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“These Things Don’t Work.” Young People’s Views on Harm Minimization Strategies as a Proxy for Self-Harm: A Mixed Methods Approach

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National Institute for Health and Care Excellence : NICE

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National Institute for Health and Care Excellence : NICE

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All NICE products on self-harm. Includes any guidance and quality standards.

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Gillick competency and Fraser guidelines

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Gillick competency and Fraser guidelines

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Introduction

Gillick competency and Fraser guidelines help people who work with children to balance the need to listen to children's wishes with the responsibility to keep them safe.

When practitioners are trying to decide whether a child is mature enough to make decisions about things that affect them, they often talk about whether the child is 'Gillick competent' or whether they meet the 'Fraser guidelines'.

Although the two terms are frequently used together and originate from the same legal case, there are distinct differences between them.

Both Gillick competency and Fraser guidelines refer to a legal case from the 1980s which looked at whether doctors should be able to give contraceptive advice or treatment to young people under 16-years-old without parental consent.

Applying Gillick competence and Fraser guidelines

The Fraser guidelines still apply to advice and treatment relating to contraception and sexual health. But Gillick competency is often used in a wider context to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.

You should always encourage a child to tell their parents or carers about the decisions they are making. If they don't want to do this, you should explore why and, if appropriate, discuss ways you could help them inform their parents or carers. For example, you could talk to the young person's parents or carers on their behalf.

If the young person still wants to go ahead without their parents' or carers' knowledge or consent, you should consider the Gillick and Fraser guidelines. The following information looks at how this can be applied in practice.

Gillick competence

Gillick competence

Gillick competency applies mainly to medical advice but it is also used by practitioners in other settings. For example, if a child or young person:

would like to have therapeutic support but doesn't want their parents or carers to know about it

is seeking confidential support for substance misuse

has strong wishes about their future living arrangements which may conflict with their parents' or carers' views.

Medical professionals need to consider Gillick competency if a young person under the age of 16 wishes to receive treatment without their parents' or carers' consent or, in some cases, knowledge.

If the young person has informed their parents of the treatment they wish to receive but their parents do not agree with their decision, treatment can still proceed if the child has been assessed as Gillick competent.

There is specific guidance for medical professionals on using Gillick competence - see case history and legislation.

Assessing Gillick competence

There is no set of defined questions to assess Gillick competency. Professionals need to consider several things when assessing a child's capacity to consent, including:

the child's age, maturity and mental capacity

their understanding of the issue and what it involves - including advantages, disadvantages and potential long-term impact

their understanding of the risks, implications and consequences that may arise from their decision

how well they understand any advice or information they have been given

their understanding of any alternative options, if available

their ability to explain a rationale around their reasoning and decision making.

Remember that consent is not valid if a young person is being pressured or influenced by someone else.

Children's capacity to consent may be affected by different factors, for example stress, mental health conditions and the complexities of the decision they are making. The same child may be considered Gillick competent to make one decision but not competent to make a different decision.

If you don't think a child is Gillick competent or there are inconsistencies in their understanding, you should seek consent from their parents or carers before proceeding.

In complex medical cases, such as those involving disagreements about treatment, you may wish to seek the opinion of a colleague about a child's capacity to consent (Care Quality Commission, 2019).

Young people also have the right to seek a second opinion from another medical professional (General Medical Council, 2020).

Refusal of medical treatment

Gillick competency can be used when young people wish to refuse medical treatment.

However, if a young person refuses treatment which may lead to their death or severe permanent harm, their decision can be overruled. More information about this is available in the guidance for medical professionals in each UK nation - see case history and legislation.

Child protection concerns

The child's safety and wellbeing is paramount.

When you are assessing Gillick competency if you have any concerns about the safety of the young person you should check whether previous child protection concerns have been raised, and explore any factors that could put them at risk of abuse.

You must always share child protection concerns with the relevant agencies, even if this goes against a child's wishes.
> Find out more about recognising and responding to abuse

Fraser guidelines

Fraser guidelines

The Fraser guidelines apply specifically to advice and treatment about contraception and sexual health. They may be used by a range of healthcare professionals working with under 16-year-olds, including doctors and nurse practitioners.

Following a legal ruling in 2006, Fraser guidelines can also be applied to advice and treatment for sexually transmitted infections and the termination of pregnancy (Axton v The Secretary of State for Health, 2006).

Using the Fraser guidelines

Practitioners using the Fraser guidelines should be satisfied of the following:

the young person cannot be persuaded to inform their parents or carers that they are seeking this advice or treatment (or to allow the practitioner to inform their parents or carers).

the young person understands the advice being given.

the young person's physical or mental health or both are likely to suffer unless they receive the advice or treatment.

it is in the young person's best interests to receive the advice, treatment or both without their parents' or carers' consent.

the young person is very likely to continue having sex with or without contraceptive treatment.

(Gillick v West Norfolk, 1985)

Child protection concerns

When using Fraser guidelines for issues relating to sexual health, you should always consider any potential child protection concerns:

Underage sexual activity is a possible indicator of child sexual exploitation and children who have been groomed may not realise they are being abused.

Sexual activity with a child under 13 should always result in a child protection referral.

If a young person presents repeatedly about sexually transmitted infections or the termination of pregnancy this may be an indicator of child sexual abuse or exploitation.

You should always consider any previous concerns that may have been raised about the young person and explore whether there are any factors that may present a risk to their safety and wellbeing.

You must always share child protection concerns with the relevant agencies, even if a child or young person asks you not to.

> Find out more about recognising and responding to abuse

Case history, legislation and guidance

Gillick v West Norfolk and Wisbech Area Health Authority 1986

In 1982 Victoria Gillick took her local health authority (West Norfolk and Wisbech Area Health Authority) and the Department of Health and Social Security to court in an attempt to stop doctors from giving contraceptive advice or treatment to under 16-year-olds without parental consent.

The case went to the High Court in 1984 where Mr Justice Woolf dismissed Mrs Gillick's claims. The Court of Appeal reversed this decision, but in 1985 it went to the House of Lords and the Law Lords (Lord Scarman, Lord Fraser and Lord Bridge) ruled in favour of the original judgment delivered by Mr Justice Woolf:

"...whether or not a child is capable of giving the necessary consent will depend on the child's maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment proposed, so the consent, if given, can be properly and fairly described as true consent" (Gillick v West Norfolk, 1984).

What are the Fraser guidelines?

The Fraser guidelines refer to the guidelines set out by Lord Fraser in his judgment of the Gillick case in the House of Lords (Gillick v West Norfolk, 1985), which apply specifically to contraceptive advice.

Lord Fraser stated that a doctor should always encourage a girl aged under 16 to inform her parents or carers that she is seeking contraceptive advice (or allow the doctor to inform the parents or carers on her behalf). But if she cannot be persuaded to do so they can proceed to give contraceptive advice and treatment as long as certain conditions are met. This includes making sure it's in the girl's best interests for advice to be given and that she understands the advice.
> Find out more about using the Fraser guidelines
What is Gillick competence?

Lord Scarman's comments in his judgment of the Gillick case in the House of Lords (Gillick v West Norfolk, 1985) are often referred to as the test of "Gillick competency". He said:

"...it is not enough that she should understand the nature of the advice which is being given: she must also have a sufficient maturity to understand what is involved."

He also commented more generally on parents' versus children's rights:

"parental right yields to the child's right to make his own decisions when he reaches a sufficient understanding and intelligence to be capable of making up his own mind on the matter requiring decision."
> Find out more about assessing Gillick competency
Legislation and guidance

Gillick v West Norfolk and Wisbech Area Health Authority went to the House of Lords and is often used as a legal precedent across the UK.

In Scotland, the Age of Legal Capacity (Scotland) Act 1991 sets out when children have the legal capacity to make decisions. Section 2 sets out when a child under the age of 16 can consent to medical treatment or procedures.

Medical guidance

In England, the Department of Health and Social Care provides guidance for medical professionals on the legal framework they need to consider when obtaining valid consent to examination, treatment or care (Department of Health and Social Care, 2009).

In Northern Ireland the Department of Health provides consent guides for healthcare professionals (Department of Health, 2003).

In Scotland the NHS has provided a good practice guide on consent for health professionals (PDF) (Scottish Executive Health Department, 2006).

References and resources

References and resources

Axton v The Secretary of State for Health (The Family Planning Association: intervening) (2006) EWHC 37. As cited in Family Law Week.

Care Quality Commission (2019). Brief guide: capacity and competence to consent in under 18s (PDF). Care Quality Commission.

Department of Health (2003). Consent guides for healthcare professionals. [Accessed 02/02/2020].

Department of Health and Social Care (2009) Reference guide to consent for examination or treatment (second edition). London: Department of Health and Social Care.

Gillick v West Norfolk and Wisbech Area Health Authority and Department of Health and Social Security [1984] Q.B. 581. As cited in Children's Legal Centre (1985) Landmark decision for children's rights. Childright, 22: 11-18.

Gillick v West Norfolk & Wisbech Area Health Authority, UKHL 7 (17 October 1985) Available via (BAILII) in The law reports (appeal cases) [1986] AC 112.

Scottish Executive Health Department (2006). A good practice guide on consent for health professionals in NHS Scotland (PDF). Edinburgh: Scottish Executive

Childline

If a child or young person needs confidential help and advice direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online or read about children's rights on the Childline website.

You can also download or order Childline posters and wallet cards.

Elearning

Our online and face-to-face training courses can help develop your understanding of how to protect children from abuse and safely recruit staff and volunteers to work with children:

Further reading

For further reading about Gillick competency and Fraser guidelines, search the NSPCC Library catalogue using the keywords "Gillick competency" and "Fraser guidelines".
> Find out more about the Library and Information Service

Introduction

Gillick competency and Fraser guidelines help people who work with children to balance the need to listen to children's wishes with the responsibility to keep them safe.

When practitioners are trying to decide whether a child is mature enough to make decisions about things that affect them, they often talk about whether the child is 'Gillick competent' or whether they meet the 'Fraser guidelines'.

Although the two terms are frequently used together and originate from the same legal case, there are distinct differences between them.

Both Gillick competency and Fraser guidelines refer to a legal case from the 1980s which looked at whether doctors should be able to give contraceptive advice or treatment to young people under 16-years-old without parental consent.

Applying Gillick competence and Fraser guidelines

The Fraser guidelines still apply to advice and treatment relating to contraception and sexual health. But Gillick competency is often used in a wider context to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.

You should always encourage a child to tell their parents or carers about the decisions they are making. If they don't want to do this, you should explore why and, if appropriate, discuss ways you could help them inform their parents or carers. For example, you could talk to the young person's parents or carers on their behalf.

If the young person still wants to go ahead without their parents' or carers' knowledge or consent, you should consider the Gillick and Fraser guidelines. The following information looks at how this can be applied in practice.

Gillick competence

Gillick competence

Gillick competency applies mainly to medical advice but it is also used by practitioners in other settings. For example, if a child or young person:

would like to have therapeutic support but doesn't want their parents or carers to know about it

is seeking confidential support for substance misuse

has strong wishes about their future living arrangements which may conflict with their parents' or carers' views.

Medical professionals need to consider Gillick competency if a young person under the age of 16 wishes to receive treatment without their parents' or carers' consent or, in some cases, knowledge.

If the young person has informed their parents of the treatment they wish to receive but their parents do not agree with their decision, treatment can still proceed if the child has been assessed as Gillick competent.

There is specific guidance for medical professionals on using Gillick competence - see case history and legislation.

Assessing Gillick competence

There is no set of defined questions to assess Gillick competency. Professionals need to consider several things when assessing a child's capacity to consent, including:

the child's age, maturity and mental capacity

their understanding of the issue and what it involves - including advantages, disadvantages and potential long-term impact

their understanding of the risks, implications and consequences that may arise from their decision

how well they understand any advice or information they have been given

their understanding of any alternative options, if available

their ability to explain a rationale around their reasoning and decision making.

Remember that consent is not valid if a young person is being pressured or influenced by someone else.

Children's capacity to consent may be affected by different factors, for example stress, mental health conditions and the complexities of the decision they are making. The same child may be considered Gillick competent to make one decision but not competent to make a different decision.

If you don't think a child is Gillick competent or there are inconsistencies in their understanding, you should seek consent from their parents or carers before proceeding.

In complex medical cases, such as those involving disagreements about treatment, you may wish to seek the opinion of a colleague about a child's capacity to consent (Care Quality Commission, 2019).

