Introduction

If a school or educational setting has experienced a Critical Incident, it is important that the Local Authority are notified immediately so that any relevant support can be coordinated and put in place as soon as possible.

When reporting a Critical Incident impacting a school or educational setting, please download and complete the Critical Incident Form and send it to Children’s Social Care ‘Front Door’  (MASH). multiagencysafeguardinghubsecure-mailbox@devon.gov.uk

If you require an urgent response, please telephone MASH Tel: 0345 155 1071

Managing critical incidents in schools

This information pack is intended to help schools and educational settings be prepared for a critical incident and to ensure effective management in a difficult situation. Although it is not possible to prepare in detail for every situation it is essential to have a general plan to hand which outlines the steps that need to be taken.

What is your role in a critical incident?

Critical incidents happen when least expected. When a school or educational setting is affected by a crisis, all staff have an important role to play in supporting the emotional health and wellbeing of their school/setting community and in maintaining control of the situation in the school/setting. Schools and educational settings are a normal place for a child/young person to be and offers security at a time of insecurity. Teachers and education leaders have many skills and techniques which they use routinely to help children/young people and with some further training and confidence building, these skills can be adapted to help children/young people understand and cope with a range of traumatic incidents.

What support is available to your school in a critical incident?

The Educational Psychology Service (EPS) has a key role in:

• Providing schools and educational settings with information and training to ensure confidence in their preparation to manage in the event of a critical incident.
• Offering on-going support to schools and educational settings including work with individual pupils or members of staff as appropriate. This will be delivered by the Educational Psychologist allocated to that location.
• Offering direct support to schools and educational settings immediately following a critical incident. On receiving a request for support from a Headteacher or educational leader, the EPS will respond promptly with a level of support which is judged to be appropriate to the nature, size and severity of the event. This work is considered a priority for the EPS and therefore may mean postponement of other planned work.

First steps

What is a critical incident?

Terminology

A Critical Incident is a single incident or a sequence of incidents which:

• are sudden and unexpected
• contain real or imagined threats to a person
• overwhelm usual coping mechanisms
• cause severe disruption
• are traumatic to anyone

Critical Incidents affecting educational settings may include:

• death of a pupil or a member of staff
• serious accident involving pupils or school personnel, on or off school premises
• violent attack or intrusion into premises e.g. armed intruder or bomb alert
• fire, flood, building collapse, or major vandalism
• a hostage situation
• a disaster in the community

A Serious Incident is a single incident or a sequence of incidents which:

• may be expected but are none the less distressing
• overwhelm usual coping mechanisms
• cause disruption
• could be traumatic to individuals or groups involved

Serious Incidents affecting educational settings may include:

• an incident or series of events that have a negative impact on several team members or a whole team
• pupil or staff member accused of a serious criminal offence

Responding to the first communication of tragic news

This conversation requires a calm, steady, quiet and sensitive approach. It will be important to allow the person to tell their story, and to listen.

You might want time to take a breath and steady yourself. It is okay to ask for a pause, for example to get something to note down contact details and important information.

Demonstrate that you are listening through occasional gentle responses. These could be empathetic sounds or short phrases like “Oh I’m so sorry”, “I’m listening”, “Take your time”.

Leave pauses so that the caller does not feel hurried and has time to gather their thoughts.

Allow the caller to tell their story in their words and in their own time and avoid asking questions.

You can check that you have heard and understood by paraphrasing back, for example “You said that he died at home last night, is that right?” and again leave pauses so that the caller can correct you.

When the conversation reaches a natural break, explain that you need to take very clear notes of the important information.

Obtain as much accurate, factual information about the critical incident as possible. Bear in mind that it is very easy for rumours to spread: uncertainty or misinformation can greatly add to distress levels, create confusion and will take time and effort to correct.

Before ending the call, check that you have collected sufficient factual information and the personal and contact details of the person you are talking to.

What to say when talking to someone about difficult news

There is no ‘best way’. The most useful guideline is to try and communicate that you care.  It is probably better that you don’t have preconceived ideas about what is the best way to help as different people will appreciate different approaches and acts.

Here are a few guidelines to consider:

Can be helpful	Best avoided
Quiet company and listening – in the initial stages you may need to say very little. Take your cues from the mourner.	Cliches – ‘Life just has to go on’ or ‘Time is a great healer’ etc.
Be yourself, be available and be sympathetic.	Religious messages – for people who are not religious comments about God or Allah may be hurtful or annoying.
Learn to accept silence. Don’t feel that you must force a conversation, chatter on aimlessly, or force socialisation.	Don’t probe for details about the effect of the situation or trauma but be a good and willing listener if the person wants to talk about it.
Concentrate on the other person – rather than trying to express your concern to people who have had a devastating personal experience.	Humour – what is humorous for one person will not seem funny to another and may be seen as an attempt to minimise the loss.
Ask naive questions such as, “I was wondering if you felt a bit sad this morning in the playground, or whether you were just cold?”	Assumptions. Do not attempt to tell the mourner how he or she feels, eg “You must feel really angry…”
Respect confidentiality – avoid talking to people about disclosures of another.	Avoid offering to do or give what you are not able to follow through.

Care for the ‘caretaker’

Responding to traumas and other major disasters can be extremely exhausting, traumatic and overwhelming at times, for the community as well as those directly affected.  If you are in a ‘helping role’ or in a position of responsibility you will have particular demands made upon you and you are likely to make heavy demands on yourself. Try to take care of yourself, so that you are better able to, in turn, help others.

• Be gentle with yourself!
• Remind yourself that you are an enabler and not a magician. We cannot change anyone else – we can only change how we relate to them.
• Find a hermit spot. Use it daily.
• Give support, encouragement and praise to peers and to management. Learn to accept it in return.
• Consider setting up a ‘buddy’ system so that everyone is able to support each other.
• Remember that in the light of all the pain we see, we are bound to feel helpless at times. Admit it without shame.
• Caring and being there are sometimes more important than doing.
• On the way home, focus on a good thing that occurred during the day.
• Say ‘I choose to’ rather than ‘I should, I ought to or I have to.’
• Take time to care for yourself and engage in hobbies or relaxing activities.

Navigating a critical incident as a senior leader

Gather information

• Follow ‘responding to the first communication of tragic news’ (see below).
• Obtain as much accurate, factual information about the incident as possible. It is all too easy for rumours to spread: uncertainty or misinformation can greatly add to distress levels, create confusion and will take time and effort to correct.
• Identify who are likely to be the central affected persons in the school community.
• Ensure that school/setting-based records or information about the children/young people who have been involved and who may have died in the incident are collated and removed to a secure place for a time in case there is a need for further investigation.
• Identify a small group of staff who can work to support you with management of the critical incident. Consider governor support also.

