a Notifiable Event, see Notification of Serious Events Procedure.
In the case of residential family centres, there is a requirement under the National Minimum Standards for the registered manager to have a system for notification to responsible authorities of any serious concerns about the emotional or mental health of a parent or child such that a mental health assessment would be requested under the Mental Health Act 1983.
An Incident Report must also be completed.
If First Aid is administered, details must be recorded.
The child's Risk Assessment and Management Plan must be reviewed at agreed intervals with a view to incorporating strategies to reduce or prevent future incidents.
Statutory Guidance and Government Non-Statutory Guidance
Suicide Prevention Strategy for England
Suicide Prevention: Resources and Guidance
Self-harm: Assessment, Management and Preventing Recurrence NICE Guidance
Useful Websites
Last Updated: June 10, 2024
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