Young people also have the right to seek a second opinion from another medical professional (General Medical Council, 2020).

Refusal of medical treatment

Gillick competency can be used when young people wish to refuse medical treatment.

However, if a young person refuses treatment which may lead to their death or severe permanent harm, their decision can be overruled. More information about this is available in the guidance for medical professionals in each UK nation - see case history and legislation.

Child protection concerns

The child's safety and wellbeing is paramount.

When you are assessing Gillick competency if you have any concerns about the safety of the young person you should check whether previous child protection concerns have been raised, and explore any factors that could put them at risk of abuse.

You must always share child protection concerns with the relevant agencies, even if this goes against a child's wishes.
> Find out more about recognising and responding to abuse

Fraser guidelines

Fraser guidelines

The Fraser guidelines apply specifically to advice and treatment about contraception and sexual health. They may be used by a range of healthcare professionals working with under 16-year-olds, including doctors and nurse practitioners.

Following a legal ruling in 2006, Fraser guidelines can also be applied to advice and treatment for sexually transmitted infections and the termination of pregnancy (Axton v The Secretary of State for Health, 2006).

Using the Fraser guidelines

Practitioners using the Fraser guidelines should be satisfied of the following:

the young person cannot be persuaded to inform their parents or carers that they are seeking this advice or treatment (or to allow the practitioner to inform their parents or carers).

the young person understands the advice being given.

the young person's physical or mental health or both are likely to suffer unless they receive the advice or treatment.

it is in the young person's best interests to receive the advice, treatment or both without their parents' or carers' consent.

the young person is very likely to continue having sex with or without contraceptive treatment.

(Gillick v West Norfolk, 1985)

Child protection concerns

When using Fraser guidelines for issues relating to sexual health, you should always consider any potential child protection concerns:

Underage sexual activity is a possible indicator of child sexual exploitation and children who have been groomed may not realise they are being abused.

Sexual activity with a child under 13 should always result in a child protection referral.

If a young person presents repeatedly about sexually transmitted infections or the termination of pregnancy this may be an indicator of child sexual abuse or exploitation.

You should always consider any previous concerns that may have been raised about the young person and explore whether there are any factors that may present a risk to their safety and wellbeing.

You must always share child protection concerns with the relevant agencies, even if a child or young person asks you not to.

> Find out more about recognising and responding to abuse

Case history, legislation and guidance

Gillick v West Norfolk and Wisbech Area Health Authority 1986

In 1982 Victoria Gillick took her local health authority (West Norfolk and Wisbech Area Health Authority) and the Department of Health and Social Security to court in an attempt to stop doctors from giving contraceptive advice or treatment to under 16-year-olds without parental consent.

The case went to the High Court in 1984 where Mr Justice Woolf dismissed Mrs Gillick's claims. The Court of Appeal reversed this decision, but in 1985 it went to the House of Lords and the Law Lords (Lord Scarman, Lord Fraser and Lord Bridge) ruled in favour of the original judgment delivered by Mr Justice Woolf:

"...whether or not a child is capable of giving the necessary consent will depend on the child's maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment proposed, so the consent, if given, can be properly and fairly described as true consent" (Gillick v West Norfolk, 1984).

What are the Fraser guidelines?

The Fraser guidelines refer to the guidelines set out by Lord Fraser in his judgment of the Gillick case in the House of Lords (Gillick v West Norfolk, 1985), which apply specifically to contraceptive advice.

Lord Fraser stated that a doctor should always encourage a girl aged under 16 to inform her parents or carers that she is seeking contraceptive advice (or allow the doctor to inform the parents or carers on her behalf). But if she cannot be persuaded to do so they can proceed to give contraceptive advice and treatment as long as certain conditions are met. This includes making sure it's in the girl's best interests for advice to be given and that she understands the advice.
> Find out more about using the Fraser guidelines
What is Gillick competence?

Lord Scarman's comments in his judgment of the Gillick case in the House of Lords (Gillick v West Norfolk, 1985) are often referred to as the test of "Gillick competency". He said:

"...it is not enough that she should understand the nature of the advice which is being given: she must also have a sufficient maturity to understand what is involved."

He also commented more generally on parents' versus children's rights:

"parental right yields to the child's right to make his own decisions when he reaches a sufficient understanding and intelligence to be capable of making up his own mind on the matter requiring decision."
> Find out more about assessing Gillick competency
Legislation and guidance

Gillick v West Norfolk and Wisbech Area Health Authority went to the House of Lords and is often used as a legal precedent across the UK.

In Scotland, the Age of Legal Capacity (Scotland) Act 1991 sets out when children have the legal capacity to make decisions. Section 2 sets out when a child under the age of 16 can consent to medical treatment or procedures.

Medical guidance

In England, the Department of Health and Social Care provides guidance for medical professionals on the legal framework they need to consider when obtaining valid consent to examination, treatment or care (Department of Health and Social Care, 2009).

In Northern Ireland the Department of Health provides consent guides for healthcare professionals (Department of Health, 2003).

In Scotland the NHS has provided a good practice guide on consent for health professionals (PDF) (Scottish Executive Health Department, 2006).

References and resources

References and resources

Axton v The Secretary of State for Health (The Family Planning Association: intervening) (2006) EWHC 37. As cited in Family Law Week.

Care Quality Commission (2019). Brief guide: capacity and competence to consent in under 18s (PDF). Care Quality Commission.

Department of Health (2003). Consent guides for healthcare professionals. [Accessed 02/02/2020].

Department of Health and Social Care (2009) Reference guide to consent for examination or treatment (second edition). London: Department of Health and Social Care.

Gillick v West Norfolk and Wisbech Area Health Authority and Department of Health and Social Security [1984] Q.B. 581. As cited in Children's Legal Centre (1985) Landmark decision for children's rights. Childright, 22: 11-18.

Gillick v West Norfolk & Wisbech Area Health Authority, UKHL 7 (17 October 1985) Available via (BAILII) in The law reports (appeal cases) [1986] AC 112.

Scottish Executive Health Department (2006). A good practice guide on consent for health professionals in NHS Scotland (PDF). Edinburgh: Scottish Executive

Childline

If a child or young person needs confidential help and advice direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online or read about children's rights on the Childline website.

You can also download or order Childline posters and wallet cards.

Elearning

Our online and face-to-face training courses can help develop your understanding of how to protect children from abuse and safely recruit staff and volunteers to work with children:

Further reading

For further reading about Gillick competency and Fraser guidelines, search the NSPCC Library catalogue using the keywords "Gillick competency" and "Fraser guidelines".
> Find out more about the Library and Information Service

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Gillick competence and Fraser guidelines | NSPCC Learning

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Gillick competency is often used to assess whether a child is mature enough to consent to treatment. Fraser guidelines are used for issues relating to sexual health.

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Supporting teenage mental health

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The role of SENCO is one that requires strategic thinking, with policies that must work across key stages and that are inclusive of extremely diverse educational needs. Not only that, the potential (actual) workload generated requires SENCOs to have slick procedures in place to manage what must be done day-to-day. Saira Saeed offers her advice on what to prioritise when new to the SENCO role.
It is my longstanding belief that the role of the SENCO is one that has been desired by many but obtained by few and retained by fewer still. Why? It is categorically one of the most challenging and underestimated roles you can hold in an educational setting and I say this as someone who is both a SENCO and a Designated Safeguarding Lead.

However, it is also one of the most rewarding roles and one where you can develop significantly as a teacher and leader. The role of SENCO is not new to me; it's the most long-standing role in my professional repertoire, yet I can still recall my first year as a SENCO as it if were yesterday, with the mountain of paperwork, acronyms, overworked Local Authority colleagues and the line of parents venting at me due to their frustrations with an underfunded and understaffed system.

However, I also remember the tearful parents thanking me for securing the correct support for their children, the children who settled into mainstream education and felt like they finally belonged, as equals to their non-SEND peers. I also remember the colleagues who were grateful for being able to understand and cater for the needs of their SEND learners due to CPD I had delivered and the Ofsted inspectors who told me that my passion and skills made me an asset to my school.

The first year for any SENCO is arguably the most difficult, but not impossible to complete. As such, this article lists some advice for aspiring and new SENCOs.

Your role is SENCO, which is an acronym for Special Educational Needs Coordinator, hence the accurate identification of your setting's SEND learners is key, especially if you are in a mainstream setting where they can get lost in the myriad of other learner groups (non-SEND: PP, EAL, More Able and so on.)

A SEND register should exist, which lists all students in your setting, per year group. (Software such as Arbor allows you to create and import this in a matter of minutes.) I have many memories of triangulating data and involving numerous external agencies in order to hone this register to ensure it was accurate; no easy feat I assure you, but absolutely required.
Some suggested reads to help with this:
'Essential Guides for Early Career Teachers: Special Educational Needs and Disability' (Anita Devi, 2020) - Don't be fooled by the title, it is as invaluable to experienced SENCOs as it is to ECTs or new SENCOs!

'The SENCO Handbook: Leading Provision and Practice' (Sarah Martin-Denham & Steve Watts, 2019)

'The Lone SENDCO: Questions and Answers for the Busy SENDCO' ( Gary Aubin, 2022)
2. Reach out to your families
I can still recall the first time a parent shouted at me about how their child was being failed by the system and it was upsetting, as I felt personally attacked. Upon reflection a few days later, I realised she was hurting and venting at me because she didn't know what else to do. As SENCO you must never forget that you may be responsible for 25, 70 or more students on a SEND register but for a parent/carer of a SEND child, THEIR child is the most important to them. Their child's dreams matter and deserve to be realised.

This is something that needs to respected and understood because a SENCO's job is challenging but parents of a SEND child live with their child, thus manage their respective needs all the time and this is not without impact on them and/or other members of their family.

If you are active on Twitter, I would advise following some well-known parents of children with SEND, to see what this might look like, thus gaining a better understanding of it. Beth Wilson (@Beth_Tastic ), Ben Newmark (@bennewmark ), Marie Martin (@martinimarie ), Taneisha Pascoe-Matthews (@Mellow_Pascoe ) and Helen Ashby (@HelenAshby72 ) are particularly useful to follow, as they give you an honest insight into their lives, values and feelings; insight that is most invaluable for all SENCOs (not just new or aspiring ones).

One of the first things I did in my first year as SENCO was to collate parent voice data for every child on the SEND register. A letter was posted informing them of who I was and why I wished to hear from them, a Microsoft Form was emailed out, phone calls were made (by myself and the TAs) and multiple coffee mornings were held to make the process accessible to as many parents as possible.

I also ensured that these weren't a novelty, instead ensuring that they occurred at key points throughout the academic year so that I could gauge their responses to SEND provisions at my setting. I can safely say that a lot of parents knew nothing about SEND, their child's rights and so on, so I always made sure that I regularly shared information about local support groups and CPD opportunities with them.

That being said, there were some parents who knew as much as I did (eek!) but rather than be intimidated by them, I celebrated them and utilised their expertise. Honestly, don't ever see knowledgeable parents as a threat, they almost never are. On the rare occasion that they might try to use their knowledge to undermine you, lean on your line manager/SLT for support because nobody has the right to mistreat you regardless of their knowledge; everyone is learning.
3. Know your team
Contrary to a common misconception, as SENCO you are NOT solely responsible for the SEND provisions at your respective setting: 'The SENCO has day-to-day responsibility for the operation of SEN policy and co-ordination of specific provision made to support individual pupils with SEN, including those who have EHC plans' (SEND Code of Practice, 2015). SEND, just as Safeguarding, is everyone's responsibility.

Notably, one of the most significant updates to Keeping Children Safe in Education 2021 places a much-needed importance on SEND learners, as their needs create additional barriers for staff to recognise signs of abuse and neglect, thus effectively safeguard them. In short, SEND should matter to everyone in your setting.

In light of this, it is worthwhile to undertake a staff voice and also a skills audit for them in order to see what (if anything) needs addressing. I have vivid recollections of doing this for the first time and being speechless to discover - amongst other things - that very few staff knew who the EHCP students in my setting were, what an EHCP was and thought that certain SEND learners misbehaved just because they were 'naughty'! Reader, these particular students weren't naughty, they had ADHD or ASD respectively and were receiving minimal support from support staff who themselves had little to no training.

As your setting will no doubt cater for students with a range of needs, it is inevitable that you will work with many external agencies too: PSS, an EP, CAT and so on. You will also have contact information for key staff in the LA (as the LA has many responsibilities too!)Get to know as many of them as possible - especially your LA links - and utilise them whenever necessary.