Plan communications

In the hours and days following a critical incident, it is important that information is disseminated with care and accuracy.

• As an immediate measure – prepare a brief, written statement which can be used by the school/setting secretarial staff to respond to phone calls from parents/carers etc. Such a statement can then be updated as appropriate when new information becomes available.  This is to ensure the consistency of the information being disseminated.
• Using the template on the following page as a guide, prepare formal communication for parents/carers.
• In general, less is more with communications. Ensure that what you say is factual, appropriate to share and sensitively worded.
• It is possible that the media may be in contact with the school/setting. Consider how this will be dealt with. It is highly recommended that contact is made with the LA press officer. This officer will be able to act on the school/setting’s behalf (if requested to do so) and provide appropriate support regarding press releases etc. Where schools/settings wish to deal directly with the media this can be channelled through a member of staff who acts as the nominated media liaison representative.
• Monitor social media/general media.

Sample communication to parents/carers

Dear Parent/Carer

It is with great sadness and regret that I am writing to inform you about the death of (name and details of deceased, include outline details of what happened).

I want to reassure you that the pupils and adults in school/(your setting) will be offered support. The next few days may be difficult for all, but it will be important to maintain our normal routines whilst allowing everyone to grieve in their own way and in their own time.

The Educational Psychology Service will be available to provide additional support as necessary and there is guidance attached to this letter for ways of talking to your son or daughter and maintaining a routine as far as possible.

If you have any concerns, then you are most welcome to contact the school/setting.

Yours sincerely,

Your Name

Headteacher

Tell people what has happened

• You will need to inform the local authority (refer to your LA emergency planning documentation for contact details).
• Inform your senior management team and chair of governors.
• Inform staff following the guidance below (Supporting the school/educational setting community – Staff).
• Inform pupils following the guidance below (Letting children/young people know about an incident).
• Inform families following the guidance below (Supporting the school/educational setting community – Parents and carers).
• Depending on the nature of the incident, other agencies may be able to provide support or access to resources that may be of help. These include Educational Psychology, CAMHS, the school nurse, local churches etc. Contact relevant supporting agencies.

Short to medium-term planning

• With the support of your core team. Work through the guidance and checklists in the pupil, staff and family sections of this document to ensure that appropriate support is in place.
• Find out what funeral arrangements are and communicate these to relevant parties in line with the family’s wishes.

Long-term planning

The impact of the ‘critical incident’ is likely to continue to be felt for a considerable time.

• It will be important to be vigilant and to continue to monitor pupils and staff so that any signs or symptoms of delayed grieving can be identified and appropriate action taken.  Pupils should be clear about who they can talk to, and those providing the listening service need to be clear about their role, boundaries and confidentiality issues.
• Good home-school/setting links will encourage the early reporting of difficulties being experienced in the home.
• Be aware of the potential power of anniversaries of the incident, or of the deceased person’s birthday etc. in reawakening feelings of distress.
• Consider whether a school/setting-based memorial would be helpful and appropriate. Always check this out with the family first. This could take the form of a service or ceremony, dedicated piece of equipment or furniture, an award, an area of the school/setting grounds etc. Planning a memorial can in-itself be a therapeutic act and such an event can acknowledge that an incident is over.

Checklist

When – if possible	What	Completed
Same day	Obtain factual information about what has occurred.
Same day	Prepare a short-written statement for staff to use in response to telephone queries.
Same day	Identify a core staff team to support you.
Same day	Identify who are likely to be the central affected pupils, staff or families.
Same day	Inform the local authority.
Same day	Inform the chair of governors.
Same day	Tell staff.
Same day	Tell pupils.
Same day	Consider contacting the local authority press officer.
Same day	Write a letter for parents/carers and share this.
Same day	Collate school/setting-based records about the child or children involved.
Same day	Contact relevant agencies or groups.
Same day	Consider consent documents if any pupils will require external professional support (see below).
Same day	Follow guidance for pupils, staff and families.
First weeks	Be vigilant and monitor pupil and staff wellbeing.
First few weeks	Monitor social media and media.
Subsequent weeks and months	Consider anniversaries and school/setting-based memorials making sure that consent is gained from parents for any memorial activities.

Supporting the school community – Pupils

School/setting staff who are supporting bereaved children and young people during this time and may be concerned about saying the wrong thing or making things worse.

The Educational Psychology Service is here to support your school/setting. We can provide consultation and support for school/setting staff feeling under pressure or managing sensitive issues.

Children’s understanding and response to loss: A developmental picture

When talking to children, it can be helpful to consider how their developmental stage may impact upon their understanding of death and trauma.

Early Years: Understanding of loss

• At this age children do not understand that death is permanent. They think it is temporary or reversible.
• They do not often understand abstract language. When we talk about abstract language, we mean words which describe concepts or ideas that cannot be observed using our senses.
• Young children show a very literal understanding of language, for example, the phrase “gone away” could lead to misconceptions for them.

• Children’s understanding of time in the early years tends to be focused on their immediate present or on events of big significance for them such as a birthday. This can affect the way that children understand events and permanence. They may be quite confused by timescales beyond their here and now (e.g. “Next week, we are going to see Grandad”) and might ask repeated questions about when someone is coming back.
• Young children may use magical thinking e.g. thinking someone will come alive again or thinking that they made someone die. Young children can feel responsible and may blame themselves.
• Young children do understand separation and will feel insecure and frightened when the familiar things around them change.
• Young children may ask what appear to be insensitive questions e.g. “When will you die?” This is because they perceive death as temporary.
• This age group will be most influenced by how adults near to them behave and they need a lot of reassurance that they will be safe and looked after.

Early Years: What you might see

• Regression in development – returning to crawling, wanting a bottle.
• Toileting problems; wetting and soiling.
• Clinginess to trusted adults and needing more support than usual.
• Looking for the person who has died.
• Being irritable; having more tantrums.
• Withdrawing, being quiet, showing a lack of response.

