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Prompt Sheet For People Working With Children Who Have Self-Harmed Or Have The Potential For Suicide

Immediate Response -

  • Show appropriate concern and reassurance; allow the young person to talk.
  • Ensure immediate safety and necessary medical treatment is applied.
  • Being sympathetic will not reinforce the behaviour. A punitive or dismissive response will increase the risks for the young person.

Messages to give young people -

  • Remain calm and demonstrate concern for the distress which lies behind the self harm
  • Acceptance - it is ok to talk about self harm; it is something you know about and can handle
  • Acknowledgement - that it is hard to talk about and takes courage
  • Understanding - there are reasons why people self harm and other people do it too
  • Respect and Reassurance - acknowledge the need for this coping strategy and the fear that results if it is taken away from them
  • Hope - it is possible to stop self harming; with help lots or people achieve this
  • Information - Give information about help and support but be emotionally available and let the young person talk before you give messages that 'expert/specialist' help is needed
  • Confidentiality - respect confidentiality within safeguarding procedures. Be clear and why and how you may need to share information with another person. This will include parents unless to do so may place the young person at further risk of harm. See also Information Sharing Procedure.

Starting to assess self-harm - issues to consider -

  • Suicidal thoughts, feelings and intent
  • Levels of distress
  • Previous self harm
  • Nature of harm caused
  • Other self harming behaviours - drug/alcohol use, eating disorders etc
  • Context of the self harm
  • Other reasons for the self harm
  • Meaning to the young person
  • Current problems faced
  • Available resources and support
  • Safety issues for the young person
  • Attitude to help
  • Consent and competency
  • Links to abuse or neglect

What to do next -

  • Record the incident in detail
  • Inform parents/carers (having considered consent, confidentiality and possible further harm to the young person)
  • Consider evidence of links to potential abuse/neglect and refer to Children's Social Care as necessary
  • Give explicit consideration to a referral to Children's Social Care and CAMHS/AMHS where a young person has expressed suicidal intent and/or has been admitted to hospital following an episode of self-harm
  • Consider what support is available within your own agency/establishment and via other agencies
  • Establish ongoing links between your agency, the young person, their parents and support agencies