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The ADHD Foundation Neurodiversity Charity - an integrated health and education service.

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ADHD symptom tests, ADD medication & treatment, behavior & discipline, school & learning essentials, organization and more information for families and individuals living with attention...

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CAMHS advice

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Stress bucket to identify how we are coping

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Stress bucket to identify how we are coping

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Belvedere Mental Health and Emotional Well being Policy

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Belvedere Mental Health and Emotional Well being Policy

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Providing mental health and emotional wellbeing services for Merseyside's children, young people (aged 5-25 years old) and families

Providing mental health and emotional wellbeing services for Merseyside's children, young people (aged 5-25 years old) and families

Providing mental health and emotional wellbeing services for Merseyside's children, young people (aged 5-25 years old) and families

Providing mental health and emotional wellbeing services for Merseyside's children, young people (aged 5-25 years old) and families

Providing mental health and emotional wellbeing services for Merseyside's children, young people (aged 5-25 years old) and families

How are you feeling today?

Click the emoji that best describes how your feeling today.

Serving a Merseyside population of over 150,000 children and young people. YPAS delivers a wide range of wellbeing and therapeutic services for children, and young people aged 5 to 25 years old and their parents and families. Our citywide services consist of individual support and open access groups. They are delivered from: three community hubs, primary schools, secondary schools and GP practices and other community education settings.

Each and every one of us has mental health and it's just as important to look after it, as we do our physical health.

Open Access Groups Calendar

Thank you ever so much to Hannah for your support over the last few months.
Parent/Carer

Thank you YPAS, firstly as a whole for the service you provide. Thank you for letting Lilly come and see you when needed. Special thank you to Dagmar for literally everything she has done for Lilly. We are so grateful. Thank you.
Young Person Aged 14

I received amazing support specifically from Paul. He made the process easy and efficient after waiting months trying to do it alone. Extremely grateful having accessed the service and at the amazing support I've received.
Young Person Aged 23

My son has recently finished therapy with YPAS and even though it was difficult to get him to engage with her due to his disability she was brilliant with him. She was patient, understanding and very supportive. Thank you for all your help and support.
Parent/Carer

I have been working with grace and I am feeling so much better in myself thank you Grace. :)
Young Person Aged 18

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YPAS delivers a wide range of wellbeing and therapeutic services for children, and young people aged 5 to 25 years old and their parents and families.

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How to refer to CAMHS for mental health support:

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How to refer to CAMHS for mental health support:

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Liverpool CAMHS Mental Health Leads' Hub provides a one-stop shop for schools.

The hub features a range of support and resources for schools in Liverpool:

Support for an individual pupil

Parent/carers

Staff training and support

Whole School Approach & Workshops

Mental Health Aftercare following a Liverpool school critical incident

Resource hub

Visit the directory here.

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Liverpool CAMHS Mental Health Leads' Hub provides a one-stop shop for schools. The hub features a range of support and resources for schools in Liverpool: Support for an individual pupil Parent/carers Staff training and support Whole School Approach & Workshops Mental Health Aftercare following a Liverpool school critical incident Resource hub Visit the directory here.

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Place2Be is a children and young people's mental health charity with almost 30 years' experience working with pupils, families and staff in UK schools.

We provide mental health support in schools through one-to-one and group counselling using tried and tested methods backed by research. In addition, we also offer expert training and professional qualifications.

Why it's important

1 in 5

children and young people have a probable mental health condition, and many continue to have these problems into adulthood.

50%

of those with lifetime mental health problems first experience symptoms by the age of 14.

1 in 10
boys aged 5-19 with a mental health condition are suspended in some form from school.

Find out more about our work

How we help

Mental health support in schools

Our in-school mental health service supports the wellbeing of pupils, families and staff.
Find out more

Our mental health services in schools

We provide mental health services in schools that contribute to a whole-school approach to mental health.
Find out more

Counselling training and placements

Gain experience and skills with our child counselling training and placements.
Find out more

Place2Be is part of our school family. It is more than an office, more than a therapy room and more than a collection of counsellors.

Glyn Ellis - Headteacher, Haslingden Primary School

My daughter had become a different person - one we didn't recognise - but since counselling we see signs of our old loving daughter coming back.

