The overall aim of this document is to ensure that all HATW staff are able to recognise and act appropriately to all cases of self-harm in young people that we are working with.
Self-harm is the act of deliberately causing harm to oneself either by causing a physical injury, by putting oneself in dangerous situations and/or self-neglect, and can include but is not limited to:
Those who self-harm are usually suffering emotional or psychological distress and it is vital that all such distress is taken seriously to assist in alleviating it or to minimise the risk of increasing distress and potentially suicide.
Emotional/psychological risk factors associated with self-harm can include but are not limited to:
Other casual or risk factors:
Self-harm may present but not always visible. Therefore staff should be vigilant and should take any warning signs seriously. These may include but are not limited to:
All staff should take these signs seriously; however, we are dealing with young people who self-harm, on a daily basis. If it is already identified that a young person self-harms and they are discussing past or current behaviours in a group setting, one on one in mentoring or in a conversation, then a disclosure of self-harm shouldn’t necessarily cause serious concern for staff.
If they disclose that they are a serious risk to themselves or others then it should be escalated as a child protection and safeguarding issue.
If they disclose that the self-harming behaviour is a result of abuse or neglect (as defined in the Child Protection Policy) then it should be escalated as a child protection issue.
In the event of an escalation, the relevant organisations to be contacted would be the school contact, and also one of the following:
If you aren’t sure whether a disclosure should be escalated then talk to one of the Directors, as every young person’s case will be individual and will be handled as such.
The risk of self-harm can be significantly reduced by the creation of a supportive environment in which an individual’s self-esteem is raised and healthy peer relationships are fostered. This can be achieved through respect, honesty and openness. Staff awareness of issues leading to self-harm is increased through accessing training, following the child safeguarding polices created by HATW and sharing stories of how people have overcome their issues on the HATW website (www.hatw.co.uk)
HATW doesn’t aim to necessarily enforce stopping self-harming, but rather, our aim is to introduce other, more positive alternatives, for service users to find their own way, and stop self-harming in their own time.
HATW will provide service users with a wide range of internal and external sources of help that can be contacted or used through a variety of methods. Staff will all have access to contact information for external agencies that can offer advice and/or assist with issues including self-harm.
The first thing to remember is that if someone has chosen to tell you that they are self-harming then you will be someone that they trust and feel comfortable talking to. It is not easy to tell someone for the first time about something very private like self-harm. The person may have considered for a long time whether to talk about it or not and the fact that they have disclosed to you, even though it might be difficult, might be the first steps to finding help and changing their situation.
Try not to panic or over react; MORE DETAILS of what it is to over react.. both good and bad! they are not alone in self-harming and neither are you as someone trying to support them. Self-harm is a coping mechanism but it does not necessarily mean that the person is feeling suicidal or mean that they are at serious risk. However, staff should remain vigilant for signs that an issue is more serious.
If a young person discloses that they self-harm there are some initial key things to remember including:
When self-harming behaviours are being discussed remember to:
If physical harm occurs during a HATW session, the young person should be taken to the Health Centre or to A&E for medical assessment and care. If it is severe or life threatening, ring 999 immediately.
If a young person harms themselves in front of other service users, then all witnesses should be spoken to individually, and supported appropriately, to ensure that they’re not at an increased risk of self-harming as result of the incident.
There isn’t a “one size fits all” solution to self-harm. Try to help the young person come up with things that might work for them. If the young person cannot or will not find their own solution, some suggestions could be made like writing, screaming into a pillow, going for a really fast run or painting/listening to music really loudly.
They could also consider:
While working on behalf of Heads Above The Waves, every conversation should be prefaced with the confidentiality guidelines, so that the young person is aware of what will and will not be disclosed outside of that conversation.
Confidentiality is about keeping things that you are told between the people involved, unless someone is at risk or in danger (this could be the person who is self-harming or anyone else). Be honest and tell them if you need to tell someone else.
While you listen and talk to the person about how they are feeling, you should never promise to keep everything they are telling you a secret.
If you believe that the person self-harming is in need of medical attention or has taken an overdose then you will need to tell someone, perhaps a teacher, youth worker or parent.
If the person mentions suicide, you must take it seriously and tell a responsible adult (teacher, youth worker etc.), even if they tell you not to. Perhaps suggest that you go to talk to someone together.
In relation to confidentiality, where there is no child protection issue raised, although it is better if parents or a carer are notified and involved to support the young person, each individual case and approach needs to be handled carefully and sympathetically to support the wellbeing of the young person. The decision about involving parents/guardians should be taken into consultation with the young person’s school. If a decision to contact parents/guardians is reached, then the school will make the contact, wherever possible.
In the case of severe self-harm requiring medical intervention/ A&E, parents will be informed immediately, unless it is known that self-harm is symptomatic of abuse in the home, at which point, you may take the decision to make a referral directly to the appropriate authority without informing the parents.
If a member of staff becomes aware of or is alerted to a new or escalated self-harming issue, or a young person discloses new or escalated self-harm, they should make a written report, WHAT SHOULD BE INCLUDED IN THIS REPORT? Who they are (HATW ID number), date of the event, what was disclosed, how concerned staff member is about it. even if the incident eventually turns out to be an isolated one that was not indicative of a serious underlying emotional or abusive cause.
If a young person suggests there is evidence of self-harm beneath their clothing, a member of staff should accept such statements and must never ask the pupil to remove clothing to reveal wounds/bruises etc. A school nurse or a Doctor may investigate such evidence in a sensitive and appropriate manner in the Health Centre or A&E.
A Health Centre may be a school’s medical office, or a local/nearest Doctors’ surgery.
A Self-Harm Report Form should be completed and will be kept as a record of all incidents in a private locked drawer that only the Directors will have access to.
The Directors may review this record to identify any trends or other areas of concern. They may also show the form to third parties such as the NSPCC, Police, School or Social Services but only in line with the Data Protection Policy.
WE ALSO NEED A SECTION ON HANDLING STUFF OUTSIDE OF WORKSHOPS (e.g. at gigs)
A case file should be held on every formal service users including a HATW ID reference. They then have their own bit in the drawer, with their referral form, notes of any contact that causes concern and notes of personal improvement.
SELF HARM REPORT FORM
Finally make sure that you take care of yourself. It is hard dealing with the fact that someone you know or are in regular contact with is self-harming. You shouldn’t be afraid of seeking some support for yourself. Remember, you will be able to better support the person who is self-harming if you are taking care of yourself too.
Should you require additional support or someone else to talk to, either contact an outside listening service, or get in touch with the voluntary counsellor for Heads Above The Waves, and request time to talk through your concerns. Conversations with the voluntary counsellor are bound by the same confidentiality and privacy guidelines as all Heads Above The Waves work.
The voluntary counsellor is: Emily Jones – 07806 629210
National Self-Harm Network – 0800 622 6000 – nshn.co.uk – firstname.lastname@example.org
Get Connected – 0808 808 4994 – get connected.org.uk
ChildLine – 0800 1111 – childline.org.uk
Samaritans – 08457 90 90 90 – samaritans.org – email@example.com
NightLine – nightline.ac.uk/nightlines to find your local branch
Youth2Youth – 0208 772 9900 – youth2youth.org.uk
SupportLine – 01708 765 200 – supportline.org.uk
CALL Helpline – 0800 132 737 – callhelpline.org.uk – Text “Help” to 81066
MIND – 0300 123 3393 – mind.org.uk
SANE – 0845 767 8000 – sane.org.uk
This policy will be reviewed annually (or earlier if necessary) by the Directors.