Early Years: What you can do to support

• Have one to one time on a shared activity.
• Keep routines and normal activities going as much as possible.
• Tell them you know they are sad – teach and use words that describe feelings.
• Tell them they are safe, and who is looking after them.
• Ensure they have access to their comfort items, such as a cuddly toy, special blanket.
• Explain death as part of life, so they come to understand it over time. Using some examples in nature may be helpful, such as watching plants grow, bloom and die.
• Use simple concrete language and give simple explanations.
• Death may be made clearer by explaining it in terms of the absence of familiar life functions – when people die they do not breathe, eat, talk, think, or feel any more; when dogs die they do not bark or run anymore; dead flowers do not grow or bloom any more.
• Avoid using words such as “gone to sleep”, “rest”, or “went away” as this can cause confusion and young children may become scared of sleeping in case they don’t wake up or of brief separations.
• Young children often repeat questions, be prepared for this.
  Encourage play to help them process what has happened; sand play, puppets, dolls.
• By attending to a child’s play, or playing alongside them, you can correct misconceptions. How much do they understand? Are they making misconceptions?
• Stories are a good way to explain more abstract concepts with images. Choose stories with concrete, simple language and read them together making plenty of time for children to ask questions.

Primary aged child: Understanding of loss

• Most children at this age are beginning to understand that all living things eventually die, although they may not understand that death is final. Children tend to understand that death is final at 10 – 12 years.
• Children at this age tend to not relate death to themselves and may think that they can personally escape it.
• Children may think that the person who has died may still feel things such as coldness, hunger, or loneliness etc.
• They may ask where the person is now and have blunt questions to ask about what happened to them and to their body. Explaining death to them is very important.
• They may associate images with death, such as a skeleton and may have nightmares..

Primary aged child: What you might see

• Looking for the person who has died.
• Having dreams about, or sensing the presence of, the person who has died.
• Blaming themselves for the death.
• Being easily distracted, forgetful.
• Being anxious; having increased fears, such as of the dark.
• Clinginess – wanting to be near key adults.
• Withdrawing, being quiet, and showing a lack of response.
• Being fretful, distressed, not wanting to leave parents/go to school.
• Physical complaints such as tummy aches and headache.
• Being irritable, having more tantrums, being defiant, or showing challenging behaviours.

Older primary children may

• Be particularly anxious about the safety of others.
• Try very hard to please adults and not worry them.
• Want to take on more adult responsibilities to ‘help’ out.
• Feel stronger emotional reactions, such as anger, guilt, sense of rejection.
• Feel embarrassed and different from others; they may want to conceal their loss.
• Become focused on what has happened and ask questions, think about it a lot, have dreams about it, and perhaps want to talk about it often to others.

Primary aged child: What you can do to support

In addition to the support for Early Years children, you can support in the following ways:

• Ensure there is time to talk with trusted adults when they need to.
• Don’t expect them to behave like adults, allow them to be the age and stage they are.
• Let them show their emotions: don’t say things like, “Be brave” or “Big boys don’t”

Secondary aged child: Understanding of loss

• By adolescence, death is accepted as part of life, but it may not have affected a teenager personally yet. Their reactions may fluctuate between earlier age group reactions and reactions that are more adult.
• Teenagers will often want to spend more time with friends than family as they seek support.
• They may find the intensity of emotion overwhelming or scary. They may not be able to find the words or ways to talk about their emotions with others.
• They may want to feel they are coping, and be seen to be, but inside they may be hurting a great deal, or be putting their emotions on a shelf for a later time.

Secondary aged child: What you might see

• Being unsettled in class, a change in class performance, not wanting to go to school.
• Being overwhelmed by intense reactions, such as anger, guilt, fear.
• Having difficulty expressing intensity of emotions, or conflict of emotions.
• Risk-taking behaviour to escape, to comfort, or to prove they’re alive and strong, for example, drinking, drugs or more sexual contact.
• Jokes or humour, masking feelings.
• Saying, or acting like they don’t care.
• Strained relationships with others – fear or awkwardness about being close to others.
• A sense of loneliness – isolation.
• A change in self-image, lower self-esteem.
• Suicidal thoughts and/or depression.

Secondary aged child: What you can do to support

In addition to the support for Primary aged students, you can support in the following ways:

• Be honest and let them know what is happening.
• Acknowledge the emotions they may be feeling—fear, sadness, anger.
• Frequently reassure them they are safe, who is caring for them, and which adults they can trust to ask for further support.
• Keep routines and normal activities going as much as possible.
• Talk to them about grief – what it is, that it’s normal, that everyone is different.
• Avoid expectations of adult behaviour and encourage them to express their thoughts and feelings.
• Give them ideas of things they could try such as doing physical activities, writing, singing, listening to music, talking with friends, reading etc.
• Talk about death together; answer any questions they may have as honestly as you can.
• Help them to prepare something to remember the loss.
• Look out for them in the long term as sadness may turn to depression and they may require more specialist support.

Letting children know about an incident

• Depending on the nature and timing of the incident, some pupils may already know or suspect that something untoward has happened.  As above it is important to ensure that accurate information, containing facts rather than speculation, is disseminated.
• Inform close friends and close friends of any siblings individually or in small groups.
• Inform other pupils with factual information calmly and sensitively – if possible within their form or class groups rather than in large groups. Avoid whole school assemblies.
• When talking to groups of pupils, ensure there are at least two adults available.  Ideally, one adult should be known to them.
• Using the information above, consider the children’s developmental stage and think about the language you use to explain what has happened clearly.

Establishing spaces and structures for support

• It is generally felt that keeping as much ‘normal structure’ as possible is beneficial, this is to ensure some stability in the lives of pupils at a time of crisis.
• Remember that feelings and expressions of grief are normal, appropriate and healthy.
• There may be some children who are not at school/setting owing to the incident. Help them to feel connected to events in school/setting and plan support for their return.
• As with any ‘emotionally charged’ experience, it is important for staff to remain aware of confidentiality issues and respond appropriately to information or concerns shared with them by their pupils.
• Identify and make available designated places on site (e.g. ‘Mr Y and Mrs X will be working in the library this week and are available if you would like to talk about Y or take some time) and perhaps on line school/setting web link for children to go for reflection time or for expressions of emotion.
• Consider whether a school-based memorial would be helpful and appropriate. Always check this out with the family first. This could take the form of a service or ceremony, dedicated piece of equipment or furniture, an award, an area of the school grounds etc.  Planning a memorial can in itself be a therapeutic act, even where a period of time must elapse before the event can happen. Such an event can acknowledge that an incident is over.
• Consider contributions to a book or a display board to share memories and thoughts.
• Be alert for individual pupils who may be particularly vulnerable to such events due to their own particular circumstances (e.g. personal experiences of bereavement or loss, close relationship with the affected person(s)).
• Establish procedures for identifying and monitoring the wellbeing of vulnerable pupils (e.g. a pastoral meeting, a familiar adult checking in, ‘watchful waiting’ not ‘wait and see’ but identify, observe and monitor).
• Encourage pupils and staff to be open with their feelings and memories e.g. collections of photographs. Some children may not know that they are ‘allowed’ to talk about the person who died. They should be.