Parent

If you have problems or worries you get a chance to talk to a person you trust. When I grow up I want to help children like Place2Be helps children.

Eight-year-old girl

Your support makes it possible

Thousands of vulnerable children and families depend on our work every single day. We simply cannot reach them without your help. There are so many ways to lend your support.

Place2Be's counselling service in primary schools has the potential to return £8 to society by improving long-term outcomes for each child.

Make a donation

How you can help

Fundraise for us

Raise money to transform children and young people's mental health. Browse ideas, tips and advice.

Get fundraising inspiration

Take part in an event

Run, cycle, walk. Trek to great heights or tackle some muddy obstacles. Take a look at our fundraising events.

Take on an event

Partner with us

See how your organisation can help us to support more children, families and school staff across the UK.

Find out more

Our impact

In the last school year

6,901

pupils were supported through one-to-one counselling.

33,327

pupils booked their own appointments o speak to our mental health professional.

After one-to-one counselling with Place2Be

76%

of children with severe difficulties show an improvement in mental health, according to parents.

64%

of pupils whose difficulties impacted their learning in class improved, according to teachers.

75%

of children and young people found it easier to make and keep friends, according to parents and carers.

Place2Be: mental health support in schools

Hear from children and teachers about the impact of Place2Be.

News & blogs

Eating Disorders in Children and Young People: a major public health concern

Clara Faria and Professor Tamsin Ford reflect on the impact of eating disorders on children and young people's mental health.

Read more

New report from NHS England shows increase in children experiencing mental health difficulties

Published today, the report reveals that 1 in 5 children and young people now have a probable mental health condition.

Read more

The BAFTA Roadshow with Place2Be arrives in North-West London

BAFTA and Place2Be team up to bring the BAFTA Roadshow to North-West London.

Read more

Sign up to our newsletter

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Improving children's and young people's mental health - Place2Be

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Place2Be provides mental health counselling support and training to schools to improve the emotional wellbeing of children, young people, families, teachers and staff.

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This dedicated Community-based service provides a timely access to multi-disciplinary assessment and intervention to children and young-people from across Liverpool and Sefton up to the age of 18.

Meet The Team

There is a number of difference clinicians involved in our team. The team is made up of; Service Lead, Consultant Psychiatry, Consultant Paediatricians, Clinical Psychologists working alongside an array of staff including dieticians, nurses, therapist and a support workers.

Referrals

We accept self-referrals and referrals made by professionals. A referral to the service can be made by using the online platform.

Additionally, GP Referrals can be accessed through EMIS, Please email any referrals to [email protected]

Please note - we do not currently operate on Choose and Book.

Referral triage process

Once a referral is received, this will be reviewed by the clinical team and triaged as appropriate. We aim to see all urgent cases within 7 days of referral and routine cases within 28 days of the date of referral if accepted.

If you have any queries, please contact our Administrator on 0151 282 4911 who will then deal with and redirect the call as appropriate.

If you are concerned about a young person, please contact our Crisis Care Team who operate on a 24/7 service on 0151 293 3577.

Email us at [email protected] . Please be aware this is a non-urgent mailbox.

Our main base is the Catkin Building in Alder Hey, although we do offer appointments at other locations such as Burlington House, Southport Hub and in the family's home.

You can see a little more of our Catkin base on the below video:

Helpful Videos

What is an eating disorder?

How best to help if you are worried someone you know may have an eating disorder?

What therapeutic approach are used in the team?

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The Eating Disorder Young People Service (EDYS) - Alder Hey Children's Hospital Trust

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This page provides information on our Eating Disorder Service at Alder Hey. Find out more about what the team do here.

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Beat provides Helplines offering support and information about eating disorders no matter where you are in your journey.

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Avoidant/restrictive food intake disorder (ARFID) is a relatively new term, that was introduced in 2013 when it first appeared in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). It has also previously been known as Selective Eating Disorder.

It is anticipated that it will similarly, make its debut in the World Health Organisation's next edition of its equivalent (the ICD). Favoured by European countries, the next edition of the ICD (ICD-11) was presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022.

