Self-Harming and Suicidal Behaviour
Scope of this chapter
This chapter should be read in conjunction with the Multi-Agency Safeguarding Children Procedures for your area.
Relevant Regulations
Regulation 20 Supported Accommodation (England) Regulations 2023
Many 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 young people 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.
NICE guidelines define self-harm as "self-poisoning or self-injury, irrespective of the apparent purpose of the act".
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 situations where staff are involved with a young person 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 young people in the setting.
All reasonable measures should be taken 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.
If there is any suspicion that the young person may be involved in self harming or any attempts of suicide, 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 young person's Placement Plan.
Staff should support the young person to access suitable professional support to help keep the young person safe and to help the young person to better understand their previous experiences and behaviours of self-harm (where applicable).
The young person should be involved in decision making around any changes to their support package and living arrangements.
Staff should keep appropriate records of self-harming incidents and share relevant information and decisions with the young person’s accommodating authority and other relevant professionals.
Minor or non-persistent self-harming should be notified to the registered person at the first opportunity; the registered person will decide whether to inform the relevant social worker.
Serious or persistent self-harming or attempted suicide must be notified immediately to the registered person 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 Young People and Referring Safeguarding Concerns Procedure.
All self-harming must be recorded.
If First Aid is administered, details must be recorded.
The Placement Plan should be reviewed with a view to incorporating strategies to reduce or prevent future incidents.
Whilst the person who has harmed will understandably be the focus of the response, those who have witnessed the harm and its aftermath will also require support. It is essential that staff receive a debrief and have the opportunity to discuss their feelings with the management.
All young people will require key care sessions to explore any additional support that they may need.
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: February 20, 2023
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