Self-harm guidance for school staff

What is self-harm?

Self-harm is where someone does something to deliberately hurt themselves when they find things difficult to cope with.

It can include behaviours such as:

Cutting
Over-dosing
Hitting (self and others)
Burning or scalding
Picking or scratching skin
Pulling hair
Ingesting toxic substances
Eating disorders

Why do people self-harm?

People self-harm for lots of different reasons. Sometimes this is because they feel bad about something that has happened to them but often there is no known cause. Self-harming behaviours may have the following functions:

To communicate distress to others
To relieve unbearable feelings
To provide soothing and comfort by releasing tension and gaining care from others
To feel alive if they feel numb due to life experiences
To punish themselves as they feel shame and self-blame
To control things in their life when everything feels out of control

Who self-harms?

There is not a ‘type’ of person who self-harms. People who self-harm are of any age, religion, sex or background. Both girls and boys self-harm but may use different methods.

Is there a link to suicide?

People often think that there is a link between self-harm and suicide, however, most people who self-harm are not trying to kill themselves.

What do I do if I’m worried someone is self–harming?

Pupil shows signs and symptoms of self-harming:

Stay calm – try not to panic or show you feel shocked, even though you may be.
Ensure all physical wounds are treated before any conversations around the non-physical aspects of self-harm.
Do not ignore, punish or criticise the behaviour.
You may want the young person to stop but telling them to stop is not helpful and can be dangerous as it takes away their coping strategy
Listen to them non-judgmentally and try to understand
Explain about duty of care and confidentiality
Record concern and inform Designated Child Protection lead
Have an awareness of your own feelings and need for safe support
Be aware of ‘social contagion’ – self-harm spreading between members of a group

Undertake a risk assessment and create a ‘safety’ plan:

Designated Child Protection lead will work with available information to undertake risk assessment and safety plan – see Risk Assessment and Safety Plan for Young Person
Inform parents and carers unless clear reason not to.
Relevant course of action will depend on level of risk
Seek support from other agencies
Document concerns and actions to be taken – within whole school approach/policy/protocol

Low/ medium risk

Identify key adult to work with young person.
Support them to stay safe if they continue to self-harm. Help them to minimise risks such as infection.
Support them to develop new coping strategies. Other strategies include distraction, flicking a band on their wrist, putting cold ice on their skin, going for a walk.
The Truth About Self Harm: for young people and their families and friends by the Mental Health Foundation may be useful
Seek further advice from other agencies
Ensure there is support for yourself.

High risk/Crisis

Seek immediate medical attention and administer first aid if required
Keep calm and give reassurance to pupil and others who may have witnessed the self-harm
Explain duty of care and confidentiality
Record concern and inform Designated Child Protection lead
If child/ young person is taken to hospital, emergency protocols for treatment and care will be implemented
If child/ young person is not taken to hospital, discuss with CAMHS to mark pain if possible. Pain scales may also be helpful.
Consider what might be going on for the child outside of school e.g. has there been a change or loss.
Speak to CAMHS if you need further support unpicking the ‘intention’ of the behaviour – is this self-harm or is the young person communicating an unmet need? Call the SPA and ask to speak to CAMHS clinician – 0330 0245 321.

Who can help in Devon?

CAMHS – 0330 0245 321
Call the pre-referral phone line at Single Point of Access to speak to a CAMHS Clinician regarding your concerns and they will advise on next steps and whether a CAMHS referral is appropriate. Have in mind FIDOS: Frequency, Intensity, Duration, Onset, Severity.

School Nurse – contact your locality team

Educational Psychology Service
Speak to the Educational Psychology Service for support via consultation, staff supervision and training.

Further Support

Talk works Depression and Anxiety Service: a support service for people aged over 17.5 years with mental health concerns. Can provide face-to-face, group or online support.
Pinpoint: an online directory of local community services.
Kooth: a free online anonymous counselling service for children and young people.
NHS Inform: free and fast access to self-help resources for mental health concerns.