The entry of ARFID into the DSM-5 was significant in that it had previously existed under an umbrella term used to encompass all 'other infant and early childhood' feeding disorders.

ARFID is characterised by a pattern of eating that avoids certain foods or food groups entirely and/or is restricted in quantity (eating small amounts). Avoidant and restrictive eating cannot be due to lack of available food, or cultural norms (e.g. someone who is fasting or chooses not to eat certain foods for religious or cultural reasons alone).

ARFID is different to other restrictive eating disorders in that:

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Avoidant/restrictive food intake disorder (ARFID) is a relatively new term, that was introduced in 2013 when it first appeared in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). It has also previously been known as Selective Eating Disorder.

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People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

The recommendations apply to staff from all sectors that work with people who have self-harmed, unless a recommendation or section specifically states that it is for a certain group. Because of the wide variety of criminal justice system settings that exist and the need to take other relevant national guidance into account, the recommendations in the guideline may need to be tailored for certain criminal justice system settings during implementation.

Putting recommendations into practice can take time depending on how much change in practice or services is needed. Most of the recommendations in this guideline reinforce best practice and will not need additional resources to implement if previous guidance has been followed. If changes to current local practice are needed to implement the recommendations, they may take time and significant additional resources.

The recommendations apply to all people who have self-harmed, unless a recommendation specifically states that it is for adults or children and young people only.

1.2 Consent and confidentiality

1.2.1 Healthcare professionals and social care practitioners who have contact with people who self-harm should be able to:

1.2.2 Healthcare professionals and social care practitioners who have contact with children and young people who self-harm should also be able to:

understand how to apply the principles of the Children Act 1989 and the Children and Families Act 2014 in relation to competence, capacity and confidentiality and the scope of parental responsibility

understand how to apply the principles of the Mental Health Act 2007 to young people

understand how issues of capacity and competence to consent apply to children and young people of different ages

assess the young person's capacity to consent (including Gillick competence).

1.2.3 If staff working with people who self-harm need to discuss issues relating to capacity and consent, they should have access to:

1.2.4 Staff working with people who self-harm should be familiar with the limits of confidentiality with regard to information about a person's treatment and care.

1.2.5 Staff working with people who self-harm should be aware of the benefits of involving the person's family and carers and sharing information, and should recognise the need to seek consent from the person as early as possible. Also see the Department of Health and Social Care's consensus statement on information sharing and suicide prevention.

1.2.6 Staff working with people who self-harm should recognise that if it is necessary to breach confidentiality, they should ensure that the person who has self-harmed is still involved in decisions about their care and, where possible, is informed about the breach of confidentiality.

1.4 Involving family members and carers

The recommendations in this section should be read alongside the recommendations on consent and confidentiality.

1.4.1 Ask the person who has self-harmed whether and how they would like their family or carers to be involved in their care, taking into account the factors in recommendation 1.4.2, and review this regularly. If the person agrees, share information with family members or carers (as appropriate), and encourage them to be involved.

1.4.2 When thinking about involving family members or carers in supporting a person who has self-harmed, take into account issues such as:

1.4.3 When involving family members or carers in supporting a person who has self-harmed:

encourage a collaborative approach to:

empower and support the person who has self-harmed

minimise the person's self-harm behaviours and

support the person's recovery to prevent recurrence

give them opportunities to be involved in decision making, care planning and developing safety plans to support the person beyond the initial self-harm episode, and through their care pathway

ensure that there is ongoing and timely communication with the family or carers

regularly review whether the person who has self-harmed still wants their family or carers to be involved in their care, and ensure that they know they can withdraw consent to share information at any time.

1.4.4 Be aware that even if the person has not consented to involving their family or carers in their care, family members or carers can still provide information about the person.

1.4.5 If the person who has self-harmed finds it difficult to vocalise their distress when they are in need of care, support the person and their family members or carers (as appropriate) in trying alternative methods of communication (such as non-verbal language, letters, emotional wellbeing passports, and using agreed safe words, phrases or emojis).