Funeral arrangements

• Ascertain details of the funeral arrangements.  Allowing children and young people to attend the funeral may help in their grieving process.
• If the friends or classmates wish to attend, the consent of their parents needs to be obtained.
• Consider recommending that pupils in primary schools/settings are collected by and attend the funeral with their parents, taking them home afterwards if necessary.
  Secondary schools/settings/colleges may be able to arrange transport and staffing to enable their pupils to attend (if appropriate).

Supporting pupils – checklist

When – if possible	What	Completed
Same day	Inform children in classes and groups
Same day	Identify designated places and staff
First week	Establish procedures to identify and monitor vulnerable pupils
First week	Plan ‘return to school/setting’ support for pupils if required
First week	Arrange memory book or display
First week	Ascertain details of any funeral arrangements and consent
Subsequent weeks/months	Consider a school/setting-based memorial

Supporting the school/educational setting community – Parents and carers

When responding to a critical incident, you will need to inform and reassure parents and carers. You will also need to speak with – and support where possible – any affected families.

Supporting the bereaved family/families

Before speaking with affected persons consult the guidance: ‘Responding to the first communication of tragic news’ (see above) and ‘What to say when talking to someone about difficult news’ (see above).

• Contact families directly affected to express sympathy.
• Obtain as much accurate, factual information about the incident as possible.
• Ask families how they would like to be contacted/communicated with. Is there a better time of day? Is there a particular family member or friend who can support with queries?
• When the time is appropriate, ascertain information about the funeral arrangements and family’s wishes for attendance.
• Establish how families feel about memorials or related activities.
• If additional professional support is required for affected children or siblings, speak with parents and carers and obtain appropriate consent.

Working with other parents and carers

• Prepare a letter informing parents/carers of the facts of the incident on the same day.  Depending on the circumstances, it may also be necessary to provide additional health information or contact numbers where such information can be obtained.  This is particularly important where parents/carers may have concerns for their own child’s health or well-being – for example in the case of known or suspected meningitis.
• The families of close friends or class members of the pupil(s)/staff who have died may also be reassured to be provided with information about how to support each other regarding loss and bereavement (see below).
• Remember that churches or other religious or community-based groups may be able to provide support at this time, but be sensitive and alert to religious and/or cultural sensitivities for individual families.
• If additional professional support is required for affected children or siblings, speak with parents and carers and obtain appropriate consent.
• Communicate with parents/carers about funeral arrangements seeking consent as appropriate.
• If appropriate, consider an after-school meeting (arranged with relevant support staff if required) for parents to discuss practical concerns and / or bereavement issues may be helpful.  Although the numbers attending may be small, this provision has been highly valued by parents.
• Good home-school/setting links will encourage the early reporting of difficulties being experienced in the home.
• Keep messaging clear and consistent, direct parents to a key point of contact in school/setting with any specific queries or concerns (see ‘plan communications’ – above).
• If additional professional support is required for some children, speak with parents and carers and obtain appropriate consent.

Supporting parents and carers – checklist

When – if possible	What	Completed
First days	Contact the family directly to express sympathy when appropriate
First day	Prepare a letter to inform parents/carers
First day	Identify families of close friends
First week	Consider an after-school ‘drop in’ if required
First week	Share resources with parents and carers
First weeks	Obtain consent paperwork if children are attending the funeral or require onward referral to professional services (e.g. Educational Psychology, counselling)
Subsequent week/months	Maintain good home-school/setting links

Supporting the school/educational setting community – Staff

School/setting staff are constantly supporting each other, providing emotional support for colleagues experiencing a range of personal and professional challenges including those who have been bereaved. Staff may feel worried about how to do this and concerned about saying the wrong thing or making things worse.

The Educational Psychology Service is here to support your school/setting. We can provide consultation and support for school/setting staff feeling under pressure or managing sensitive issues.

Informing staff

• Be mindful that some staff may already have some understanding of what has happened. It is important that you gain clear, factual information before talking to staff (see ‘plan communications’ – above).
• Consider which staff are likely to be particularly impacted by the news. You may wish to inform key individuals (e.g. class teachers) on a 1:1 or small group basis.
• Hold a meeting to inform staff about what has happened. See ‘What to say when talking to someone about difficult news’ (above) for guidance and support.
• Offer appropriate reassurance and have plenty of tissues available.
• Share information with staff about support arrangements in place for pupils, families and staff themselves.
• Direct staff to relevant aspects of this guidance (e.g. ‘Supporting the school/educational setting community – pupils’ – above).
• Talk with staff about the importance of clear communication and confidentiality. Where staff encounter questions from parents or pupils that they feel unable to answer, have an identified member of staff available for staff to direct to (see ‘plan communications’ – above).
• Keep staff regularly updated and supported. Providing comfort for distressed pupils is a difficult and draining task; all staff – including the senior management team, need the opportunity to express their own feelings. Having the time and space for this to happen is essential.
• Be alert for individual staff or pupils who may be particularly vulnerable to such events due to their own particular circumstances.

Support structures

• Identify spaces within the school/setting grounds where staff can go for a moment of quiet reflection or to speak with a colleague. This could be as simple as ‘Ms X and Mr Y will be based in the PPA room this week, and this can be used as a staff as a quiet space if required or somewhere to speak with colleagues.’
• Consider setting up a ‘buddy’ system so that staff can support one another.
• Where possible, pre-empt the need for additional staffing/cover in affected groups. Additional staffing can support staff to take a brief break if required.
• Make sure that you have good supplies of tea, coffee, biscuits and tissues. Small things can make a big difference in times of distress.
• Continue to ensure that staff members have the opportunity (perhaps with the help of outside support) to deal with their own feelings, both about the incident and the distress of the pupils. The Educational Psychology Service can be available as a point of contact for members of staff.
• Ensure that there are procedures in place – which staff are aware of – for discussing concerns about any particular children/young people.
• Direct staff to the self-care checklist (see below).