Lastly, network as much as possible with fellow SENCOs; Twitter is again great for this. I myself am one of the moderators of the SEND Twitter Community. Reach out to others. You will gain knowledge and reassurance and make some good professional links too.
Some suggested reads to help with this
The pastoral team are those you will work particularly closely with in order to ensure that SEND learners are treated fairly (including making sure that relevant policies are fully inclusive). Take a look at some of these books to help you inform your work with Pastoral leads, Heads of Year, etc.

'The Complete Guide to Pastoral Leadership' (Amy Forrester, 2022)

'The Behaviour Manual: An Educator's Guidebook' (Samuel Strickland, 2022)

'After the Adults Change.Achievable Behaviour Nirvana' (Paul Dix, 2017)

'Running The Room.The Teacher's Guide to Behaviour' ( Tom Bennett, 2020)

'The Ladder.Supporting Students towards Successful Futures and Confident Career Choices' (Andrew Bernard, 2021)
4. Lead strategically and operationally
'The SENCO has an important role to play with the headteacher and governing body, in determining the strategic development of SEN policy and provision in the school. They will be most effective in that role if they are part of the school leadership team' (SEND Code of Practice, 2015).

Throughout my career thus far, I have been a SENCO as a member of Middle Leadership, Extended Leadership and Senior Leadership and in all honesty, the level of leadership itself did not impact my work. What did impact my work was the level of autonomy I was given, as well as my own ability to lead both operationally and strategically when required; confidence is absolutely key here - believe in yourself! Teachers are more likely to be invested when they are trusted (not constantly judged), given time and guided by a knowledgeable leader who empowers them.
Some recommended reads to help with this
'Great Expectations: Leading an Effective SEND Strategy in School' (David Bartram, 2018)

'The Leadership Book: A Step by Step Guide to Excellent Leadership' (Neil Jurd, 2020)

'Leadership Matters 3.0: How Leaders at All Levels Can Create Great Schools' (Andy Buck, 2018)

'Intelligent Accountability: Creating the Conditions for Teachers to Thrive' (David Didau, 2020) - definitely one to share with your line manager/SLT!
5. Keep the importance of pedagogy in mind
I have worked in schools where seeking an investment in SEND (CPD-time, staff interest, value in SLT's eyes, etc) was a battle and I have also worked in schools where I was able to make SEND a priority without any struggle. How? Amongst other things, I leaned on The Teachers' Standards; namely, Standard 5.

Yes, the SEND Code of Practice and multiple laws should be enough but The Teachers' Standards are far easier to share via CPD sessions, which is why I tend to share this with staff prior tointroducing them to legislation. They also add that extra layer of accountability. This has served me particularly well when faced with conversations about 'bottom sets', 'simplifying the curriculum' and 'they can't do that GCSE option, it's too hard' (cue lengthy sigh of despair.)

Once I had staff investment in SEND (ie staff understood how important SEND learners are and how important staff are in ensuring these learners have access to a broad and balanced curriculum) I needed to provide guidance on how to make the curriculum accessible.

Some of my most successful CPD sessions for staff ensured that (a) staff gained a better understanding of how SEND can manifest in a classroom setting and (b) staff left the CPD session with 'takeaways' to help them address this and support student progress.

Staff were reassured that what works for SEND learners, will work for every learner; it's not additional work. Moreover, I made it crystal clear that progress would not necessarily look the same for all SEND learners, especially in direct comparison to their non-SEND peers.
Some suggested reads to help with this
'Teaching Walkthrus 3. Five-Step Guides to Instructional Coaching' (Tom Sherrington and Oliver Caviglioli, 2022)

'The researchED Guide to Special Educational Needs: An Evidence-Informed Guide for Teachers' (Karen Wespieser, 2021)

'Understanding How We Learn: A Visual Guide' (Yana Weinstein, 2018)

'Anna Murphy Paul's The Extended Mind in Action' (Emma Turner, David Goodwin and Oliver Caviglioli, 2022)

'The Inclusive Classroom: A New Approach to Differentiation' (Daniel Sobel and Sara Alston, 2021)
6. Never stop revisiting statutory guidance and the law
Be kind to yourself - you can't be the all-knowing oracle. The world of SEND is laden with laws and statutory guidance (I haven't even touched upon the medical side of things in this article). There is a plethora of information to remember and refer to, which is made even more challenging by the fact that much of it is forever being updated.

Ensure you familiarise yourself with key laws, as well as statutory guidance including: Children and Families Act (2014), Equality Act (2010) and the SEND Code of Practice (2015) to name but three.

It is also worth getting a subscription to a reputable organisation such as NASEN, as their publications will help you keep up-to-date with key SEND news and reforms etc. If on Twitter, Special Needs Jungle (@SpcialNdsJungle ) are also a brilliant source of information, as well as IPSEA.The latter is an organisation that runs regular CPD on SEND Law for professionals and parents.
Some suggested reads to help with this:
An example of SEND Funding explained (Birmingham Local Offer, 2022) - please note, this Local Offer website is for Birmingham in the UK, every LA will have their own LA Offer website.Ensure you familiarise yourself with any LA websites that apply to your setting's cohort.For instance, if your setting is based in Birmingham but has students who live in Sandwell too, then ensure you engage with both LAs (Birmingham and Sandwell.)

'How Grand is 6 Grand?' (Garry Freedman, 2020)

'The SEND Green Paper - how can we move towards a more affirmatory conception of SEND and learning disability?' (Ben Newmark & Tom Rees, 2022)

SEND and Disability Statute Law, Regulations and Guidance (IPSEA, 2022)
7. Invest in your wellbeing
The role of SENCO is one of the most exciting, pivotal and rewarding roles I have ever undertaken. However, I have also, on many occasions, sat in my office wanting to scream, through sheer exhaustion as well as frustration, at the ongoing misconceptions about SEND (eg the idea that EAL is a category of SEND - ugh!).

Consequently, it is paramount that you make time to 'switch off' from work completely every day, as this job (like most in education) will consume you if you let it.

Sacrilegious as it will sound to many, do not keep a stock of chocolates, soft drinks and coffee in your room/office 'in case of emergencies' either; treat yourself but please do so sensibly. The job is strenuous as it is, hence being and staying healthy is absolutely paramount. Now, I do have a penchant for bonding with a Bounty or pack of Bourbon biscuits after a particularly challenging day but this is only on the odd occasion, not a daily occurrence.

Have a snack drawer by all means but stock up on healthy treats that will give you much-needed energy boosts; protein bars, fruit, nuts (only keep nuts if your setting isn't nut-free and you don't work with any students who have severe nut allergies), seeds (particularly squash and pumpkin), as well as Green Tea (Matcha has a particular kick to it!)
End note
I have deliberately suggested a range of reads that are mostly succinct and not dear in cost, as I wish to give you some variety. I also am fully aware of the lack of time and CPD budgets that many SENCOs face. By all means, purchase as many of these books as you so wish - and as your pocket allows - but where possible, ask for your choice of books to be purchased in your school as part of your own CPD or for a staff CPD library (if your setting has one). Also, do not feel compelled to read any of them from cover to cover; 'dip' into them as required.

All in all, the world of SEND is always evolving, hence your role as the SENCO will too. Prioritise your SEND learners and their families, collaborate with colleagues and external agencies, keep holding your LA accountable (remember the law, as well as statutory guidance) and most importantly, ensure you eat healthily and take toilet breaks on time!

The role will always be challenging, so learn from every mistake and celebrate every win, no matter how small. I guarantee that even the smallest win will make a BIG difference in the life of your SEND learners, as well as their families.

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Advice For New And Aspiring SENCOs - HWRK Magazine

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The role of SENCO is one that requires strategic thinking, with policies that must work across key stages and that are inclusive of extremely diverse educational needs. Not only that, the potential (actual) workload generated requires SENCOs to have slick procedures in place to manage what must be done day-to-day.

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https://www.selfinjurysupport.org.uk/FAQs/young-people-who-self-harm-a-guide-for-school-staff

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charity self-harm self-injury self harm distress trauma women girls

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Young People who self-harm: A guide for school staff

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University of Oxford Developed by researchers and clinicians at the University of Oxford University for school staff, this resource outlines information about self-harm and its impact and practical ways to support young people

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Headspace research on suicide and self-harm attempts in primary school aged students

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Headspace research on suicide and self-harm attempts in primary school aged students

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https://headspace.org.au/assets/download-cards/02-HSP254-Suicide-in-Primary-Schools-Summary-FA-low-res2.pdf

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Oxford NHS self-harm guidelines for school staff.

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Oxford NHS self-harm guidelines for school staff.

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https://www.oxfordhealth.nhs.uk/wp-content/uploads/2018/03/self-harm-guidelines-for-school-staff.pdf​

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Guardian article - Why NHS support services are failing children in distress.

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Guardian article - Why NHS support services are failing children in distress.

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https://www.theguardian.com/society/2022/nov/08/why-nhs-support-services-are-failing-children-in-distress​

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Further Mental Wellbeing free toolkit and resources from Coram SCARF

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Further Mental Wellbeing free toolkit and resources from Coram SCARF

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Originally designed for Children's Mental Health Week, this page brings together resources to support your children's health and wellbeing at a time that works best for your school.

Toolkits to support children's mental health

Our range of additional, flexible resources to be used during the course of a week, including special resources to hold your own Wear your Scarf to School day. This impactful toolkit draws from the evidence-based NHS 5 Steps to Mental Wellbeing and gives you:

1-a-day or 1-a-week age-related activities to help children improve their wellbeing

Engaging stories and inspiring writing: starting points for activities that build on the 5 wellbeing themes

Additional resources to support your own mental wellbeing

SCARF schools: automatic access mental health toolkit Non-SCARF schools access mental health toolkit here
If you're not registered for the free toolkit, click here to get access:
Sign up for your free mental health toolkit here
We'll then set up your login and send you details as quickly as possible.

If you've registered and received your login details, just click on the orange button below to access the resources:

Interested in becoming a SCARF school? To sign up for our free sample lesson plans click here. Or take a free tour of SCARF and find out why more than 50,000 subscribers love using SCARF.

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Free Mental Health Toolkits from Coram SCARF

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Originally designed for Children's Mental Health Week, this page brings together resources to support your children's health and wellbeing at a time that works best for your school. Our range of additional, flexible resources to be used during the course of a week, including special resources to hold your own Wear your Scarf to School day.

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If you need help right now

If you feel like you are about to self-harm now, there are things you can do to help keep your mind off it. Watch the video about the TIPP technique - a simple technique you can use to help you in the moment.
If you are in an emergency or worried for your life you should call 999.

Self-harm is when you intentionally cause harm to yourself as a way of dealing with difficult feelings, traumatic experiences or memories, neglect, or situations that you find overwhelming. People sometimes self-harm when life feels hard to cope with.

Self-harm can look different for different people. You might find yourself doing things which are harmful, but not think of them as 'self-harm'. But that doesn't make your experience any less valid.

Self-harm can look like:

cutting yourself

using drugs or alcohol to cope with your problems

not eating, over-eating, or forcing yourself to throw up

spending all your time on addictive behaviours like gaming, social media or gambling

over-exercising and/or exercising when you are injured

biting, hitting or burning yourself

hitting walls

getting into situations on purpose where you risk getting hurt, including fights or risky sexual behaviour

Often self-harming only brings temporary relief. You might also have negative feelings after self-harming, such as guilt, shame or fear. When difficult feelings start to build up again, you might feel like you have to harm again. It can be really hard to break out of this cycle. Self-harming can become a habit and it can be upsetting to think that this is your only way to cope. But there are things you can do to stop self-harming and get better. And with support, you can learn other ways of coping when things feel too much.

People self-harm for many different reasons. Some people find it hard to explain why they do it, but often it's a way for people to let out feelings that are hard to explain or control.

There are many reasons why you might self-harm and these reasons will be different for everyone. You might be dealing with lots of intense thoughts and feelings and hurting yourself might feel like the only way to let those feelings out. Or you might feel numb and want to hurt yourself so that you can feel something.