1.5 Psychosocial assessment and care by mental health professionals

1.5.1 At the earliest opportunity after an episode of self-harm, a mental health professional should carry out a psychosocial assessment to:

1.5.2 Do not delay the psychosocial assessment until after medical treatment is completed.

1.5.3 If the person who has self-harmed is intoxicated by drugs or alcohol, agree with the person and colleagues what immediate assistance is needed, for example, support and advice about medical assessment and treatment.

1.5.4 Do not use breath or blood alcohol levels to delay the psychosocial assessment.

1.5.5 If the person is not able to participate in the psychosocial assessment, ensure that they have regular reviews, and complete a psychosocial assessment as soon as possible.

1.5.6 If the person who has self-harmed has agreed a care plan, check this with them and follow it as much as possible.

1.5.7 Carry out the psychosocial assessment in a private, designated area where it is possible to speak in confidence without being overheard.

1.5.8 Take into account the needs and preferences of the person who has self‑harmed as much as possible when carrying out the psychosocial assessment, for example, by:

making appropriate adaptations for any learning disability or physical, mental health or neurodevelopmental condition the person may have and

providing the option to have a healthcare professional of the same sex carry out the psychosocial assessment when the person has requested this.

1.5.9 During the psychosocial assessment, explore the functions of self-harm for the person. Take into account:

1.5.10 During the psychosocial assessment, explore the following to identify the person's strengths, vulnerabilities and needs:

1.5.11 For children and young people who have self-harmed, ensure that a mental health professional experienced in assessing children and young people who self-harm carries out the psychosocial assessment. They should ask about:

their social, peer group, education and home situations

any caring responsibilities

the use of social media and the internet to connect with others and the effects of these on mental health and wellbeing

any child protection or safeguarding issues (also see the section on safeguarding).

1.5.12 For older people who have self-harmed, ensure that a mental health professional experienced in assessing older people who self-harm carries out the psychosocial assessment. They should:

1.5.13 For people with a learning disability who have self-harmed, ensure that a mental health professional experienced in assessing people with a learning disability who self-harm carries out the psychosocial assessment.

1.5.14 If a person has self-harmed and presents to services but wants to leave before a full psychosocial assessment has taken place, assess the person's safety and any mental health problems before they leave.

1.5.15 Together with the person who self-harms and their family and carers (if appropriate), develop or review a care plan using the key areas of needs and safety considerations identified in the psychosocial assessment (see recommendations 1.5.8 to 1.5.14).

1.5.16 Give the person a copy of their care plan, and share the plan as soon as possible with relevant healthcare professionals and social care practitioners involved in the person's care.

1.5.17 If a person presents with frequent episodes of self-harm or if treatment has not been effective, carry out a multidisciplinary review with the person and those involved in their care and support, and others who may need to be involved, to agree a joint plan and approach. This should involve:

1.6 Risk assessment tools and scales

1.6.1 Do not use risk assessment tools and scales to predict future suicide or repetition of self-harm.

1.6.2 Do not use risk assessment tools and scales to determine who should and should not be offered treatment or who should be discharged.

1.6.3 Do not use global risk stratification into low, medium or high risk to predict future suicide or repetition of self-harm.

1.6.4 Do not use global risk stratification into low, medium or high risk to determine who should be offered treatment or who should be discharged.

1.6.5 Focus the assessment (see the section on principles for assessment and care by healthcare professionals and social care practitioners) on the person's needs and how to support their immediate and long-term psychological and physical safety.

1.6.6 Mental health professionals should undertake a risk formulation as part of every psychosocial assessment.

1.8 Assessment and care by professionals from other sectors

The recommendations in this section apply to all staff in non-healthcare and social care settings. Because of the wide variety of criminal justice system settings that exist and the need to take other relevant national guidance into account, staff working in the criminal justice system may need to tailor the recommendations for certain criminal justice system settings during implementation.

Principles for assessment and care by professionals from other sectors

1.8.1 When a person who has self-harmed presents to a non-health professional, for example, a teacher or a member of staff in the criminal justice system, the non-health professional should:

1.8.2 When a person presents to a non-health professional, for example, a teacher or a member of staff in the criminal justice system, the non-health professional should establish the following as soon as possible:

Assessment in schools and educational settings

1.8.4 Educational settings should have a designated lead responsible for:

1.8.5 All educational staff should:

be aware of the policies and procedures for identifying and assessing the needs of students who self-harm

know how to implement the policies and procedures within their roles and responsibilities

know who to go to for support and supervision.

