Self harm is any act of self-injury or self-poisoning; it might include cutting, scratching, biting, substance misuse or sexual promiscuity. It is not attention seeking; it is the way the individual is expressing overwhelming emotion or it may be a way of asking for help.
Self-harm needs to be taken seriously. It is always a warning sign of emotional distress and can be a sign of psychological illnesses such as depression. Over half of those who die by suicide have a previous history of self harm.
Timely support can allow the young person to address their mental health needs and find positive coping strategies for the future.
In Professional Settings
If you suspect or become aware that a young person is self harming, a prompt response is essential.
First Aid
If a child or young person has injured themselves / taken an overdose this will need immediate first aid assessment.
First Response
Responding in a non-judgemental and calm way to any disclosure or discovery of self-harm is vital. Young People often feel embarrassed and ashamed and can be reluctant to talk about the issue. You do not have to have immediate solutions – being listened to and feeling able to share their distress is an important first step.
Safeguarding
Safeguarding the young person’s physical and emotional wellbeing is paramount. Share what you know with the designated safeguarding lead, follow policy and seek advice as necessary to ensure safety.
Confidentiality
The young person may be scared of others finding out about the self harm. Be clear about the confidentiality you can offer from the outset – the young person should know that if you are concerned about their safety you have an obligation to share with appropriate others.
If you do feel it is necessary to tell others, including their parents, talk this through with the young person and plan how you will manage this together. If at all possible parents and carers should be put in the picture as soon as possible as long as it does not increase risk e.g. where there has been disclosure of abuse. The young person may feel very worried about this; letting them share some control of how this happens can help make it easier.
Next Steps & Ongoing Support
Support the young person and their family to seek medical assessment – either by attending the GP or A&E if they have wounds that need attention or are voicing suicidal thoughts. This will also allow the young person to be referred for the appropriate level of mental health support.
Support offered in settings should not take the place of specialist support. There are lots of resources and materials online that can help you offer ongoing support to the young person. It might be helpful to;
Peer Group
Be mindful of the needs of the young person’s support group who may need to talk about the worries they have for their friend. It is not unusual for a friendship group to share self harm as a mutual way of displaying distress. They may also need help to manage their feelings in a healthy way.
Self Care
It is hard to support young people displaying such distress and this can take a toll on your own emotional wellbeing. Use the support network available to you within settings from peers and the senior team and ask for additional support if you are struggling.
Resources
CARE
The CARE animation is a short animation for all professionals that recognises the importance of supporting children and young people’s mental health in settings, and offers a simple principle for staff to remember; CARE. (Curious, Approachable, Refer, Empathy). It is aimed at all professionals, including support staff and those who may not have direct contact with young people. The animation can be used in one of the following ways:
You can watch the CARE animation and download the accompanying guidance and poster at www.annafreud.org/careanimation
E-Learning
'All Our Health' offer free, bite-sized e-learning sessions - to improve the knowledge, confidence and skills of health and care professionals in preventing illness, protecting health and promoting wellbeing. The sessions cover some of the biggest issues in public health including;
They contain signposting to trusted sources of helpful evidence, guidance and support to help professionals embed prevention in their everyday practice.
Shelf Help - Reading Well