For some people, self-harm feels like a way to show the feelings they have inside on the outside. It can be a way of:

People often start self-harming due to something stressful or upsetting that is going on in their life that is difficult to deal with . This could be something like:

suffering abuse

experiencing a traumatic incident

family problems like a divorce

money worries

bullying

a sudden change in your life, like a death, a relationship ending or moving school

exam stress or extreme pressure or criticism from family, friends, teachers or at work

low self-esteem or issues with body image

difficult feelings like loneliness, anxiety, depression or anger

an illness or health problem

feelings of guilt, failure, or being unloved

experiencing discrimination against your race, religion, sexuality, gender or disability

These are just examples. Whatever the reason you started self-harming, your feelings matter and you can get through this.

You may not always know the reason why you are self-harming. If you're unsure why, or don't understand the reasons, you are not alone and you can still get help.

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Artwork credit: @the_mini_ADHD_coach

An illustration of a face with eyes closed. Text reads: 'It's ok to feel overwhelmed.'

Things can happen in life that can leave us feeling overwhelmed, angry and hurt. Instead of finding ways to express those feelings to the world, we might start to take this pain and anger out on ourselves.

We might self-harm because we have learnt that in order to be accepted or loved we have to be 'perfect'. When we don't live up to this 'perfect' image we can feel like a 'failure'. The constant guilt, or worry about disappointing people, can make us feel like we need to punish ourselves for not being 'good enough'. If this resonates with you, you're not alone. With the right support, you can stop feeling this way, and learn to love yourself for who you are.

Sometimes people make comments about self-harm being attention-seeking. Comments like this can be hurtful and make you feel judged, alone or misunderstood. Those who self-harm actually often keep this private. However, if you do self-harm as a way of bringing attention to yourself, remember that there is nothing wrong with wanting people to notice you more and wanting to have your feelings taken seriously. You deserve to feel loved by those around you and you deserve support.

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Artwork credit: @ohhappydani

An illustration of six arms all of different skin tones. On each arm reads the word 'worthy'.

Overall, the most important thing which I hope everyone knows is you don't have to go through this alone.

I was only 14 when I started to self-harm. I was never intending to hurt myself. I was doing it for the sense of relief it provided. I felt like the only way I could function and leave my room was if I had that release.

Ways to keep yourself safe now

It's really important to keep yourself as safe as possible and reduce your risk of serious self-injury. Even though you want to stop self-harming, you might not feel able to stop straight away. Sometimes it can take time to find new ways to cope, and that's normal.

If you are unable to stop self-harming right now, make sure you are at least doing it as safely as possible. This means using sterile equipment, keeping your wounds clean, and avoiding mixing drugs and alcohol with other forms of self-harm. You can also call Samaritans at any time - whether you're thinking about self-harm or have already harmed yourself.
If you are in an emergency or worried for your life you should call 999 or go to A&E.

Things you can do to help

There are also lots of things you can do in the moment to help you not self-harm.

When you feel the urge to self-harm building, you could try to:

go for a walk or do some gentle exercise

distract yourself by focusing on your breathing

text a friend and let them know you need them to help you take your mind off things

play music and sing or dance along

hold an ice cube

write down your thoughts

hit a cushion or pillow

tear up a magazine or newspaper

make a self-soothe box

go to a public place like a park or a cafe

You might find the TIPP technique helps to stop your urge to self-harm.

This video explains how to use the TIPP technique to help you feel calmer.

Ways to keep yourself safe in the long term

There are also a number of ways to help yourself in the long term and support your recovery journey.

Talking about self-harm can feel difficult. It is understandable that you might feel nervous to talk to someone, feel like you'll be judged or feel you won't be understood. But talking about how you're feeling with someone you trust can help you to get the right support.

Try talking to someone you feel comfortable and safe with, like a friend or family member. If you don't feel like you can talk to friends or family, you could talk to someone in your wider community, such as a teacher, a school counsellor/nurse, a faith leader or a youth worker. Think about who you would feel most comfortable communicating with and how, whether it's face to face, over the phone, by text or email.

In some communities it can feel more difficult to reach out for help because of certain stigmas around mental health. If you reach out for help and the person you talk to does not react the way you hoped, remember that this reaction is about them, not you. Don't let their reaction discourage you from reaching out again. If you don't feel like you can reach out to someone you know, remember that there are still lots of people who can help. You may prefer to get support from a professional, a helpline or through a charity. Take a look at our list of organisations that can help, and don't struggle on your own.

Speaking to a professional about self-harm can feel scary, but it's often an important step to recovery. You may be worried that you'll be misunderstood or judged, but there are lots of trained people that you can talk to who understand and really care. That's because they speak to lots of young people who are going through this too. They are there to listen and support you.

It is helpful to tell the GP exactly what you are doing and what your worries are. If you need medical treatment for injuries, do make sure you get it. Don't be afraid or embarrassed to go to your GP or hospital for this - they are there to help you get better and it is not their job to judge you.

Your GP will listen and discuss the best options to support you. They might offer you an assessment with a local community mental health team, or if you are under 18, they can refer you to Child and Adolescent Mental Health Services (CAMHS) for an assessment. These assessments are so they can help you to find the right treatment, such as counselling or talking therapy, where you can talk with a trained mental health professional about what you are feeling and ways you can cope.

The types of talking therapy you might be offered include:

cognitive behavioural therapy (CBT) - a type of therapy that focuses on how your thoughts, beliefs and attitudes affect your feelings and actions

dialectical behaviour therapy (DBT) - a type of CBT adapted specifically for people who experience emotions very intensely

mentalisation-based therapy (MBT) - a type of therapy that focuses on helping you to make sense of your own and other people's thoughts, feelings and actions

Find out more about counselling and therapy in our guide.

Sometimes the first person you speak to won't help, but that doesn't make your feelings invalid. If you are finding it hard to get the right support from your GP, you may find it helpful to turn to other support, such as your school nurse or a specialist organisation such as Samaritans. For more tips and advice getting the right support from your GP, including information about your rights as a patient, visit our guide on how to speak to your GP about mental health.

Journaling can be a helpful way to let out your emotions. It can also help you to recognise what is bothering you and any patterns in what triggers you or causes you to feel bad.

Take a few minutes every day to write down how you are feeling. If you don't like writing, try doodling, drawing or recording a voice note. Remember this is just a way to express yourself - there's no right or wrong way to do this and nobody has to see it but you.

If you want to, you could show your journal to any mental health professionals who are supporting you, to help them understand what you are going through.

Sometimes just making small changes to your daily routine can help improve your mood. Consider trying some of these changes:

Make sure you get enough sleep and stay hydrated - staying physically healthy can help you to feel happier.

Take time out when you need to - this could be going for a walk, doing some drawing or relaxing however you like to.

Think of three things you are proud of each day - you could do this when you first wake up or just before you go to sleep.

Be as kind to yourself as you would be to your best friend - think about the advice and support you would give someone else if you heard they were struggling.

The internet can be a helpful space for those who self-harm. It offers a lot of information, advice and support. You may also find that it's easier to speak openly about your feelings through social media, rather than face-to-face. However, there is also a lot of content about self-harm on the internet that can be distressing or make you feel worse. We also know that those who have peers that self-harm are more likely to self-harm themselves. Think about how your use of social media is affecting your mood and what content is best for you. Make sure to only follow accounts that make you feel positive and safe.

Some people find it really helpful to create a 'safety plan' that they can use when the urge to self-harm is really strong. This can include whatever you think would be helpful, but generally it includes ideas of what you can do to distract yourself, who you can speak to, and what else you can do to keep yourself safe. Papyrus have a useful guide to creating a safety plan, which might help if you'd like to create your own. Although the focus of their guide is for suicidal feelings, you can use it for self-harm as well.

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Artwork credit: @crazyheadcomics

An image of a bendy road titled 'the road to recovery'. Text along the road reads: 'start', 'progress', 'hope', 'relapse', 'second attempt', 'setback', 'growth', 'change', 'calm'.

If you have self-harmed by cutting or wounding yourself in some way, you are likely to have scars on your body from this. You may find that you have a number of emotions and feelings associated with these scars, such as guilt, regret or difficulties accepting your body image. This can be particularly difficult if you are experiencing stigma around your self-harm.

For advice on how to manage stigma around self-harm within your community, take a look at Louisa's blog.

If you're really struggling with the scars left on your body, you may be able to find treatment that can help. You can find information about scar treatments on the NHS website. Scars will look different for everyone depending on skin tone, where the scar is and the type of wound that caused the scar, and this will lead to different treatment options. Not everyone will want to do this and that is completely okay - it is your body and you should only do what feels comfortable for you.

It can be really difficult if you know a friend or loved one is self-harming. It's hard to see someone you love hurting themself in that way, and it can be difficult to know how best to support them.

Just being there and letting them know they're not alone can be very helpful, but it's also important to remember that you may not be able to help them on your own.

Remember there is always support available.

Recognising the signs and symptoms of self-harm

There are lots of different ways that someone might self-harm and this can make it difficult to spot the signs. Your loved one is likely to be in both physical and emotional pain during this time. Here are some signs to look out for.

If your loved one is self-harming by cutting or wounding themself, you may be able to notice some physical signs. This could include:

keeping their body fully covered all the time, even when it is hot, like wearing long sleeves to conceal scars (this is only a sign of self-harm if they do not normally wear long sleeves or clothes that cover the whole body)

having cuts, bruises or burn marks on their body that are unexplained

unexplained scarring on their skin

unexplained blood stains on clothing or tissues

any signs that they are pulling out their hair, for example hair loss or large clumps of hair lying around

Self-harm takes lots of different forms, not just physically hurting yourself. So it's important to also be aware of the emotional signs. These might include:

becoming very withdrawn and talking less than usual to others

unusual changes in mood, such as feeling low, teary or demotivated

making suicidal comments e.g. talking about not wanting to go on

expressing feelings of self-blame, hopelessness or failure

Supporting a loved one with self-harm now
If a friend or family member has self-harmed and has injuries that need medical attention, you should take them to A&E to seek medical help.
The most important thing you can do to support someone is be there to listen. Talking about self-harm is difficult, but having that conversation can help your loved one take the first step to recovery.

Take a look at our tips below for having a sensitive conversation.

Supporting a loved one with self-harm in the long term

Here are some tips on how you can give ongoing support to someone in your life who is self-harming.

Recovery can only happen when your loved one takes steps towards this for themself. You can't force someone to get better. It can be very difficult to see someone you love struggle with self-harm, but letting them be in control of their decisions will support their recovery in the long term. But remember you should always get them medical attention if needed.

You may find it helpful to develop a 'safety plan' with your loved one. This is a tool you can use to help communicate with each other and keep your loved one safe. Samaritans have advice on this as well as a safety plan template you can use.

Speaking to a GP about self-harm may be a scary thought for your loved one, but encouraging them to do this is important so they get the right support. If they really don't want to talk to a GP, there are also lots of charity services and helplines that can help.

This page was reviewed in June 2023. It was co-created by young people with lived experience of self-harm. We will next review the page in 2026. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.

Please be aware that this form isn't a mental health support service. If you are in crisis right now and want to talk to someone urgently, find out who to contact on our urgent help page.

At YoungMinds we take your privacy seriously. If you'd like to read more about how we keep the information we collect safe, take a look at our privacy policy.

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Self-harm | Advice for young people | Get help

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Self-harm is when you intentionally harm yourself as a way of dealing with difficult feelings or experiences. Find out about self-harm and how to get help.

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Free resources

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ACAMH uses cookies in order to deliver a personalised, responsive service and to improve the site.

This Teacher Hub brings together the resources on our website that is most relevant, and useful, for teachers to use.

Recordings, podcasts, research digests

Filmed recordings

Ask the Expert sessions exclusively for teachers

COVID & the impact on Mental Health of School Closures - CAMHS around the Campfire recording
For this session we welcomed Dr. Karen Mansfield, a postdoctoral research scientist from the School Mental Health Project, Department of Psychiatry at the University of Oxford, to discuss her JCPP Advances paper ''Covid-19 partial school closures and mental health problems: a cross sectional survey of 11,000 adolescents to determine those most at risk''.

Managing transition for school leaders post lockdown
Short film from charityNip in the Bud about strategies school staff can use to support children through difficult transitions so that they feel happy, safe and open to learning.

Professor Tamsin Ford CBE - 'Supporting children's mental health as schools re-open'
Slides and transcript available. This was a live webinar recorded on Wednesday 8 July 2020 for ACAMH West Midlands Branch.

Podcasts

School behaviour difficulties, school based interventions, and inclusive education - In Conversation with Dr. Alice Jones Bartoli
Dr. Alice Jones Bartoli looks at how well equipped schools and teachers are when it comes to dealing with child and adolescent mental health issues, and what more can be done to support teachers and leaders in creating mentally healthy schools, and in supporting the staff themselves.