Supporting staff – checklist

When – if possible	What	Completed
Same day	Inform key staff individually or in small groups
Same day	Inform wider staff team
Same day	Consider staffing support and a ‘buddy system’ for key adults
First week	Monitor staff wellbeing
First week	Create space and time for staff discussion
Following weeks	Monitor staff wellbeing

Resources and further information

Support available from the Educational Psychology Service

• Immediate telephone contact for practical support, information sharing and support for pupils, staff, and parents.
• Support for senior staff dealing directly with the media or distressed parents or governors.
• Consultation with parents/carers and staff around how to support children and young people who have experienced a traumatic event.
• Advice/information for teachers on strategies that may be helpful for colleagues who may have been traumatised.
• Initial consultation for staff (see self-care checklist).
• Advice on the management of grief and loss in school/educational setting, including coping with strong emotions such as anger; providing sympathetic and effective pastoral care.
• We believe school/setting staff are the most appropriate adults to support pupils when in school/setting. Occasionally however it may feel appropriate for the EPs to provide some ‘talking and listening’ time for pupils in the aftermath of a CI if staff feel overwhelmed. The EP service can guide and advise staff in how to support children/young people at this difficult time.
• Long-term monitoring of the impact of a CI as discussed through termly planning and review meetings.
• Providing links with other agencies that may be able to provide longer term interventions.
• Contact the Educational Psychology Service via your school link EP or via: educationlearnersupport@devon.gov.uk

In the event of a suicide

When discussing suicide, be mindful of up-to-date phraseology to avoid language which could be considered stigmatising or blaming.

Instead of saying – Committed suicide

Say:

• Died by suicide
• Took his or her own life
• Killed him or herself

Instead of saying – Failed suicide attempt/unsuccessful suicide attempt

Say:

• Aborted suicide attempt (when the person stops themselves)
• Interrupted suicide attempt (when an outside circumstances stops the individual)

Some risk factors associated with suicide include

• Self-harm
• Suicide attempts*
• Suicidal ideation, communication and threats**
• Suicide-related internet use
• Childhood abuse or neglect
• Bereavement
• Exam pressures
• Bullying
• Substance abuse – illicit drugs or excessive alcohol use
• Physical health conditions
• Mental illness in the family
• Physical illness in the family
• Substance abuse in the family
• Relationship break downs
• Vulnerable groups (e.g., Children in Care, children with mental health needs)

* Previous suicide attempts are one of the most significant risk-factors for children and young people who later die by suicide

** Not every child and young person who dies by suicide will express suicidal ideation. And not all who threaten suicide or communicate thoughts about this will attempt suicide. However, “a significant majority of young suicide attempts or deaths by suicide are preceded by threats or warnings” (Miller, 2021, p, 5.)

Suicide myths

Myth	Why it is unhelpful and/or untrue
Talking about suicide will increase the probability of its occurrence	There is no evidence to suggest this. Young people who openly discuss the topic of suicide reduce their risk and access support. The direct questioning of young people suspected of engaging in suicidal behaviour is a key component of effective risk-management.
Parents/carers are often aware of their child’s suicidal behaviour	Young people often do not tell their caregivers about their suicidal ideation or plans. They are more likely to speak to friends. This reinforces the need to directly ask young people about suicide rather than relying on parents or carers to have this information.
Young people who die by suicide leave notes	Most do not. Researchers believe that this is often because the deceased young people do not want to reveal their thoughts and feelings.
Suicidal people are impulsive	The opposite is true. Those who die by suicide have often given their suicide thought and planning. They may have considered their suicide years in advance. Impulsivity is more likely to be related to risk-factors associated with suicide (e.g. relationship difficulties, substance issues).
Young children are not suicidal	It is rare for preadolescent children to die by suicide however young children can and do engage in suicide ideation and attempts which should be taken seriously.
Suicide rates are higher in December	The inverse of this is true, Christmas can bring feelings of connectedness, belonging and togetherness which is a protective factor that prevents suicide.
If someone is suicidal, there’s nothing that can be done to help	Suicidal intervention strategies can and do work. Most people who attempt suicide do so only once.

Communication

In addition to following the guidance around communication elsewhere in this pack:

• Be mindful of the risks associated with ‘suicide clusters’ – this is where children and young people with pre-existing vulnerability may be more likely to attempt suicide following bereavement by suicide of a friend of school member. With this in mind, carefully considering the way that pupils are informed about a suicide is key. Do not provide details of the method of suicide to pupils.
• Inform other nearby schools where the deceased student may have connections so that they can communicate with and support their pupils.
• As with other critical incidents, monitor social and digital media. Be mindful of content online which:
  • Contributes to misinformation
  • Is harmful or inappropriate
  • Could indicate that there are students at-risk
• Should students start a spontaneous memorial, monitor this for messages which may identify students as at-risk or be inappropriate.

Support and monitoring

Young people who have lost friends or family to suicide can – alongside other bereavement responses – may experience:

• Feelings of stigma
• Maladaptive coping strategies
• Traumatic guilt

In addition to following the guidance around supporting pupils and staff elsewhere in this pack…

…consider the points below to support the school/setting community following a suicide:

• Identify pupils who are close contacts, consider if any may need bereavement counselling or support (e.g. friends, classmates, siblings).
• Do not allow any students affected by the suicide to leave school unaccompanied unless arranged with parents/carers.
• Beyond close contacts/friends, consider the student body more broadly. Are there other pupils with suicide risk-factors who may be vulnerable in response to the current bereavement?
• Consider the risk of ‘suicide clusters’ – this is where children and young people with pre-existing vulnerability may be more likely to attempt suicide following bereavement by suicide of a friend of school member. How can resilience be built within the school community (e.g. good systems of support, good pupil and staff knowledge)? How can ‘at-risk’ pupils be monitored and supported?
• Promote help-seeking behaviour within the school community ensuring that pupils know who they can talk to, how to support one another, and what to do if they are worried about a friend or classmate. Children and young people are often more likely to speak to their friends about self-harm or suicidal ideation.
• When monitoring pupils over a longer-time frame be sensitive to times when support networks might change (e.g. exams, holidays, transitions, family changes) and identify alternative support for these periods.
• In the longer-term, consider planning information sessions for parents and carers to promote knowledge of suicide-risk factors and prevention. Draw upon support from mental health partners to run these events.
• Similarly, upskill staff through training or team meetings around suicide risk-factors, effective support and prevention.

