Self-Harming and Suicidal Behaviour
Regulations and Standards
Related guidance
Broadly defined, self-harm refers to the deliberate attempt to physically injure oneself without causing death. This can include self-mutilation (e.g. cutting behaviours), self-poisoning, burning, scalding, banging, and hair-pulling.
Although clearly damaging, the misuse of alcohol and drugs, self neglect, eating disorders, unsafe sexual behaviour and other forms of risk taking, such as dangerous driving, are not generally classified as self-harm.
If a child is self harming, this should be addressed according to the strategies set out in any existing plan, for example, in the child's Placement Plan.
If no plan or strategy exists, staff in the unit should take measures 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.
The child / young person’s social worker must be informed, and a risk assessment undertaken with a view to deciding whether a Strategy should be adopted to reduce or prevent the behaviour. Any such strategy should be included in the child's Placement Plan.
If necessary, specialist advice or support should be sought.
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 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 Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.
The Designated Manager (Self Harming) should also be notified and consideration given to whether the incident is a Notifiable Event, see Notifications of Serious Events Procedure.
All self harming must be recorded in the Home's Daily Log and relevant child's Daily Record. If First Aid is administered, details must be recorded.
A serious incident of self harm is likely to constitute a notifiable event (see Section 2.2, Notifications of Serious or Persistent Self Harming). 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 and, where necessary, strategies to reduce or prevent future incidents should be detailed.
Statutory Guidance and Government Non-Statutory Guidance
Suicide Prevention Strategy for England
Suicide Prevention: Resources and Guidance
Good Practice Guidance
Self-harm: Assessment, Management and Preventing Recurrence NICE Guidance
Useful Websites
Last Updated: June 18, 2024
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