The Mental Health Impact of COVID-19 School Closures
The focus of this podcast is on the JCPP Advances paper 'Covid-19 partial school closures and mental health problems: a cross sectional survey of 11,000 adolescents to determine those most at risk', written by Dr. Karen Mansfield, Professor Mina Fazel, and colleagues.

'Creating mentally healthy schools' - In conversation with Professor Jess Deighton
We are honoured to spend some time talking to Professor Jess Deighton, about the role schools can play in young people's mental health, about school-based interventions, and some insights from her latest research.

Mental Wellbeing in Schools, and the Global Mental Health Crisis
In this podcast, we talk to Lauren Cross about her research interests around mental health and wellbeing in schools and inequalities during childhood and adolescence, as well as her co-authored CAMH debate paper 'Is There a True Global Children and Young People's Mental Health Crisis Fact or Fiction'.

'Data sets, mental well-being and school-based interventions' In Conversation with Dr. Praveetha Patalay
In this podcast, Dr. Praveetha Patalay discusses data sets, the difference between mental health and mental health well-being and school-based interventions. Praveetha also talks about her recent JCPP paper on 'Prescribing measures: unintended negative consequences of mandating standardized mental health measurement'.

Dr. Maria Loades 'COVID19 and social isolation, school-based interventions, and CBT' - In Conversation
Dr. Maria Loades discusses Covid19 and its implications for young people's mental health, the Rapid Systematic Review exploring the repercussions of the pandemic on social isolation and loneliness.

In Conversation... Professor Tasmin Ford the importance of schools in a child's mental health
Professor Tamsin Ford, Professor of Child and Adolescent Psychiatry, University of Exeter Medical School, talks about attachment and early intervention, and explains why schools are an important setting in relation to child mental health.

Research Digests

How effective are tools to help school staff better respond to young people who self-harm?
Aureliane Pierret and colleagues at the University of Cambridge carried out a systematic review into the effectiveness, feasibility and acceptability of interventions and tools to support school staff to better respond to young people who disclose self-harm.

Are school-based interventions for depression and anxiety symptoms effective?
Gee et al. conducted a systematic search for randomised controlled trials of indicated psychological interventions delivered in an education setting. They focused on trials of interventions for adolescents aged 10-19 with elevated symptoms of depression and/or anxiety.

How useful are Ofsted ratings for predicting educational outcomes and wellbeing at secondary school?
"The factors parents care about most when selecting a school - their child's educational achievement and wellbeing - are negligibly predicted by Ofsted ratings", says Sophie von Stumm, lead researcher of a new study published in the Journal of Child Psychology and Psychiatry.

The association between anxiety and poor school attendance
School plays a key role in children's development, and frequent absence from school increases the likelihood of a range of adverse outcomes in childhood and later life. This includes poor academic performance, social isolation, economic deprivation and unemployment in adulthood. There are many risk factors for frequent school absence, including factors related to the child and their family, school and community.

Teacher assessments could replace high-stake testing to improve student well-being
Many students experience anxiety and distress during exams, and these emotions can have a negative effect on achievement. Notably, one of the top-reported concerns voiced by children in the UK is the stress and anxiety associated with school work and exam performance.

Schools need more specialist support
Schools have a central role in supporting young people with mental health problems, but the level of and type of support available to affected students is unclear. A convenience sample survey of 577 school staff from 341 schools in England has shed light on this issue.

Anxiety 'Pedagogy in practice' recording and resources

ACAMH are delighted to have teamed up with the Chartered College of Teaching to present a FREE online training series, 'Pedagogy in practice', exclusively for teachers and school leaders, and Chartered College of Teaching Members.

Pedagogy is the method and practice of teaching, especially as an academic subject or theoretical concept. This series gives teachers an incredible opportunity to take part in interactive expert webinars looking at how to teach key topics in school. The first of these sessions looked at Anxiety, something that pupils, and us, at some point, have all experienced.

Presenters

Due to technical difficulties we were limited with the live presentations. These were be given by: Polly McMeeking, SEND Governor, Chaddesley Corbett Endowed Primary School, and Shona McCann, Vice Principal, Riverside School. Jonathan Baggaley, CEO, PSHE Association, joined for the Q&A session, and Cat Scutt MBE, Director for Education and Research, Chartered College of Teaching facilitated the session.

Resources and talks

Key supporting points from Coram Life Education and SCARF

How can schools support pupils with anxiety and support wider understanding of anxiety through PSHE and beyond? Dana Abdulkarim, Assistant Principal, Oasis Academy Don Valley

Padlet with attendees sharing approaches
Anxiety Reading List Anxiety research review
Polly McMeeking, SEND Governor, Chaddesley Corbett Endowed Primary School - Slides

Shona McCann, Vice Principal, Riverside School - Slides
Q&A session
Ask the expert session with Professor Cathy Creswell and Helen Manley

Myth Busting Anxiety with Chloe Chessell

About the session

Anxiety is a part of life and some anxiety is essential because it helps us to act to protect ourselves and ensure our safety. However, anxiety can become problematic when it is out of proportion to the threat in the environment, causes distress and interferes with children and young people's everyday lives. When this occurs it is often considered to be an 'anxiety disorder'. Anxiety disorders are extremely common and often start in childhood or adolescence. They can have a significant and ongoing impact on mental health and well-being. Anxiety disorders can affect family, school and social life, leisure activities and educational achievement.

Teachers have a role to play in supporting children and adolescents to understand anxiety as part of the new RSHE curriculum, as well as needing to feel confident that they can recognise the impact it may have on the children they work with. This webinar brings together teachers from a range of settings to consider how they are supporting pupils in the school to understand anxiety. Event attendees will have access not just to the event itself but to supporting materials and resources to help them embed effective practice in their schools.

About the 'Pedagogy in practice' series

These are series of FREE online events is exclusively for teachers and school leaders, and offer insights into best practice in supporting children and adolescents building on the latest evidence base. They are brought to you as part of an exciting new partnership between The Association for Child and Adolescent Mental Health (ACAMH) and The Chartered College of Teaching, two charities who are dedicated to supporting teachers to make a difference to the mental wellbeing of children and young people.

These sessions are designed to help close the knowledge gap in a range of topics that now form part of the statutory Relationship, Sex and Health Education (RSHE) curriculum. We think it is important to help equip teachers with knowledge in areas that may be less familiar to them and to help them consider how they might most effectively deliver these topics to children and adolescents as part of the curriculum.

These sessions will build on our previous 'Ask the Expert' webinars, and delegates for this session are strongly encouraged to watch these, and in particular the topic of Anxiety. All of these sessions plus a host of other free resources for teachers can be found on our Teacher Hub.

About the speakers and panel

Lauren Pinney, Head of Student Wellbeing and PSHE, Hove Park School

Lauren is an experienced teacher and qualified SENCO specialising in the social, emotional and mental health needs of young people. As Head of PSHE and Student Wellbeing at Hove Park Lauren not only oversees the mental health education for all students but has developed an innovative graduated response to mental health needs, blending universal and targeted inventions within a mainstream setting. She is the founder of the Mental Health and Wellbeing Champions; an in school project allowing students to gain the skills and experience to become peer mentors which has since been adopted by many schools in the city. Lauren currently leads a team of embedded mental health professionals and chairs Hove Park's multidisciplinary triage process. She's also leading on Hove Park's Covid Wellbeing response for staff and students. Lauren's specialist knowledge and unique approach to mental health support in school has been nationally recognised and Hove Park was amongst one of the first schools to be awarded the Wellbeing Award for Schools. She is an experienced trainer, speaker and advisor in this area.

Rose Scott, School Counsellor, Hove Park School

Rose is an integrative arts counsellor with experience working with children and young people form 6 -19. She leads Hove Park School's Wellbeing Team and works in Private Practice. A Pen Portrait of Hove Parks counselling provision has been included in a Department for Education paper 'Supporting Mental Health and Wellbeing in Schools and Colleges', where the value of having a fully integrated and embedded counselling service was highlighted.

Shona McCann, Vice Principal, Riverside School

Shona began her teaching career in 2010. While working in a special school in New Zealand she quickly found her passion for working with young people with special educational needs. She values pupils as individuals and builds positive relationships with them and their families. Equipping pupils with skills for independence is a passion of hers, including supporting emotional and social development. Shona has recently been appointed as Vice Principal at Riverside School in Antrim. She is currently working on an inquiry-based research project with the Education Authority in Northern Ireland and Professor Barry Carpenter. The project focuses on the impact of Sports and Sensory Sanctuaries on engagement in learning.

Polly McMeeking, MA(Ed), SEND Governor, Chaddesley Corbett Endowed Primary School

Polly is a retired executive headteacher and Director of Education from the independent special school sector who, in recent years, has served as Chair of Governors at Chaddesley Corbett Endowed Primary School and currently act as specialist SEND governor with oversight of the development of a new autism resource centre at the school. My expertise lies within the SEMH arena and I am working with staff to establish an innovative "portal" facility as part of the school's provision for children who display acute anxiety; forms the interface between main school and resource centre, and which establishes practices to sustain low levels of staff anxiety. Drawing on a model of establishment of a "dynamic equilibrium" approach to integration, we hope to maximise the potential of our new development to enhance well being for all members of the school.

Cat Scutt MBE, Director for Education and Research, Chartered College of Teaching

A former English teacher, Cat's roles have since focused on supporting teacher development both online and through face-to-face activities, with a particular focus on development through collaboration and through engagement with research and evidence. Cat leads on the Chartered College of Teaching's work around teacher development and certification, including the Chartered Teacher programme, and their research activities and publications, including their award-winning peer-reviewed journal, Impact. She received an MBE for services to education in 2021 and has been a member of several government advisory groups.

Dana Abdulkarim, Assistant Principal, Oasis Academy Don Valley

Dana is a senior teacher in Sheffield, leading on PE and PSHE. In 2000 she became the first Muslim and Arab woman to compete for England Internationally with 67 caps in Rounders, she was the first to then Coach an England side of her own. In 2008 Dana was the first Hijabi Muslim Woman to qualify to teach PE in England. It is Dana's aim to inspire a lifelong passion for movement, developing wellbeing and the whole child; she aims to develop belonging and toolkits for survival in the world around us. As a prominent and visible Muslim woman she talks nationally about change, authenticity, anti-racism and visibility using her various sporting experiences and beyond to draw upon. Dana believes every child should thrive, not just survive. Since September 2020, Dana has been a trustee for Chance to Shine, a charity using cricket as a vehicle to develop young people. Most recently, Dana has been named as an ambassador for Sporting Heritage.

Jan Forshaw, Head of Education, Coram Life Education

Jan began her career teaching across primary and middle schools, including senior leadership roles, in Bradford, West Yorkshire. Children's wellbeing and mental health was always at the heart of her work as a teacher and influenced her move to children's health and wellbeing charity Coram Life Education. She has been Head of Education at Coram Life Education since 2009, having been Director of Training and before that an educator and senior trainer. Jan oversees development of the diverse education programmes at Coram Life Education which include provision of high-quality education workshops in school and its acclaimed SCARF online PSHE (including statutory RSHE) curriculum. She understands that within education the teacher's role is crucial in helping children to thrive - socially, physically, mentally and academically - and works hard to ensure that Coram Life Education's ethos and practices prioritise relevant, practical and timely support for teachers, alongside the provision of the highest-quality, inspiring programmes and resources that children deserve and need, to be their best.

Jonathan Baggaley, CEO, PSHE Association

Jonathan is Chief Executive of the PSHE Association, leading efforts to ensure all children and young people receive high-quality PSHE education. Jonathan led the Association's campaign for statutory PSHE, bringing together over 100 leading organisations to call for curriculum change. He is now working closely with government and wider stakeholders to ensure the new statutory requirements for Relationships, Sex and Health education achieve their transformative potential. Jonathan has worked in education at a national level for many years, bringing particular expertise in educating young people about risks, harms and opportunities of online technologies. Prior to joining the PSHE Association he was Head of Education at the Child Exploitation and Online Protection centre (now part of the National Crime Agency). He is currently a member of the UK Council for Child Internet Safety Digital Resilience group and sits on the DCMS Media Literacy Taskforce Steering Board. He is Vice Chair of the National Youth Jazz Collective.

