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5.7 Self Harm and Suicidal Behaviour

REGULATIONS AND STANDARDS

The Positive Relationships Standard

The Protection of Children Standard

Note: This chapter should be read in conjunction with the relevant Nottingham City Safeguarding Children Board Procedures Manual.

RELATED INFORMATION AND GUIDANCE

NHS Choices – Self Harm

NHS Choices – Suicide

RELEVANT CHAPTERS

First Aid, Home Remedies and Medication Procedure

Recognising Abuse and Neglect Guidance

Children Who Go Missing from Home and Care - Joint Procedure

Notification of Serious Events Procedure

AMENDMENT

In May 2018, this chapter replaced the previous chapter and should be re-read in its entirety.


Contents

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


1. Introduction

Many children and young people who come into the ‘looked after’ system will have experienced significant trauma in their lives. It is likely that these children will have multiple and complex needs and behavioural and emotional difficulties, which can lead to them acting in ways that place themselves in situations of high risk.


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 Referrals, Placements and Admissions Procedure.

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 CAMHS) 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 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 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.

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 residential units 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.

End