Local procedures

There is formal procedure for alerts when there is a suspected suicide:

When reporting a Critical Incident that involves a suspected suicide impacting a school or educational setting, please download and complete the Critical Incident Form and send it to Children’s Social Care ‘Front Door’ (MASH). multiagencysafeguardinghubsecure-mailbox@devon.gov.uk

If you believe the concerns require an urgent response, please telephone MASH Tel: 0345 155 1071

NB: Outside normal working hours please contact: Tel: 0345 6000 388

For more information and guidance please see: DCC Partnership website link: https://www.devonscp.org.uk/training-and-resources/making-a-mash-contact/ 

Other official procedures to be aware of

Deaths of children (<18 years) are reviewed by a Child Death Overview Panel (CDOP) on behalf of the Local Safeguarding Children Board. The CDOP will look at information from any agencies involved with the child before their passing and will consider factors which may have contributed to death.

A Serious Case review (SCR) occurs when a child either dies or is seriously injured in circumstances where neglect or abuse are either known or suspected. A SCR may also occur when there are concerns about the way professionals have acted.

Where a child has recently been in police custody, was residing in a detention centre or immigration centre, the Prisons and Probation Ombudsman (PPO) or the Independent Police Complaints Commission (IPCC) may also investigate.

Onward referrals may include

• Kooth Online Counselling Service – www.kooth.com
• Pete’s Dragons – www.petesdragons.org.uk

Resources and organisations who offer support

C.A.L.M – Campaign Against Living Miserably
An organisation who campaign against suicide, offering a 24hr helpline and a range of online resources.
Homepage | Campaign Against Living Miserably (CALM) (thecalmzone.net)

The MIX
A wellbeing charity for under 25s with support through digital and phone services.
The Mix – Essential support for under 25s

The Letter of Hope which includes a CYP version (Letter for Tomorrow). This may be useful to pass on the families/carers when working with Young People who are struggling with suicidal thoughts.

Debrief service | Papyrus UK | Suicide Prevention Charity (papyrus-uk.org)

Step by Step | Samaritans

Papyrus conversation starters – suicide https://papyrus-uk.org/wp-content/uploads/2018/09/papyrus_conversation_starters.pdf

Papyrus – Building Suicide Safer schools and colleges; a guide for teachers and staff https://papyrus-uk.org/wp-content/uploads/2018/08/toolkitfinal.pdf

Samaritans – Support for schools – https://www.samaritans.org/how-we-can-help/schools/

Survivors of Bereavement by Suicide (SOBS) – Emotional and practical support and local groups for anyone bereaved or affected by suicide.
uk-sobs.org.uk

When a parent/carer dies

• A representative from the school/setting should discuss with the family (and if appropriate the child/young person) what information should be given to classmates and other school/setting pupils.
  • Some will want to be absent for this talk and some will want to participate.
  • Then use the opportunity to talk about grief and reactions.
• Consider whether a representative from the school/setting should attend the funeral. Some closest friends may also want to attend (consent must be obtained).
• After the bereavement there will be a long period when the child/young person will have a reduced capacity to work.
• Extra help may be needed later.
• Let the child/young person decide how much s/he wants to talk about what happened but let them know you are willing to listen if s/he comes to you.
• Maintain contact with the home about the child’s progress in school.
• Refer to ‘Supporting pupils’ (see above) for guidance around a child’s developmental understanding of bereavement.

Talking to children and young people about serious illness

Talking to children and young people about serious and life-threatening illness is not easy. We instinctively want to protect children/young people and not scare them with too much negative information. However, the advice of specialists including the bereavement charities is that it is better to be open and honest.

Partial or inaccurate information may be even more worrying and could affect the child or young person’s trust in you in the future. It is important not to underestimate the ability of children and young people to hear the truth.

Key information to tell children and young people

• that someone is ill
• what the illness is called
• how serious the illness is

How to begin a conversation

What reaction might there be?

Everyone processes information in different ways, there could be a range of reactions from upset or anger, people sometimes even laugh or smile when they are presented with information they can’t quite process or that appears frightening. There may appear to be no reaction at all. Give children and young people some time and space to react in their own way without negative comment. Offer kind words acknowledging that it is a sad time, we are thinking about the person who is ill and we are all trying to look after each other.

Guidance for parents and carers when talking to children/young people about traumatic events

Parents and carers are faced with the challenge of explaining traumatic events to children and young people. Although difficult, these conversations are extremely important. They give parents/carers an opportunity to help their children feel more secure and understand the world in which they live. The following information can be helpful:

Listen to children/young people

• Create a time and place for children/young people to ask their questions. Don’t force children/young people to talk about things until they’re ready.
• Remember that children/young people tend to personalize situations. For example, they may worry about friends or relatives who they are unable to have contact with.
• Help children/young people find ways to express themselves. Some children/young people may not be able to talk about their thoughts, feelings, or fears. They may be more comfortable drawing pictures, playing with toys, or writing stories or poems directly or indirectly related to current events.

Answer children/young people’s questions

• Use words and concepts your child can understand. Make your explanation appropriate to your child’s age and level of understanding. Don’t overload a child with too much information. See ‘Supporting pupils’ (above) for guidance around a child’s developmental understanding of bereavement.
• Give children honest answers and information. Children will usually know if you’re not being honest.
• Be prepared to repeat explanations or have several conversations. Some information may be hard to accept or understand. Asking the same question over and over may be your child’s way of asking for reassurance.
• Acknowledge and support your child’s thoughts, feelings, and reactions. Let your child know that you think their questions and concerns are important.
• Be consistent and reassuring, but don’t make unrealistic promises.
• Remember that children/young people learn from watching their parents/carers and teachers. They are very interested in how you respond to events. They learn from listening to your conversations with other adults.
• Let children/young people know how you are feeling. It’s OK for them to know if you are anxious or worried about events. However, don’t burden them with your concerns.
• Don’t confront your child’s way of handling events. If a child/young person feels reassured by saying that things are happening somewhere else, it’s usually best not to disagree. The child/young person may need to think about events this way to feel safe.

Provide support

• Don’t let children watch lots of violent or upsetting images on TV. Repetitive frightening images can be very disturbing, especially to young children.
• Help children establish a predictable routine and schedule. Children are reassured by structure and familiarity. Physical activity, quiet time and time to be noisy and have fun take on added importance during stressful times.
• Where possible coordinate information between home and school/setting. Parent/carers should know what school/setting are expecting. Teachers should know about the child/young person’s specific fears or concerns.
• Children/young people who have experienced trauma or losses may show more intense reactions to tragedies or news of further incidents. These children/young people may need extra support and attention.
• Watch for physical symptoms related to stress. Many children/young people show anxiety and stress through complaints of physical aches and pains.
• Watch for possible preoccupation with health and anxiety around being ill.
• Children/young people who seem preoccupied or very stressed about their own health may need to be evaluated by a qualified mental health professional. Other signs that a child/young person may need professional help include: on-going trouble sleeping, persistent upsetting thoughts, fearful images, intense fears about death, and trouble leaving their parents/carers or going to school or an educational setting.
• Help children/young people communicate with others and express themselves at home. Some children/young people may want to write letters to politicians, newspapers, or grieving families.
• Let children be children. They may not want to think or talk a lot about these events. It is OK if they’d rather play a game, watch a suitable TV programme, play outside (if appropriate) etc.