The Chartered College of Teaching

The Chartered College of Teaching is the professional body for teachers. We are working to celebrate, support and connect teachers to take pride in their profession and provide the best possible education for children and young people. We are dedicated to bridging the gap between practice and research and equipping teachers from the second they enter the classroom with the knowledge and confidence to make the best decisions for their pupils.

Helping Teachers Help Pupils With Mental Health
ACAMH commits to developing a comprehensive series of resources that disseminate research-informed, evidence-based practice in schools, to support children & young people's mental health & wellbeing
Part of our remit as a charitable membership organisation has been to share best evidence in order to improve the mental health and wellbeing of young people for more than six decades. Following a hugely successful pilot programme launched in October 2021, ACAMH has made a commitment to expand its mental health in schools initiative, which aims to bridge the gap in teachers' knowledge and practice in important mental health topics, which are now part of the statutory relationships, sex and health education (RSHE) curriculum.

ACAMH's 'Ask the Expert' webinars are free to attend and developed in collaboration with the education charity, Coram Life Education aim to build knowledge in a range of mental-health related topics that teachers may feel less confident about. Past sessions are available on our Teachers Hub. To date, almost 1,200 teachers and education professionals have joined ACAMH's 'Ask the Expert' webinars to build their knowledge in topics such as screen-time; sleep & mental health; anxiety in children and young people; and the impact of bullying & loneliness. Of those attendees surveyed, 92% said they would recommend the Ask the Expert webinars to their colleagues, with qualitative feedback recognising the value these knowledge-sharing sessions can provide teachers in supporting the needs of their pupils.

The next wave of Ask the Expert webinars will commence in June and run through until April 2023, with six new topics being added to the series including: trauma, self-harm and eating-disorders. Topics are rooted in the new statutory RSHE curriculum and have been selected based on feedback provided by teachers, in relation to the topics they are most interested in understanding more about.

To complement the suite of Ask the Expert webinars, ACAMH has partnered with the Chartered College of Teaching to develop an accompanying series of 'Pedagogy in Practice' webinars under the same topic headings, which aim to stimulate innovative practice in teaching and learning to meet curriculum requirements and support mental health across the school. The first webinar will be delivered in June covering the anxiety topic, followed by a session on sleep in July, with the further eight webinars scheduled from September through to May 2023.

The Chartered College are currently calling on practising teachers and school leaders to contribute to this project as webinar speakers, and for teachers, leaders and researchers to contribute case studies in audio, video or written form. This provides trail-blazing schools a great opportunity to share best practice, showcase the excellent work they are doing and recognise the expertise of teachers who are developing and delivering it.

Professor Barry Carpenter, ACAMH Board Member and Mental Health in Schools Advisory Group Chair said: "We have been overwhelmed by the support that educators have given us in relation to our mental health in schools initiative; the levels of interaction and richness of the questions posed at our webinars has been tremendous. Teachers are telling us they want more professional development in order to support our young people with complex mental health concerns, our Ask the Expert and Pedagogy in Practice series certainly contribute to addressing that need. We are delighted to be able to continue to provide these free sessions over the next year".

Do please share our upcoming sessions with your colleagues that are teachers and the resources available on our Teacher Hub.

Understanding Trauma - Ask The Expert - 13 June 3:45pm start

Anxiety - Pedagogy in practice - 21 June 3:45pm start

Sleep - Pedagogy in practice - 12 July 3:45pm start

Eating Disorders - Ask The Expert - 13 September 3:45pm start

Improving research-informed practice in schools

We have recently launched an initiative aimed at teachers, to enable schools to access and put to use resources that can genuinely make a difference to the mental wellbeing and educational outcomes of young people.

In recognition of the rising mental health challenges faced by children and young people, we have kick-started our Mental Health in Schools initiative, with the aim of producing a series of webinars for teachers which disseminate research-informed, evidence-based knowledge and practice around current key issues in the mental health and wellbeing of children and young people.

The first of this pilot series, known as ' Ask the Expert' aims to increase the knowledge of teachers and consists of 4 x 75-minute live webinars, with an expert guest speaker and hosted by Professor Barry Carpenter. The webinars have been developed in collaboration with the education charity, Coram Life Education. Topics are rooted in the new statutory relationships, sex and health education (RSHE) curriculum, with Screen Time and Sleep delivered in the Autumn term of 2021 and Anxiety and Common Mental Health Conditions coming in Spring 2022.

The second of this pilot series, coined ' Pedagogy in Practice', is aimed at creating engaging
resources for teachers relating to mental health teaching themes in the RSHE framework and is
closely aligned to the 'Ask the Expert' series. 'Pedagogy in Practice' aims to stimulate innovative
practice in teaching and learning to meet curriculum requirements and support mental health. The pilot phase will include the development of two modules: Sleep and Anxiety, and will be developed in partnership withThe Chartered College of Teaching during the first half of 2022.

Professor Barry Carpenter, CBE, OBE, D. Litt, PhD, ACAMH Board Member and Mental Health in Schools Advisory Group Chair, said "We are committed to helping improve the knowledge needed by Teachers to deliver the statutory Relationship, Sex & Health Education (RSHE) curriculum requirements, specifically in relation to subjects pertaining to mental wellbeing. We are also looking to build capacity for differentiating and personalizing content to meet individual, as well as group needs."

He goes on to say "Schools are an anchor institution in supporting young peoples' mental wellbeing, we believe ACAMH and our partners Coram Life Education and The Chartered College of Teaching can truly make a difference by sharing the best evidence in a way that is accessible and tailored to the needs of teaching professionals."

We plan to develop a wider series of Ask the Expert & Pedagogy in Practice resources over the course of the next 18 months, incorporating up to ten of the most pertinent topics within the RSHE framework, such as Trauma, Self-Harm and Bereavement.

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ACAMH uses cookies in order to deliver a personalised, responsive service and to improve the site. This Teacher Hub brings together the resources on our website that is most relevant, and useful, for teachers to use.

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Winter Wellbeing toolkit for primary and secondary schools - Anna Freud

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Winter Wellbeing toolkit for primary and secondary schools - Anna Freud

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Winter wellbeing toolkit : Mentally Healthy Schools

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Two toolkits of resources for primary schools and secondary/FE settings, with suggested resources to boost winter wellbeing for pupils and staff.

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Understanding Self-harm & Suicide – Ask the Expert (recording)

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Understanding Self-harm & Suicide – Ask the Expert (recording)

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For this teachers and education professional session welcomed Professor Dennis Ougrin to share his knowledge and insights into self-harm and suicide; specifically exploring the complexity around this phenomenon, by providing data on prevalence, risk factors and strategies for support. Dennis will also be answering your questions in a session facilitated by leading education professional Professor Barry Carpenter.

Professor Ougrin is the author of Therapeutic Assessment, a novel model of assessment for young people with self-harm. He also developed and tested an Intensive Community Care Service model for young people with severe psychiatric disorders called Supported Discharge Service. Professor Ougrin has expertise in conducting randomised controlled trials in the fields of psychological therapy and mental health service models.

Slides from the session

About the event

Self-harm is an increasingly recognised phenomenon and one of the strongest predictors of suicide, which continues to be one of the leading causes of death in young people worldwide. Self-harm can take many forms and may present with or without suicidal intent and both in the context of mental disorder, and without.

Self-harm does not occur exclusively in the context of mental disorder, there are many known psychosocial risk factors and it is associated with a range of mental disorders including anxiety, depression and attention deficit hyperactivity disorder (ADHD).

As anchor institutions in society, schools play an important role in identifying, referring and supporting pupils who may be at risk of self-harming. As teachers, it is important to be aware of some of the risks, clues and cues of self-harm, in order to better support children & young people who are experiencing difficulties.

Key Takeaways

Identify the general trends in self-harm and suicide

Recognise the risk factors for self-harm in children and adolescents

Explore the role of emotional regulation in supporting young people who are at risk of self-harm & suicidal ideation

Resources

Topic Guide
Self-harm is an increasingly recognised phenomenon and one of the strongest predictors of suicide, which continues to be one of the leading causes of death in young people worldwide. Self-harm can take many forms and may present with or without suicidal intent and both in the context of mental disorder, and without.

Podcasts - we have a number of different podcasts on this topic

Literature review of support tools for school staff to respond to CYP self‐harm - CAMHS around the Campfire recording
A review of literature of support tools for school staff to respond to CYP self‐harm, with the focus on Aureliane Pierret (pic), Dr. Joanna Anderson, Professor Tamsin Ford, and Dr. Anne‐Marie Burn, CAMH paper 'Review: Education and training interventions, and support tools for school staff to adequately respond to young people who disclose self‐harm - a systematic literature review of effectiveness, feasibility and acceptability.'

Understanding Self-Harm
TRIGGER WARNING: Please be aware that this blog discusses self-harm, including personal experiences of self-harm. It is estimated that between 10%-20% of all people self-harm at some point during their lifetime. It is hard to gather exact figures due to the stigma surrounding self-harm, and because people try to hide their wounds, scars and bruises. Watch this 8-minute film to understand more.

NICE guidelines for self-harm: a new school of thought
New NICE guidelines for the management of self-harm in the UK emphasise the important role of non-specialists. In this article,Holly Crudgington and Dennis Ougrin discuss this guidance, focusing on the new advice for schools and its implications.

How effective are tools to help school staff better respond to young people who self-harm?
Aureliane Pierret and colleagues at the University of Cambridge carried out a systematic review into the effectiveness, feasibility and acceptability of interventions and tools to support school staff to better respond to young people who disclose self-harm.

About the Speakers

Professor Ougrin graduated from a medical school in Ukraine in 1998 and came to the Maudsley hospital in the UK to undertake his post-graduate training in child and adolescent psychiatry. He worked as a consultant child and adolescent psychiatrist establishing and leading intensive community care services at South London and Maudsley NHS Foundation Trust. He also led the MSc in Child and Adolescent Mental Health at King's College London and acted as the Chief Investigator of major NIHR, MRC and charity-funded studies in the field of self-harm and intensive community care services. In 2018-2020 Professor Ougrin was the editor-in-chief of Child and Adolescent Mental Health, a key clinical journal in child and adolescent psychiatry, psychology and allied disciplines. In September 2021 Professor Ougrin was appointed to lead the Youth Resilience Research Unit at Queen Mary University of London.

Professor Ougrin leads a programme of global mental health studies aimed at developing community mental health services in Ukraine and other Low- and Middle-Income Countries. His main professional interests include the prevention of Borderline Personality Disorder and effective interventions for self-harm in young people.

Professor Ougrin is the author of Therapeutic Assessment, a novel model of assessment for young people with self-harm. He also developed and tested an Intensive Community Care Service model for young people with severe psychiatric disorders called Supported Discharge Service. The model was evaluated in the first randomised controlled trial of an intensive community care service for young people in the UK. The results of the trial informed the development of intensive community care services in the UK and internationally. Professor Ougrin has expertise in conducting randomised controlled trials in the fields of psychological therapy and mental health service models. Professor Ougrin also works on developing modular psychotherapeutic interventions for self-harm and on understanding the pathophysiology of self-harm in young people.

Professor Barry Carpenter Professor Barry Carpenter has been appointed to the ACAMH Board with special responsibility for disseminating our work to schools, teachers, and others involved in the education of children and young people. Barry is the UK's first Chair of Mental Health in Education, at Oxford Brookes University

In a career spanning more than 40 years, Barry has held the leadership positions of Headteacher, Principal, Academic Director, Chief Executive, Inspector of Schools and Director of the Centre for Special Education at Westminster College, Oxford. In 2009, he was appointed by the Secretary of State for Education as Director of the Children with Complex Learning Difficulties and Disabilities Research Project. Since completing that research, Barry has overseen the development of a national project developing online 'Training materials for teachers of children with severe, profound and complex learning disabilities' www.complexneeds.org.uk

Full bio on ACAMH Board page.

About the 'Ask the Expert' sessions

This FREE 'Ask the Expert' online event is for teachers and education professional, and offers insights into the latest evidence-base around anxiety in children & adolescents. They are brought to you as part of an exciting new partnership between The Association for Child and Adolescent Mental Health (ACAMH) and Coram Life Education (CLE), two charities who are dedicated to making a difference to the mental wellbeing of children and young people.

Following our pilot events in Autumn 2021 / Spring 2022, we have a series of 'Ask the Expert' events over the coming year, to help close the knowledge gap in a range of topics that now form part of the statutory Relationship, Sex and Health Education (RSHE) curriculum. We think it is important to help equip teachers with knowledge in areas that may be less familiar to them, which is grounded in academic rigour.