1.8.6 For students who have self-harmed, the designated lead should seek the advice of mental health professionals to develop a support plan with the student and their family members and carers (as appropriate) for when they are in the educational setting. This should include guidance from other agencies involved in the person's care, as appropriate.

1.8.7 Educational staff should take into account how the student's self-harm may affect their close friends and peer groups, and provide appropriate support to reduce distress to them and the person.

Assessment and care in the criminal justice system and other secure settings

1.8.8 Staff in criminal justice settings and other secure settings such as immigration removal centres should be aware that those in their care have higher rates of self-harm and suicide.

1.8.9 Staff in criminal justice settings and other secure settings such as immigration removal centres should be aware of support services available to them to support their own wellbeing.

1.8.11 Staff in criminal justice settings and other secure settings such as immigration removal centres should follow local guidance on assessing people who have self-harmed, and healthcare professionals and social care practitioners in these settings should also follow the NICE guideline on mental health of adults in contact with the criminal justice system.

1.8.12 Staff in criminal justice settings and other secure settings such as immigration removal centres should ensure that people who have self‑harmed have a safe location to await assessment or treatment following an episode of self-harm.

1.9 Admission to and discharge from hospital

The recommendations in this section apply to all healthcare professionals and social care practitioners.

1.9.1 Consider admission to a general hospital after an episode of self-harm if:

there are concerns about the safety of the person (for example, the person is at risk of violence, abuse or exploitation) and psychiatric admission is not indicated

safeguarding planning needs to be completed and psychiatric admission is not indicated

the person is unable to engage in a psychosocial assessment (for example, because they are too distressed or intoxicated).

1.9.2 If a 16- or 17-year-old is admitted to a general hospital, ensure that it is to a ward that can meet the needs of young people.

1.9.3 For arrangements for initial aftercare for people who have been admitted to a general hospital after they have self-harmed, see the section on initial aftercare after an episode of self-harm.

1.9.4 Do not delay carrying out a psychosocial assessment or offering mental health treatment if the person is admitted to hospital or needs treatment for physical injuries.

1.9.5 If a person self-harms during a hospital admission, follow the local hospital policy for investigating untoward incidents and undertake a full investigation. Local areas should be aware of the NHS Patient Safety Incident Response Framework.

1.9.6 Before discharging a person who has self-harmed from a general hospital, ensure that:

a psychosocial assessment has taken place

a plan for further management has been drawn up with all appropriate agencies and people

a discharge planning meeting with all appropriate agencies and people has taken place and

arrangements for aftercare have been specified, including clear written communication with the primary care team.

1.10 Initial aftercare after an episode of self-harm

The recommendations in this section apply to all healthcare professionals and social care practitioners.

1.10.1 After an episode of self-harm, discuss and agree with the person, and their family members and carers (as appropriate), the purpose, format and frequency of initial aftercare and which services will be involved in their care. Record this in the person's care plan and ensure that the person and their family members and carers have a copy of the plan and contact details for the team providing the aftercare.

1.10.2 If there are ongoing safety concerns for the person after an episode of self-harm, the mental health team, GP, team who carried out the psychosocial assessment or the team responsible for their care should provide initial aftercare within 48 hours of the psychosocial assessment.

1.11 Interventions for self-harm

The recommendations in this section apply to all healthcare professionals unless otherwise stated.

1.11.1 When planning treatment following self-harm, take into account any associated coexisting conditions and the psychosocial assessment.

1.11.3 Offer a structured, person-centred, cognitive behavioural therapy (CBT)-informed psychological intervention (for example, CBT or problem-solving therapy) that is specifically tailored for adults who self-harm. Ensure that the intervention:

starts as soon as possible

is typically between 4 and 10 sessions; more sessions may be needed depending on individual needs

is tailored to the person's needs and preferences.