Traumatic events are not easy for anyone to comprehend or accept. Understandably, many young children may feel confused, upset, and anxious. Parents and caring adults can help by listening and responding in an honest, consistent, and supportive manner. Most children/young people, even those exposed to trauma, are quite resilient. Like most adults, they can and do get through difficult times and go on with their lives. By creating an open environment where they feel free to ask questions, parents and carers can help them cope and reduce the possibility of emotional difficulties.

Guidance for teenagers following a traumatic event

When a traumatic event strikes, it can seem like the entire world is upside down and confusing. It’s hard to believe what’s happening and to know when things will get back to normal.

Here are some things teenagers can do:

• Give yourself a fear reality check. It’s normal to be worried about your safety and your family’s safety. Even though your chances of experiencing a traumatic event may be small, the images you see on TV or online can make danger seem close by.
• Share your feelings. Anger, sadness, fear, and numbness are some of the reactions you might have. Don’t be embarrassed or afraid to express how you feel. Just talking and sharing your feelings with your parents, friends, teachers, and others can help them and help you.
• Take care of yourself. Losing sleep, not eating, and worrying too much can make you sick. As much as possible, try to get enough sleep, eat right, exercise, and keep a daily routine. It may be hard to do, but it can keep you healthy and better able to handle a tough time.
• Limit the time you spend watching the news. It’s good to be informed about what’s happening, but spending hours watching news reports can make you feel more anxious and sad.
• Be respectful of others. You may have heard of certain people or countries being blamed. Don’t give into prejudice by blaming a whole group, or disliking people just because of the country where they were born, the faith they practice, the way they dress, or the colour of their skin.
• Get additional support if you need to. A traumatic event can cause strong reactions, but if your feelings make it impossible for you to function and do normal daily stuff, it’s time to seek additional help. Turn to a parent, teacher, religious leader, or guidance counsellor, so you can get the help you need.

Talking to children about terrorism and war

In today’s world, parents and carers are faced with the challenge of explaining violence, terrorism and war to children. Although difficult, these conversations are extremely important. They give parents/carers an opportunity to help their children feel more secure and understand the world in which they live. The following information can be helpful to parents and carers when discussing these issues:

Listen to children

• Create a time and place for children to ask their questions. Don’t force children to talk about things until they’re ready.
• Remember that children tend to personalize situations. For example, they may worry about friends or relatives who live in a city or state associated with incidents or events.
• Help children find ways to express themselves. Some children may not be able to talk about their thoughts, feelings, or fears. They may be more comfortable drawing pictures, playing with toys, or writing stories or poems directly or indirectly related to current events.

Answer children’s questions

• Use words and concepts your child can understand. Make your explanation appropriate to your child’s age and level of understanding. Don’t overload a child with too much information.
• Give children honest answers and information. Children will usually know if you’re not being honest.
• Be prepared to repeat explanations or have several conversations. Some information may be hard to accept or understand. Asking the same question over and over may be your child’s way of asking for reassurance.
• Acknowledge and support your child’s thoughts, feelings, and reactions. Let your child know that you think their questions and concerns are important.
• Be consistent and reassuring, but don’t make unrealistic promises.
• Avoid stereotyping groups of people by race, nationality, or religion. Use the opportunity to teach tolerance and explain prejudice.
• Remember that children learn from watching their parents and teachers. They are very interested in how you respond to events. They learn from listening to your conversations with other adults.
• Let children know how you are feeling. It’s OK for them to know if you are anxious or worried about events. However, don’t burden them with your concerns.
• Don’t confront your child’s way of handling events. If a child feels reassured by saying that things are happening very far away, it’s usually best not to disagree. The child may need to think about events this way to feel safe.

Provide support

• Don’t let children watch lots of violent or upsetting images on TV. Repetitive frightening images or scenes can be very disturbing, especially to young children.
• Help children establish a predictable routine and schedule. Children are reassured by structure and familiarity. School, sports, birthdays, holidays, and group activities take on added importance during stressful times.
• Coordinate information between home and school. Parents should know about activities and discussions at school. Teachers should know about the child’s specific fears or concerns.
• Children who have experienced trauma or losses may show more intense reactions to tragedies or news of war or terrorist incidents. These children may need extra support and attention.
• Watch for physical symptoms related to stress. Many children show anxiety and stress through complaints of physical aches and pains.
• Watch for possible preoccupation with violent movies or war theme video/computer games.
• Children who seem preoccupied or very stressed about war, fighting, or terrorism may need to be evaluated by a qualified mental health professional. Other signs that a child may need professional help include: on-going trouble sleeping, persistent upsetting thoughts, fearful images, intense fears about death, and trouble leaving their parents or going to school. The child’s physician can assist with appropriate referrals.
• Help children communicate with others and express themselves at home. Some children may want to write letters to the President, Governor, local newspaper, or to grieving families.

Let children be children. They may not want to think or talk a lot about these events. It is OK if they’d rather play ball, climb trees, or ride their bike, etc.

War and terrorism are not easy for anyone to comprehend or accept. Understandably, many young children feel confused, upset, and anxious. Parents, teachers, and caring adults can help by listening and responding in an honest, consistent, and supportive manner. Most children, even those exposed to trauma, are quite resilient. Like most adults, they can and do get through difficult times and go on with their lives. By creating an open environment where they feel free to ask questions, parents can help them cope and reduce the possibility of emotional difficulties.

Guidance for teenagers dealing with difficult news about terrorism and war

Terrorism is a violent act committed by people who want to get attention for their cause. When a terrorist strikes, it seems like the entire world is upside down and confusing. It’s hard to believe what’s happened or that someone would do something like that.

Acts of terrorism have been a reality in many places for years. In the United States, the worst attacks happened on September 11, 2001. In the years that followed, other attacks also happened in Spain, London, and elsewhere.