Our 'Ask the Expert' sessions are primarily aimed at knowledge building, we will be working on other initiatives to help evolve pedagogical approaches based on the evidence we share at these 'Ask the Expert' events.

Coram Life Education is the leading provider of relationships, health, wellbeing, and drugs education to almost half a million children across the UK, delivered under the strapline 'Helping Children Make Healthy Choices'. Trained Educators use evidence-based, interactive, creative methods and resources to stimulate curiosity and imagination amongst children in 1 in 10 English and Scottish primary schools (2,041 schools).

Our memorable life skills sessions are currently delivered as 'Life Base' in school or as 'SCARF Live Online' sessions via Zoom. Coram Life Education takes a three strand approach addressing children's knowledge, skills and attitudes, and programmes are aligned with the National Curriculum (Citizenship, PSHE Education), covering all Key Stages. Coram Life Education helps schools meet their statutory requirements for Relationships and Health Education, children's Spiritual, Moral, Social and Cultural development, and Ofsted inspection criteria for personal development, behaviour and welfare. Coram Life Education's programmes are also aligned with Scotland's Curriculum for Excellence. Recognising the role of the community and home life in influencing children's choices, we design our programme with schools and deliver special sessions and assemblies for parents and carers to amplify our effectiveness.

Sign up to this free event at this link or on the Book Now button at the top of the screen and complete the form that follows.

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Understanding Self-harm & Suicide - Ask the Expert (recording) - ACAMH

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For this teachers and education professional session welcomed Professor Dennis Ougrin to share his knowledge and insights into self-harm and suicide; specifically exploring the complexity around this phenomenon, by providing data on prevalence, risk factors and strategies for support. Dennis will also be answering your questions in a session facilitated by leading education professional Professor Barry Carpenter.

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We hope you found the event both engaging and rewarding.

As part of our work to ensure the events we run meet the needs of the profession, we would value your feedback.

Thank you in advance, we look forward to seeing you at another event soon.

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We hope you found the event both engaging and rewarding.

As part of our work to ensure the events we run meet the needs of the profession, we would value your feedback.

Thank you in advance, we look forward to seeing you at another event soon.

To view our privacy policy, please visit:
https://chartered.college/website-privacy

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Pedagogy in Practice: Self Harm - session evaluation

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We hope you found the event both engaging and rewarding. As part of our work to ensure the events we run meet the needs of the profession, we would value your feedback. Thank you in advance, we look forward to seeing you at another event soon.

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T hank you for providing your details. Our Building Suicide-Safer Schools and Colleges: A guide for teachers and staff is available once you click download. Due to the content of the guide we will make contact with you using the email address provided in the short future to provide any additional information and support which may help you to use the guide in your school or college.
Download Toolkit Click Here

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Schools guide download | Papyrus UK | Suicide Prevention Charity

# data[].attributes.attachment_link.description
Skip to content T hank you for providing your details. Our Building Suicide-Safer Schools and Colleges: A guide for teachers and staff is available once you click download. Due to the content of the guide we will make contact with you using the email address provided in the short future to provide any additional information and support which may help you to use the guide in your school or college.

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The truth about self-harm | Mental Health Foundation 

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The truth about self-harm | Mental Health Foundation 

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Order this publication
This booklet aims to help you understand more about self-harm and what to do if you are worried about yourself or someone else. It explains what self-harm is, what to do if you or someone you know is self-harming, and how to get help.
All of the information here is based on the findings of the National Inquiry into Self-harm among young people. The Inquiry was carried out by two charities, The Mental Health Foundation and The Camelot Foundation. The Inquiry panel heard evidence from many hundreds of people including young people who self-harm, or have self-harmed in the past, and those who work with or care about them. This booklet is based on what they said. For more information about the National Inquiry, and a full list of contributors, see the Truth Hurts report. We realise that this does not cover the whole area of self-harm, as it is based on a report that focusses on self-harm among young people. For more information on this topic, visit our A-Z page.
Introduction

Self-harm is very common and affects more people than you might think.

10% of young people self-harm [1]

This means it's likely that at least two young people in every secondary school classroom have self-harmed at some time. [2] If you are self-harming, you are not alone - lots of information and support is available.

Remember, self-harm isn't a suicide attempt or a cry for attention. However, it can be a way for some people to cope with overwhelming and distressing thoughts or feelings. Self-harm should be taken seriously, whatever the reason behind it.

It is possible to live without self-harm. It is important to know that you won't always feel the way you do now.

With the right help and support most people who self-harm can and do fully recover.

What is self-harm?

Self-harm describes any behaviour where someone causes harm to themselves, usually as a way to help cope with difficult or distressing thoughts and feelings [3]. It most frequently takes the form of cutting, burning or non-lethal overdoses. However, it can also be any behaviour that causes injury - no matter how minor, or high-risk behaviours [4].

Basically, any behaviour that that causes harm or injury to someone as a way to deal with difficult emotions can be seen as self-harm.

The self-harm cycle

Self-harm usually starts as a way to relieve the build-up of pressure from distressing thoughts and feelings. This might give temporary relief from the emotional pain the person is feeling. It's important to know that this relief is only temporary because the underlying reasons still remain. Soon after, feelings of guilt and shame might follow, which can continue the cycle. [5]

Because there may be some temporary relief at the start, self-harm can become someone's normal way of dealing with life's difficulties. This means that it is important to talk to someone as early as possible to get the right support and help. Learning new coping strategies to deal with these difficulties can make it easier to break the cycle of self-harm in the long term.

Who does it?

There is no such thing as a typical young person who self-harms. Self-harm is something that can affect anyone. It's believed that around 10% of young people self-harm [6], but it could be as high as 20% [7]. If you self-harm, there are a lot of people who also know what you're going through.

Most young people reported that they started to hurt themselves around the age of 12. [8]

While it is true that anyone can be affected by self-harm, some people are more likely to self-harm than others because of things that have happened in their lives - where they live, things that are happening with friends, family or at school, or a combination of these. This means that some people are more at risk of self-harm than others. Some factors that might make someone more at risk are:

Experience of a mental health disorder. This might include depression, anxiety, borderline personality disorder, and eating disorders. [9, 10]

Being a young person who is not under the care of their parents, or young people who have left a care home. [11]

Being part of the LGBT community. [12]

Having been bereaved by suicide. [13]

It is important to remember that although these are risk factors that can make someone more likely to self-harm, having any of these does not mean someone will self-harm. Similarly, someone who self-harms might not experience any of these. Anyone can be affected.

Why do people self-harm?

Everyone has different things that cause stress and worry them. Some people can manage these troubles by talking to friends and family, while others may find these difficulties overwhelming. When we don't express our emotions and talk about the things that make us distressed, angry or upset, the pressure can build up and become unbearable. Some people turn this in on themselves and use their bodies as a way to express the thoughts and feelings they can't say aloud. People often harm themselves when this all gets too much. If you self-harm, you might find that when you feel angry, distressed, worried or depressed, you feel the urge to hurt yourself even more.

Someone's reason to self-harm can be very different from other people who self-harm. Some of the reasons that young people report as triggers or reasons that lead them to self-harm include [14]:

difficulties at home

arguments or problems with friends

school pressures

bullying

depression

anxiety

low self-esteem

transitions and changes, such as changing schools

alcohol and drug use.

When a few of these issues come together they can quickly feel overwhelming and become too much for one person to deal with. As one young person said, many people self-harm to "get out the hurt, anger and pain" caused by pressures in their lives. They hurt themselves because they didn't know what else to do and didn't feel like they had any other options. Talking to someone you trust or a healthcare professional can help you find other options for coping with the emotional pain you are feeling.
If you are experiencing difficult issues in your life, there is support available. Please see the 'Where can I get further help and information?' section of this booklet.
Breaking Down The Myths

There are lots of myths attached to self-harm. This isn't surprising - myths and misunderstandings often arise when a problem like self-harm is poorly understood. Negative stereotypes can be powerful. They need to be challenged because they stop people talking about their issues and asking for help. These myths also mean that professionals, family and friends can misunderstand people who self-harm.

MYTH: 'Self-harm is attention-seeking'

One of the most common stereotypes is that self-harm is about 'attention seeking'. This is not the case. Many people who self-harm don't talk to anyone about what they are going through for a long time and it can be very hard for people to find enough courage to ask for help. [15]

MYTH: 'Self-harm is a goth thing'

Self-harm has been stereotyped to be seen as part of youth subcultures such as "goth" or "emo". While there is some research suggesting a link, there is no conclusive evidence of this with little or no evidence supporting the belief that self-harm is part of any particular young person subculture.

MYTH: 'Only girls self-harm'

It is often assumed that girls are more likely than boys to self-harm, however it isn't clear if this is true. [16] Boys and girls may engage with different self-harming behaviours or have different reasons for hurting themselves [17], but this doesn't make it any less serious.

MYTH: 'People who self-harm must enjoy it'

Some people believe that people who self-harm take pleasure in the pain or risk associated in the behaviour. There is no evidence that people who self-harm feel pain differently than anyone else. The harming behaviour often causes people great pain. For some, being depressed has left them numb and they want to feel anything to remind them they are alive, even if it hurts. Others have described this pain as punishment. [18]

MYTH: 'People who self-harm are suicidal'

Self-harm is sometimes viewed as a suicide attempt by people who don't understand it. For many people self-harms is about trying to cope with difficult feelings and circumstances. Some people have described it is a way of staying alive and surviving these difficulties. However, some people who self-harm can feel suicidal and might attempt to take their own life, which is why it must always be taken seriously. [19]

People often link self-harm to suicide but for me it was something very different; it was my alternative to suicide, my way of coping even though sometimes I wished that my world would end.

Getting Help

Should I tell someone?
Yes. Talking to someone is often the first step to getting out of the cycle.
It isn't an easy thing to do and you might find it difficult to talk about your self-harm and the reasons behind it. This is normal - lots of young people who self-harm find asking for help very difficult. But it is an important step towards recovery and feeling better. [20]

Telling someone about your self-harm shows strength and courage; it can often be a huge relief to be able to let go of such a secret, or at least share it.

Don't be afraid to ask for help whenever and however you need to. Talking about your feelings isn't a sign of weakness. It shows that you are taking charge of your well-being and doing what you need to stay healthy. It isn't always easy to express how you are feeling. If you can't think of one word to describe a feeling, use as many as you need to illustrate how you feel.

Talking can be a way of coping with a problem you've been carrying around in your head for a while. Feeling listened to can help you feel more supported. And it works both ways: if you open up it might encourage others to do the same.

Who can I talk to?

There are lots of people you can talk to about what you are going through. It is important to tell someone you trust and feel comfortable with, as they will be able to help and support you. Young people told us that they have been able to talk to:

friends

family

someone at school, such as a trusted teacher, school nurse or pastoral care staff

a youth worker

their GP or healthcare professionals such as a counsellor or nurse

charities and helplines (some of which are listed below).

There are no rules about how you should tell someone. The most important thing is that you feel comfortable and trust the person you decide to tell. Set time aside to talk to them. Remember you can set the pace and it is up to you how much you want to tell them.

If you find speaking about it too difficult, you can tell someone in writing or in an email. You can even ask a friend to speak to a trusted adult on your behalf.

Let them know you need help with how you are feeling. There is no need to give details about how you have harmed yourself and you don't need to talk about things you feel uncomfortable talking about. Try to focus on the thoughts and feelings behind your self-harm rather than the behaviours.

If you decide to talk to a GP or other health professional, you can take a friend or family member with you to support you.

Sometimes after telling someone you may feel worse. That's normal. But remember that once you get over this hurdle there is support and help available.

If you're worried that when you tell someone they won't understand, or if you have experienced this, try giving them a copy of this booklet or suggest they talk to an expert in the field to try to understand more about self-harming.

Remember that health professionals, GPs and teachers are familiar with this issue and are there to help.

Don't let the fear of a bad reaction put you off seeking the help you need and deserve. As hard as it is to tell someone, sharing will take the pressure off you and help you get the right support and help available.

What help is available for me?

There are lots of support services and treatments available when you feel ready to seek help. If you seek help from your GP, it is likely they will offer you counselling, where a professional will listen and help you to work on solutions and strategies to cope with the problems you are dealing with.

Talking therapies such as cognitive behavioural therapy (CBT) focus on building coping strategies and problem-solving skills and have been found to be very effective in helping to reduce self-harm [21].

