Self-Harming and Suicidal Behaviour
Scope of this chapter
Note: This chapter should be read in conjunction with the Multi-Agency Safeguarding Children Procedures for the area.
Relevant Regulations
Related guidance
- First Aid, Home Remedies and Medication
- Recognising Abuse and Neglect
- Missing Children
- Notification of Serious Events
Amendment
This chapter was updated in June 2024.
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 the admissions process, there should be consideration to self-harming behaviours and there should be appropriate strategies and risk assessments in place to support the children and young people who self-harm. If there is no plan in place, or this is a new behaviour for the children or young people, then appropriate measures must be in place and implemented. This may result in supervision of children and young people, removal of sharp objects or items of risk. When a room search is undertaken, this must be in line with the Room Search Policy.
Where Risk Assessments are in place, this must be updated regularly and reviewed as there are new behaviours or changes in risk(s). These must be shared with the children and young people’s key teams including health services, social workers, and staff within the home. In the event of self-harm, there must be consideration of a strategy meeting.
Where services are involved to support the children and young people, they must be kept updates. There may also be a requirement for referrals to be completed if the support services are not already in place.
In situations 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.
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 child 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 child's Placement Plan.
If necessary, specialist advice or support should be sought.
When there are minor or non-persistent self-harming behaviours, this should be notified to the homes manager, and must be recorded accordingly including a Body Map. This information must also be shared with the 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 (or out of hours (EDT) Teams) 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.
See Notification of Serious Events Procedure. The homes manager will also consider whether a Regulation 40 notification needs to be completed and opened as a safeguarding matter and recorded as such (This may also be due to a number of incidents, rather than one singular event). It is likely when there is significant self harm or suicidal behaviours, it is likely to be notifiable. When there is an admission to hospital, it is likely that this will be a notifiable event (Regulation 40) to Ofsted.
Any form of Self-Harm is not to be recorded as an “Accident;” it is essential that this is recorded in the daily logs and body maps. When there is persistent and regular self harm, it may be appropriate for a Self-Harm record to be created.
An Incident Report must also be completed.
If First Aid is administered, details must be recorded.
As identified above, when there are self-harming or suicidal behaviours, these must be recorded within risk assessments and plans accordingly and reviewed regularly or as the needs change. This must be shared with the social care and health teams.
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
Good Practice Guidance
Useful Websites
Last Updated: June 13, 2024
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