Terrorism scares everyone because no one knows when or where it will take place. So how do you cope with it all? Here are some things you can do:

• Give yourself a fear reality check. It’s normal to be worried about your safety and your family’s safety. Even though your chances of being in an attack are very, very small, the images you see on TV or online make terrorist attacks seem close by.
• Share your feelings. Anger, sadness, fear, and numbness are some of the reactions you might have. Don’t be embarrassed or afraid to express how you feel. Just talking and sharing your feelings with your parents, friends, teachers, and others can help them and help you.
• Take care of yourself. Losing sleep, not eating, and worrying too much can make you sick. As much as possible, try to get enough sleep, eat right, exercise, and keep a normal routine. It may be hard to do, but it can keep you healthy and better able to handle a tough time.
• Limit the time you spend watching the news. It’s good to be informed about what’s happening but spending hours watching the news reports can make you feel more anxious and sad.
• Be respectful of others. You may have heard certain countries, religions, or political causes blamed for terrorism. But very few people believe in killing and hurting innocent people to make their point. Don’t give into prejudice by blaming a whole group, or disliking people just because of the country where they were born, the faith they practice, the way they dress, or the colour of their skin.
• Join with others. Participating in candlelight vigils, religious ceremonies, memorial services, or other events can be helpful. It’s a way to show you care and that the community is sticking together during a sad time.
• Get additional support. A traumatic event can cause strong reactions, but if your feelings make it impossible for you to function and do normal stuff, like go to school, it’s time to seek additional help. Turn to a parent, teacher, religious leader, or guidance counsellor, so you can get the help you need.

Bereavement charities

Winston’s Wish
Charity for bereaved children.
www.winstonswish.org.uk

Jeremiah’s Journey
Plymouth based charity for bereaved children.
www.jeremiahsjourney.org.uk

CRUSE
Bereavement Care
https://www.cruse.org.uk/

Hope Again
Website designed for young people by young people.  Youth website of CRUSE.
www.hopeagain.org.uk

The Compassionate Friends UK
Support for siblings.
www.tcfsiblingsupport.org.uk

BALLOONS (Bereavement and Loss Looking Onwards)
Charity covering Exeter, East and Mid Devon
www.balloonscharity.co.uk

FIG (Families in Grief, including Teens in Grief)
Charity supporting grieving families in North Devon. Tel: 01237 479027

Support after Murder and Manslaughter (SAMM)
http://www.samm.org.uk

Child Bereavement UK
Child Bereavement UK supports families and educates professionals when a baby, child or young person of any age dies or is dying, or when a child is facing bereavement. It also provides advice for Young People.
https://childbereavementuk.org

Mind
Mental Health Charity. Gives information about where you can get support with bereavement.
https://www.mind.org.uk

Reading list

This is a suggested Reading List to use with Pupils (a more comprehensive list is available on the Winston’s Wish website).

Books for children under 5 years

I Miss You – A First Look at Death
P. Thomas   ISBN 0764117645

Goodbye Mousie
R.H. Harris   ISBN 978-0689871344

Goodbye Grandma
D. Brauna     ISBN 1405219017

Muddles, Puddles and Sunshine: Your Activity Book to Help When Someone Has Died
D.Crossley and K.Sheppard ISBN-10: 1869890582

The Day the Sea Went Out and Never Came Back: A Story for Children Who Have Lost Someone They Love: 2 (Helping Children with Feelings)
M. Sunderland   ISBN-13: 978-0863884634

Books for children aged 5-8 years

Badger’s Parting Gifts
S. Varley   ISBN 978-0006643173

Always and Forever
A. Durant ISBN 978-0552548779

Flamingo Dream
D.J. Napoli ISBN 978-0688167967
(About a father who is ill then dies)

The Sunshine Cat
M. Moss ISBN 978-1841215679
(A child’s cat gets killed in a road accident)

When Dinosaurs die
L.K. Brown and M. Brown ISBN 031611955
(A factual book exploring issues about why someone dies and feelings about death)

Books for children aged 9-12 years

Michael Rosen’s SAD BOOK
M. Rosen ISBN 978-1406313161
(Refers to Michael Rosen’s son dying and how it affects him)

Milly’s Bug Nut
J. Janey ISBN 978-0-9539123-4-6
(About a girl whose father dies)

Water Bugs and Dragonflies
D. Stickney ISBN 978-0264674414
(A pocket book explaining death)

What on Earth to do when someone dies
T. Romain ISBN 978-1575420554

Books for young people aged 13-16

Help for the Hard Times
E. Hipp ISBN 1-56838-085-5
(Refers to different types of loss and grief and skills to help teenagers)

The Spying Game
P. Moon ISBN 978-1842750049
(About a boy whose father dies and reveals the boys response)

Vicky Angel
J. Wilson ISBN 978-0440865896
(A girl’s friend is run over and killed)

Straight Talk about Death for Teenagers: How to Cope with Losing Someone you Love
E.A. Grollman ISBN 978-0807025017

Articles to support schools

Loss in the family – A reflection on how schools can support their students Atle Dyregrov , Kari Dyregrov & Martin Lytje
To link to this article: https://doi.org/10.1080/02682621.2020.1828722

Self-care checklist

This is for anyone who is touched by the Critical Incident, whether directly or indirectly, e.g. office staff, family, friends – all should consider their own needs.

Immediate

Ideally find someone to talk to (colleague, friend, partner) within the first 12 hours. If there is no one, sit quietly and go over the events. Carry out your own reflections in drawn or written form if that helps process what has happened. In addition:

• Ask yourself if the incident has triggered memories of other traumatic events in your own life?
• Ask yourself/a colleague ‘is my continued involvement appropriate?’
• Ask ‘do I need immediate back up support for other work?’
• Tell a partner/family about your involvement because you may not feel sociable or you may feel upset, angry etc. (NB – they may not be willing listeners).
• Treat yourself to something self-indulgent that evening, e.g. bath, walk, etc. Monitor your caffeine and alcohol intake, self-medication of this kind may not be helpful.

Short term

• Share experience with colleagues. Participate in personal/team discussion both for support and sharing of experiences. Expect support and feedback on your own professional performance.
• Be aware that you may experience physical and emotional effects such as fatigue, anxiety, depression, irritability, etc. which are normal reactions.
  Consider setting up a ‘buddy’ system so that everyone is able to support each other.

Long term

• Ask ‘Do I still think about the incident when I don’t mean to?’
• Ask ‘Do I have trouble falling or staying asleep?’
• Ask ‘Does it feel as if the incident didn’t happen/wasn’t real?’
• Ask ‘Do I stay away from reminders of it?’
• Ask ‘Am I becoming withdrawn and less able to function with friends, family, or colleagues?’
• Ask ‘Do I need to seek further advice or support?”