1.11.4 For children and young people with significant emotional dysregulation difficulties who have frequent episodes of self-harm, consider dialectical behaviour therapy adapted for adolescents (DBT-A). Take into account the age of the child or young person and any planned transition between services.

1.11.5 Healthcare staff should be appropriately trained and supervised in the therapy they are offering to people who self-harm.

1.11.6 Work collaboratively with the person, using a strengths-based approach to identify solutions to reduce their distress that leads to self-harm.

1.11.7 Consider developing a safety plan in partnership with people who have self-harmed. Safety plans should be used to:

1.11.8 The safety plan should be in an accessible format and:

be developed collaboratively and compassionately between the person who has self-harmed and the professional involved in their care using shared decision making (see the NICE guideline on shared decision making)

be developed in collaboration with family and carers, as appropriate

use a problem-solving approach

be held by the person

be shared with the family, carers and relevant professionals and practitioners as decided by the person

be accessible to the person and the professionals and practitioners involved in their care at times of crisis.

1.11.9 Do not use diagnosis, age, substance misuse or coexisting conditions as reasons to withhold psychological interventions for self-harm.

1.11.10 Do not offer drug treatment as a specific intervention to reduce self-harm.

Harm minimisation

Although ways to self-harm safely are often considered a harm minimisation strategy, this guideline does not make any recommendations about the use of safer self-harm.

1.11.11 If a person is engaged in ongoing care and treatment but is not yet in a position to resist the urge to self-harm, only consider harm minimisation strategies:

in the spirit of hope and optimism, and to reduce the severity and/or recurrence of injury

as part of an overall approach to the person's ongoing recovery‑focused care and support, and not as a standalone intervention and

after being discussed and agreed in a collaborative way with the person and their family members or carers (as appropriate), and the wider multidisciplinary team.

1.11.12 Mental health professionals should discuss with the person harm minimisation strategies that could help to avoid, delay or reduce further episodes of self-harm and reduce complications, for example:

distraction techniques or coping strategies

approaches to self-care

wound hygiene and aftercare

providing factual information on the potential complications of self-harm

the impact of alcohol and recreational drugs on the urge to self-harm.

1.11.13 Be aware that harm minimisation strategies may not be appropriate for all people who self-harm.

1.12 Supporting people to be safe after self-harm

1.12.1 Ensure continuity of care, wherever possible, in the staff caring for people who have self-harmed by minimising the number of different staff they see.

1.12.3 Do not use staff who are untrained in clinical observation (for example, security staff or trainee health and social care staff) to undertake such observations in a person who has self-harmed.

1.12.4 Ensure that the care plans of people who have self-harmed can be accessed by primary and secondary care plus other professionals and practitioners involved in their care.

1.12.5 Ensure that staff working with people who have self-harmed are visible and accessible to the people they are caring for, to encourage interaction, particularly during handovers and busy periods.

1.12.6 Assess the safety of the environment, balancing respect for the person's autonomy against the need for restrictions. Use the least restrictive measures.

1.12.7 Consider removing items that may be used to self-harm and involve the person who has self-harmed in this decision.

1.12.8 At the earliest opportunity, healthcare staff should help people who have self-harmed to become familiar with the clinical setting in which they are being cared for, and tell them how to get support.

1.12.9 Staff should know how to raise concerns without delay about a person who has self-harmed.

1.13 Safer prescribing and dispensing

The recommendations in this section apply to all healthcare professionals.

1.13.1 When prescribing medicines to someone who has previously self-harmed or who may self-harm in the future, healthcare professionals should take into account:

1.13.2 Use shared decision making to discuss limiting the quantity of medicines supplied to people with a history of self-harm (for example, weekly prescriptions), and ask them to return unwanted medicines for safe disposal. Also see the NICE guideline on shared decision making.

1.13.3 Consider carrying out a medicines review after an episode of self-harm. Take into account the pharmacokinetic properties of medicines, for example, half-life, risk of toxicity and the concurrent use of medicines such as benzodiazepines and opiates. If necessary, contact the National Poisons Information Service for further advice. Also see the NICE guideline on medicines optimisation. For people with learning disabilities or autism or both, the NHS England STOMP-STAMP principles may be useful.