Other forms of counselling, like psychodynamic therapy, for instance, will help you to identify the problems that are causing you distress and leading you to self-harm [22]. It is important that you talk to your GP or a trusted health professional who will help decide the best treatment option for you.

There are also a number of charities and self-help groups throughout the UK that can support you through this experience. People who have self-harmed have said that it can be helpful to hear from other young people who have experienced self-harm. More information about these sources of support is available at the end of this booklet.

I feel a lot more confident. I've learned to be more open about my feelings and been able to move on. I felt that, without them knowing, I was being held back. I've been able to come out of myself and explain what I do, and make sense of it, not keep having to lie and cover up what I did. I no longer feel ashamed as I know people are supporting me.

Recovery

It's important to remember that you won't always feel the way you do now. The problems that are causing you to self-harm can, with help and support, become more manageable over time or even go away. Things can and do get better!

Take time and be patient with yourself. Recovery doesn't happen overnight - it can be a slow process. Start to learn how to care for yourself.

Young people who have recovered from self-harm say that changes over time and changes in circumstances in life (for example moving home, changing schools, finishing exams, going to university, changing jobs or changed financial circumstances) helped them to recover. Once one or two of the main factors that were causing them to self-harm (such as their family situation, or bullying at school) were removed, they felt they didn't have to use self-harm as a coping strategy.

Others explained that recovery was about finding new coping strategies and more helpful ways of dealing with emotions or distress. This is also an important factor towards recovery from self-harm. [23, 24]

It dawned on me that continually harming myself was not allowing me to grow; it was just proving that I was still here and I could feel. But wasn't letting me push things forward, and unless I stopped doing that, I would be in the same situation forever.

How can I stop harming myself?

Asking for help and having support is very important if you are trying to stop self-harming. It is important that you do this when you feel ready to talk about it. It doesn't matter who you talk to, as long as it's someone you trust and feel comfortable with. Talking to someone is what is important. You don't have to feel that you need to deal with this on your own. For young people used to carrying burdens on their own, it can be hard to receive support. Part of recovery is trusting people enough to let them help you.

Talking to someone you trust can help you discover why you self-harm and help to find new ways to cope with difficulties [25]. Finding out what makes you happy, sad, angry, isolated, vulnerable or strong can help you develop other ways of dealing with these feelings. Counselling is a good way of exploring these thoughts and feelings and is available through your GP.

Other young people who have self-harmed have found 'distraction techniques' to be a very useful strategy to reduce or stop self-harming. These techniques find a release for the emotional pressure you feel without the need to harm.

If you feel the need to harm yourself, try to give yourself a goal of getting through the next ten minutes without doing so.

Distraction Techniques

When you feel the urge to self-harm, distraction techniques can be a useful way to ' ride the wave' of emotion and overcome the urge to harm yourself. [26]

Young people shared their most helpful ones with us:

Write down thoughts and feelings that are distressing you; crumple the page up, rip it apart and throw them out as a way to let go of that thought.

Get some play-dough: stretch it or squeeze it to relieve tension.

Hit a pillow or cushion to vent your anger and frustration.

Have a good scream into a pillow or cushion.

Take a minute and breathe or meditate.

Go for a walk to take yourself away from triggers. Being in a public place gives you the time and space to reduce the urge to hurt yourself.

Make lots of noise, either with a musical instrument or just banging on pots and pans.

Scribble on a large piece of paper with a red crayon or pen.

Call a friend or family member and talk to them. This doesn't have to be about self-harm.

Do something creative: make a collage of colours to represent your mood or to remind you of your favourite things.

Listen to music you like or watch a film you enjoy.

Go online and look at self-help websites.

Talk to someone about what is triggering you or seek help from a professional.

I've tried so many distraction techniques - from writing down my thoughts, hitting a pillow, listening to music, writing down pros and cons. But the most helpful to my recovery was the five minutes rule, where if you feel like you want to self-harm, you wait for five minutes before you do it, then see if you can go another five minutes, and so on till eventually the feeling that you need to is over.

Tips For Looking After Yourself

Keeping safe

Self-harm is not a positive way to deal with things. However if you are self-harming it can be difficult to stop, especially when you feel distressed or upset. If you don't feel you can stop right now, it is important that you do keep yourself safe.

Wounds and injuries of any type can be dangerous and carry the risk of infection, which can be serious, so they need to be looked after. If you have serious injury, feel unwell or feel that you are going into shock (fast breathing, racing heart, feeling faint or panicked) you should seek help immediately. If you find yourself in this situation, find a trusted adult or friend who can get you the medical attention you need. This doesn't mean you have to discuss your self-harm with them (although it may help); it is about allowing someone to support you medically in a moment of crisis. [27]

Many people stop hurting themselves when the time is right for them. Everyone is different and if they feel the need to self-harm at the moment, they shouldn't feel guilty about it - it is a way of surviving, and doing it now does NOT mean that they will need to do it forever. It is a huge step towards stopping when they begin to talk about it, because it means that they are starting to think about what might take its place eventually.

Make a 'safe box'

You can create a safe box to help you through times when you feel overwhelmed by emotion and have the urge to harm yourself. Fill it with things that make you happy and calm, to help you to get through this feeling. Some suggestions: activities such as crosswords, your favourite book, CD or movie. You could also include a list of things to do that make you calm when you are feeling triggered.

Talk to someone

When you are feeling overwhelmed, talk to a friend, family member or trusted adult. Let them know what you are thinking. This can help relieve the pressure that you are feeling. Make a list of people you can talk to at these times and keep it somewhere safe. Knowing who you can talk to in times of crisis at 3am, weekends or when you are at school can make it easier to ask for help when you need it. Add these to your safe box. This will remind you that you are not alone and there are people you can talk to when you need to.

Avoid alcohol and drugs

We often drink alcohol or take drugs to change our mood or to avoid our feelings. Some people drink to deal with fear or loneliness, but like self-harm the effect is only temporary and can end up making you feel worse. [28] Alcohol is a depressant, which means it slows down brain activity. This changes how you think and feel, so can increase feelings of anxiety and depression. When it wears off you can end up feeling worse because of the effects it has on your brain and your body. [29]

Drinking alcohol or taking drugs can leave you feeling depressed or anxious, and can lower your inhibitions physically, which can lead you back to harming yourself. Visit www.drinkaware.co.uk for more information.

Do something you enjoy

Remember that there is more to you than self-harm. Do things that remind you of this and make you happy. Maybe this is a sport, or a hobby you like doing such as writing.

Doing things that you enjoy and makes you feel happy, helps you look after your mental health. It helps to improve your self-esteem and can help you remember that you are important and have value.[30]

Don't be too hard on yourself

Many young people who self-harm can be perfectionists and high achievers [31]. You might put pressure on yourself to do things in a certain way, or feel that nothing you do is good enough.

Try to not be so hard on yourself about not getting things perfect. Recovery is about knowing that it is okay for your work or performance to be ' good enough'.

I am worried about someone else

If you are worried that someone you know is self-harming, it is important to know what to look out for and what to do. Below is some information to help you.

Signs to Look Out For

It can be difficult to tell whether someone is self-harming. Here are some signs that might suggest someone could be self-harming [32]:

Withdrawal or isolation from everyday life.

Signs of depression such as low mood, tearfulness or a lack of motivation or interest in anything.

Changes in mood.

Changes in eating/sleeping habits.

Changes in activity and mood, e.g. more aggressive than usual.

Talking about self-harming or suicide.

Abusing drugs or alcohol.

Expressing feelings of failure, uselessness or loss of hope.

Risk taking behaviour (substance misuse, unprotected sexual acts).

Signs of low self-esteem such as blaming themselves for any problems or saying they are not good enough.

Unexplained cuts, bruises or marks.

Covering up all the time, when in hot weather.

Being quieter than usual.

Lacking energy.

It is important to know that these may be a sign of other things and don't always mean someone is self-harming. Also, there may be no warning signs at all. It is therefore important that if you suspect someone you know is self-harming, that you ask them openly and honestly.

What to do if you are worried about someone

If you are worried that someone you know is self-harming, it can be difficult to know what to do. When you are aware there is an issue, it is important that you do not wait. Waiting and hoping they will come to you for help might lose valuable time in getting them the best support and treatment to help them [33].

Be mindful that they might not feel ready or able to talk about their self-harm. Let them lead the discussion at their own pace and don't put pressure on them to tell you details that they aren't ready to talk about. It takes a lot of trust and courage to open up about self-harm. You might be the first person they have been able to talk to about this.

Some tips for talking to someone about self-harm [34]:

Set plenty of time aside to talk to them where you will be free from interruption. If you don't have time at that particular moment, make sure to put time later in the day when you can listen to them.

If possible, remove distractions such as computers and phones being on. This will allow you to give your full attention, letting them know you are there to listen to and support them.

Acknowledge how difficult it might be to open up about their self-harm but don't focus on or encourage them to tell you details about specific injuries or behaviours. Instead talk about how they are feeling and what they are going through.

Try not to react shocked or disgusted. This can be hard as it's difficult to understand why someone would harm themselves, but negative reactions can hurt the other person and may put them off talking to you.

Know your limits: the person who has experienced self-harm might tell you to keep it a secret and not to tell anyone else. If you believe they are in immediate danger or have injuries that need medical attention, you need to take action to make sure they are safe.

Reassure them that you are there for them and that there are lots of sources of support available to them. You might not understand what they are going through or why they do it but remind them you are there for them regardless.

Avoid giving ultimatums; for example 'stop or else...' as these rarely work, and may drive behaviours underground. Furthermore, this may stop them talking to you and you might not get the chance to discuss the topic again.

Offer them help in seeking professional support and provide information on ways to do this. You might want to offer to go the GP with them, or help them talk to a trusted adult or family member. Try not to take control and allow them to make decisions.

Be positive and let them know that things will get better and recovery is possible!

If it is a family member or close friend you are concerned about, they might not want to talk to you. Try not to take this personally: telling someone you love about self-harm can be difficult as you are close to them and they might be worried they are hurting you.

Whether you approach someone you are worried about, or someone opens up to you about their self-harm, it is important that you respond in a non-judgemental, caring and respectful way. This can be hard when you see that someone is in distress, and it can be difficult to understand why someone would hurt themselves, however you should try to see the person and reasons they have harmed themselves rather than focusing on the behaviours.

Further Help, Information and Support

If you are worried about the immediate well-being of yourself or someone else you should call 999 or go straight to A & E. For non-emergency help you should talk to your GP or contact 111 or NHS Direct on 08454647.

You can also get more information or support through the websites below:

selfharmUK is a project dedicated to supporting young people impacted by self-harm, providing a safe space to talk, ask any questions and be honest about what's going on in your life. These pages will tell you a bit about us as well as pointing you in the right direction if you need to contact us or find out more about our policies and procedures.

YoungMinds is the UK's leading charity committed to improving the emotional wellbeing and mental health of children and young people. Driven by their experiences we campaign, research and influence policy and practice.

Some websites that have been recommended to us by young people include:

Some telephone helplines offer specialist advice on self-harm, others operate only as a 'friendly listening ear' - something many young people have said they value, particularly when they feel they have no-one else that they can turn to. Again, it's important that information about reputable phone lines is widely available to young people. Helpful telephone numbers include:

- ChildLine - 0800 1111

- Samaritans - 08457 90 90 90

- Family Lives - 0808 800 2222

- Young Minds - 0808 802 5544

- Get Connected - 0808 808 4994

References

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Order this publication This booklet aims to help you understand more about self-harm and what to do if you are worried about yourself or someone else. It explains what self-harm is, what to do if you or someone you know is self-harming, and how to get help.

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Autism, ADHD and school absence are risk factors for self-harm: new research (theconversation.com) 

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Autism, ADHD and school absence are risk factors for self-harm: new research (theconversation.com) 

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Autism, ADHD and school absence are risk factors for self-harm: new research (theconversation.com)

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Autism, ADHD and school absence are risk factors for self-harm: new research

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Data linkage, assessing information from over 113,000 teenagers in South London, addresses important gaps in research on the mental health and socio-economic risk factors for self-harm.

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Psychology in schools - free Parent/carer workshop programme.

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psychology in schools team - nsft tickets

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Norfolk and Suffolk NHS Foundation Trust is committed to transformation to develop an integrated provision for children and young people's mental health and wellbeing. A key priority is to bring specialist mental health support into local communities through a different relationship between GPs, education, primary care and community services and specialist mental health/wellbeing services.