Suicide Prevention and Self-harm

The Suicide Care Pathway and the Self Harm Pathway have been revised to include the referral route into the new Bee U Service.

In general suicide rates in children and young people are low in England with a total of 145 suicides in England between 2014 and 2015.

This is lower than 10 years ago, however the fall in suicides in children and young people occurred in the early 2000s and has been plateaued since 2006.

SSCB has developed a Suicide Care Pathway which provides:

  • A systematic approach to identifying and addressing the needs of children and young people at risk of suicide
  • Risk assessment guidance, early intervention questions (SP1) and baseline risk assessment questions (SP2)
  • A care pathway flowchart for professionals & volunteers working with children & young people to follow
  • Additional supporting information and guidance

If you have concerns that a young person has suicidal thoughts intentions and/or plans you must follow the steps laid out in the Suicide Prevention Care Pathway.

Self-Harm

Childline's Review 2012/2013, "Can I Tell You Something?", stated that during the year Childline counselled 22,532 young people whose main concern was self-harm. This represented a 41% year-on-year increase.

In Shropshire the latest figure for children and young people as self-harm inpatient admissions was 93 admissions in 2011/2012. This is high when looked at in comparison with national figures.

Shropshire's Safeguarding Children's Board has developed a Self-Harm Pathway which includes guidance and tools for practitioners working with young people who are self-harming.

Why do children and young people self-harm?

Factors that motivate people to self-harm include a desire to escape an unbearable situation or intolerable emotional pain, to reduce tension, to express hostility, to induce guilt or to increase caring from others.

A young person may self-harm because they're suffering depression, have a psychiatric disorder, have low self-esteem, have a difficult family life, are suffering from abuse or neglect, have difficulty in forming relationships or because they're isolated or being bullied. There may be many other reasons why a young person chooses to self-harm, and it's usually the symptom of an underlying problem.  

Examples of self-harming behaviour include:

  • Cutting
  • Taking an overdose of tablets
  • Swallowing hazardous materials or substances
  • Burning, either physically or chemically
  • Over/under medicating, eg misuse of insulin
  • Punching/hitting/bruising
  • Hair-pulling/skin picking/head-banging
  • Episodes of alcohol/drug abuse or over/under eating, at times may be deliberate acts of self-harm
  • Risky sexual behaviour

How to spot the signs

The young person's behaviour and emotional wellbeing may have changed. They may suffer mood swings and become withdrawn. Other signs to be aware of may include:

  • Changes in eating/sleeping habits
  • Increased isolation from friends/family
  • Low self-esteem or an increase in negative self-talk
  • Frequent injuries (ie cuts, bruises, burns) with suspicious explanations
  • Covering up their body (even in warm weather)
  • The presence of behaviours that often accompany self-injury: eating disorders, drugs/alcohol misuse, excessive risk taking
  • Discovery of tools used for self-injury (broken disposable razors, lighters, un-bent paper clips)

What to do if you know someone is self-harming

If you know that a child or young person is self-harming initially acknowledge the courage it has taken for them to seek help and acknowledge the self-harm. Discuss with them the limits of your confidentially and explain why it is necessary for you to share information in order to keep them safe.

  • keep calm and give reassurance
  • follow first aid guidelines
  • maintain the young person's trust and involve them in decisions
  • inform the designated person for child protection in your agency
  • discuss concerns with the young person's parents, unless to do so would place the young person at further risk
  • you will need to complete the Self-harm Reporting Form on page 14 of the SSCB Self-Harm Pathway Guidance. Refer to the Care Pathway on page 21 of the SSCB Self-harm Pathway Guidance for further guidance on next steps

For further information, advice and guidance for practitioners please refer to the SSCB Self-harm Pathway.

Resources

Local publications

Local sources of information

Refer to the SSCB Self-harm Pathway Guidance for details of local support services.

National advice and suicide prevention helplines

  • Childline- 24hr helpline for children and young people under 18 providing confidential counselling, call 0800 1111
  • PAPYRUS - offers a helpline to give support, practical advice and information to anyone concerned that a young person may be suicidal - HOPELineUK: 08000684141
  • Self injury support (formerly Bristol Crisis Service for Women) - supports women and girls in emotional distress, especially those who self-harm, or their friends or relatives. Limited opening hours: 0117 925 1119
  • National Self-harm Network - support for people who self-harm, provides free information pack to service users
  • Samaritans - confidential, emotional support for anybody who in crisis: 08457 90 90 90
  • Young Minds - information on a range of subjects relevant to young people. Call 0808 802 5544
  • The Mix - Support service for young people under 25.