1.13.4 Community pharmacy staff should be aware of warning signs relating to self-harm, such as identifying people who are in acute distress, buying large amounts of over-the-counter medicines or who have access to large amounts of medicines.

1.13.5 Healthcare professionals, including GPs and community pharmacy staff, should use consultations and medicines reviews as an opportunity to assess self-harm if appropriate, for example, asking about thoughts of self-harm or suicide, actual self-harm, and access to substances that might be taken in overdose (including prescribed, over-the-counter medicines, herbal remedies and recreational drugs).

1.15 Supervision

1.15.1 All staff who work with people of any age who self-harm should have the opportunity for regular, high-quality formal supervision from senior staff with relevant skills, training and experience. Supervision should:

take into account the emotional impact of self-harm on staff and how best to support them

promote the delivery of compassionate care

focus on ongoing skill development

include reflective practice

promote confidence and competence in staff working with people who have self-harmed.

1.15.2 Ensure that all staff working with people who self-harm have easily accessible ongoing support from senior staff with relevant skills, training and experience. Support should include:

clear lines of responsibility around decision making, particularly for situations where there are challenges around the balance between autonomy and safety for a person who has self-harmed

emotional support or signposting to emotional support services, as preferred by the member of staff.

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Self-harm: assessment, management and preventing recurrence

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This guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed

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Supporting a child who self-harms

Offer them emotional support

Finding out that your child's been hurting themselves can be really hard to accept and it's natural to feel anxious or upset. Some parents might also blame themselves or feel powerless to help. But if you can, it's really important to try and stay calm and remember there are things you can do to support your child.

Focus on showing them that you're there whenever they choose to talk. Remember they may prefer to talk over text or WhatsApp rather than in person. If they do feel ready to talk, try to just listen and not ask too many questions about why they've been self-harming, so it doesn't seem like you're judging them.

Let them know that you care about them and that you want to help them find healthier ways to cope with difficult or upsetting feelings they're having. But that's it's okay for them to be honest with you about what they're going through.

Focus on what's causing the self-harm

Remember self-harm is often caused by an underlying problem, like depression or anxiety, or being bullied. It can be more helpful to focus on helping them with what's causing their feelings rather than on the self-harm itself.

You can help them to get support for a mental health problem, such as by talking to their GP, someone at their school or to Childline. It can also help to ask their GP about a referral to Child and adolescent mental health services (CAMHS).

Sometimes hiding or taking away something a child is using to self-harm can lead to them finding other ways to hurt themselves. You could try asking your child what would be most helpful for them and ask them to tell you when they feel they want to hurt themselves.

Sometimes, it might be possible to come to an agreement where your child tells you when they've hurt themselves. It's important to make sure any injuries or cuts are cleaned and properly taken care of. Any serious injuries should be treated right away in a hospital.

Encourage them to find healthy ways to cope

Instead of simply asking a child to stop self-harming, it can be helpful to suggest something they could do instead to cope with difficult feelings.

Some things young people who've spoken to us have found helpful are:

paint, draw or scribble in red ink

hold an ice cube in your hand until it melts

write down your negative feelings then rip the paper up

wear an elastic band on your wrist and snap it every time you feel the urge to self-harm

listen to music

punching or screaming into a pillow

talk to friends or family

take a bath or shower

exercise

watch your favourite funny film.

Childline also has many more self-harm coping techniques for children and young people. The wall of expression game can also be a helpful way for young people to deal with difficult feelings.

Help them to build their confidence

Many children who self-harm suffer from low self-esteem or confidence. You can help by reminding them about the things they do well or help them to learn something new together, like playing guitar or making crafts.

You could write a list of all the things that make you proud of your child and that make them special, and giving it to them. Try to focus on things about their personality rather than things like their academic achievements.

Childline also has advice for children and young people on building their confidence and self-esteem.

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Being worried about a child who's self-harming can be really difficult. We've got advice to help you understand why children and teenagers self-harm, how to recognise the signs, and what you can do to support a young person who's struggling.

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Self help guide for Stress, using effective CBT strategies. Make sense of your stress, then learn how to make positive changes
Learn effective skills online - The Decider Skills for Self Help online course.

