Self Harm and Suicide

Scope of this chapter

This chapter should be read in conjunction with the relevant Hull Safeguarding Children's Partnership Guidelines and Procedures.

Regulations and Standards

The Positive Relationships Standard

The Protection of Children Standard

Related guidance

Amendment

In April 2026, this chapter was updated to contain information from the Mental Health Foundation 2003, NICE guidance for Self-harm: assessment, management and preventing recurrence and the NHS England Staying safe from suicide guidance. Additional website links were added.

April 24, 2026

1. Introduction

Many children and young people who come into the ‘looked after’ system will have experienced significant trauma in their lives. It is likely that these children will have multiple and complex needs and behavioural and emotional difficulties, which can lead to them acting in ways that place themselves in situations of high risk.

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. 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 in exploring their feelings and behaviour and the possible outcomes for them.

2. Planning and Prevention

As part of Placement Planning, relevant information should be gathered. There is evidence to conclude that many individuals who act on self-harm or suicidal impulses can have no plans or intentions to do so, even minutes beforehand. Both the NICE guidance for Self-harm: assessment, management and preventing recurrence and the NHS England Staying safe from suicide guidance emphasise that the use of suicide prediction tools, scales and stratification are flawed and should not be used and that a psychosocial approach should be taken.

All planning should be dynamically reviewed in line with the children/ young person's needs.

In situations where staff are involved with a child who is actively self-harming or suicidal, they should, in consultation with other members of the team, ensure there is a plan to manage the effects such as distress or grief that an incident of self-harm or suicide may cause other workers, family members and other children and young people in the setting.

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.

Specialist advice or support should be sought.

3. Protective and Supportive Action

Adopting a warm and empathic approach, active listening and open communication supports the building of a creating a safe space for the child and nurtures a collaborative relationship.

If a child has a sensory or learning disability, how they communicate should be learnt and observations of their responses to their environmental stimuli will assist to inform their likes and dislikes and what makes them happy and sad.

The child or young person's social worker or key worker should talk to the child or young person and establish:

If they have taken any substances or injured themselves, if so, the severity of this and whether medical treatment is needed;
Find out if there is an immediate concern for the child or young person’s safety;
If they are experiencing any delusional thoughts or behaviours;
Find out what is troubling them and if they feel they are overwhelmed or have control over their current situation;
Explore how imminent or likely self-harm might be;
Find out what help or support the child or young person would wish to have;
Find out who else may be aware of their feelings;
If they have peers or are experiencing social isolation;
If they are experiencing physical issues such as prolonged pain or infection that could impact wellbeing and behaviour, such as UTI; If there is any history or family history regarding self-harm or suicide ideation;
If there any signs or symptoms of a mental illness, such as depression or anxiety;
Do they have an AI companion? These companions differ from more generalised task-oriented AI chatbots such as ChatGPT and Alexa. They are programmed to emulate emotional intelligence, emotional support and companionship. It is important to remain professionally curious and try to understand what topics they discuss with these companions. These topics dictate the AI to algorithms, which could lead to risks of being exposed to harmful AI behaviour, which in turn could compound their issues;
If they use social media, forums, chat rooms etc and how these make them feel. Consider if the Online Safety Act 2023 has impacted their internet use and if this has had any negative or positive impact.

They should explore;

How long have they felt like this?
Are they at risk of harm from others?
Are they worried about something?
Ask about the young person's health and any other problems such as relationship difficulties, abuse and sexual orientation issues?
What other risk-taking behaviour have they been involved in?
What have they been doing that helps?
What are they doing that stops the self-harming behaviour from getting worse?
What can be done in school or at home to help them with this?
How are they feeling generally at the moment?
What needs to happen for them to feel better?

Summarise with the child to clarify your understanding of what they have shared.

Consider:

Self-harming can be secretive and often associated with guilt and embarrassment. This can present challenges when trying to approach the subject of self-harm with a child/ young person;
It is important that the adult checks their own feelings and thoughts before asking any questions. If the feelings and thoughts are negative in anyway, they will be communicated to them non-verbally and this may hinder the helping process;
It is important to young people to have someone to talk to who listens properly and does not judge;
Take a non-judgmental attitude towards the young person. Try to reassure that you understand that the self-harm is helping them to cope at the moment and you want to help.

Do not:

Panic or try quick solutions;
Dismiss what the child or young person says;
Believe that a young person who has threatened to harm themselves in the past will not carry it out in the future;
Disempower the child or young person;
Ignore or dismiss the feelings or behaviour;
See it as attention seeking or manipulative;
Trust appearances, as many children and young people learn to cover up their distress.

4. Notifications, Recording and Review

4.1 Notifications of Self harm or Suicide Attempts

If there is any suspicion that the child may be involved in self-harming or any attempts of suicide, the homes manager and social worker should be informed as agreed within their plan and the homes protocol, and a review of planning must be undertaken to reflect this information.

The social worker should give consideration to whether a Child Protection Referral should be made, if so, see Safeguarding Children and Young People and 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.

4.2 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.

A serious incident of self harm is likely to constitute a notifiable event. However, it is important that staff in residential units consider the frequency of any self harm incidents and judge whether their cumulative effect makes notification appropriate even if in isolation each event would not warrant this. In particular staff should be alert to any patterns of behaviour or unusual behaviour which may indicate an increased risk to the child.

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