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Contents

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

1. Introduction

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.

2. Definition

Definitions from the Mental Health Foundation (2003) are:

• Deliberate self-harm is self-harm without suicidal intent, resulting in non-fatal injury;
• Attempted suicide is self-harm with intent to take life, resulting in non-fatal injury;
• Suicide is self-harm, resulting in death.

The term self-harm rather than deliberate self-harm is the preferred term as it a more neutral terminology recognising that whilst the act is intentional it is often not within the young person’s ability to control it.

Self-harm is a common precursor to suicide and children and young people who deliberately self-harm may kill themselves by accident.

Self-harm can be described as wide range of behaviours that someone does to themselves in a deliberate and usually hidden way. This can include self-mutilation (e.g. cutting behaviours), self-poisoning, burning, scalding, banging, and hair-pulling.

Although clearly damaging, alcohol and drugs misuse, eating disorders, unsafe sex and other excessively risky behaviour, such as dangerous driving, are not generally classified as self-harm.

In the vast majority of cases self-harm remains a secretive behaviour that can go on for a long time without being discovered. Many children and young people may struggle to express their feelings in another way and will need a supportive response to assist them to explore their feelings and behaviour and the possible outcomes for them.

3. Planning and Prevention

If a child is suspected or found to be self harming, the strategies that should be taken are those determined by any existing plan, for example, in the child's Placement Plan.

If no plan or strategy exists, 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, the 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. That strategy should be included in the child's Placement Plan.

If necessary, specialist advice or support should be sought.

4. Notifications, Recording and Review

4.1 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.

4.2 Notifications of Serious or Persistent Self Harming

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 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 Notification of Serious Events Procedure.

4.3 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.

The child's Placement Plan should be reviewed with a view to incorporating strategies to reduce or prevent future incidents.

End