Stress is our psychological, emotional and physical response to pressure. We feel there are too many demands, and too few resources to cope.

That pressure can arise from external factors including life events, illness (ourselves or someone close to us), living conditions, work, home and family, study, lack of some necessity, or the demands we place on ourselves.

Even those events which we see as enjoyable can be stressful, such as holidays, moving home, starting a better job, pregnancy, parenthood, Christmas etc.

This is too much - I can't cope!

It's not fair. Someone should be helping me.

There is too much to do, and too little time

I'll never finish

The physical response to stress is caused by the body's adrenaline response - the body's alarm signal and survival mechanism when faced with a threat.

Heart racing, pounding

Breathing faster

Tense muscles - e.g. neck, shoulders, abdomen

Hot, sweaty

Headache

Difficulty concentrating

Forgetful

Agitated, restless

Bladder or bowel problems

Vicious Cycle Of Stress

Making Positive Changes
Identify your stressors

Thinking Differently

What's making you stressed?

Where am I when I'm feeling stressed? What am I doing? Who am I with?

What helpful changes could I make?

What is within my control?

Even if there is little you can do about some situations, maybe making some small changes - in routine, in the way you handle things, doing things differently, taking time out, thinking about it in a different way, in getting help, seeking advice - could make all the difference

Identify the factors that help keep the problem going
Use thecogs diagram (PDF) to help you identify what contributes to your stress. Look at each factor and try to make changes in each.

Example vicious cogs of stress:

Relaxing MP3s for download
Do something different (to what you normally do).Consider what demands you can reduce, or ask others to help with.

relaxation, fun, enjoyment. Create a healthy balance - allow time for activities which give you a sense of achievement, those that help us connect and give a sense of closeness to others, and of a sense of enjoyment.

When stressed, we often spend more time doing things that help us achieve, but less of enjoyment and closeness to others. Aim for a healthy balance as shown in the pie chart, between
Make time for yourself each day -
BACES: Steps to positive mental health

BACES: Steps to positive mental health

Help others

Be with others - contact a friend, visit family

Talk to someone

Physical exercise - walk, swim, go to the gym, cycle (take the stairs instead of the lift, get off the bus a stop early)

Engage in a hobby or other interest - if you don't have one, find one! What have you enjoyed in the past? What have you sometimes thought about doing but not got around to?

Limit your responsibilities - it's okay to say no

Write down your thoughts and feelings - get them out of your head

Just take one step at a time - don't plan too far ahead

Do something creative - make a box of items that remind you to use the techniques that help, or put photos on paper, or write and decorate a list

Tell yourself: "This will pass, it's only temporary". "I've got through this before, I can do it now". When we're going through a tunnel and become fearful of being trapped, there's no point in stopping - we just have to carry on in order to reach the end of the tunnel.

Eat a healthy balanced diet, with plenty of fruit and vegetables

Drink less caffeine and more water

Pamper yourself - do something you really enjoy, or do something relaxing

Download and listen to relaxing mp3s

STOPP! Pause, take a breath, don't react automatically

Ask yourself:

What am I reacting to?

What is it that I think is going to happen here?

What's the worst (and best) that could happen? What's most likely to happen?

How helpful is it for me to think this way?

Am I getting things out of proportion?

Is it worth it?

How important is this really? How important will it be in 6 months time?

What meaning am I giving this situation?

Am I overestimating the threat?

Am I underestimating my ability to cope?

What's the bigger picture? The helicopter view?

Have I got my stress-head on?

What do I look like to other people? How am I affecting them?

Am I mind-reading what others might be thinking?

Am I believing I can predict the future?

Is there another way of looking at this?

What advice would I give someone else in this situation?

Am I putting more pressure on myself?

Just because I feel bad, doesn't mean things really are bad.

Can I do things any differently here?

How much can I control in this situation? What is outside of my control?

What changes (however small) can I make to those things that I am able to control?

What do I want or need from this person or situation? What do they want or need from me? Is there a compromise?

What would be the consequences of responding the way I usually do?

Is there another way of dealing with this?

What would be the most helpful and effective action to take? (for me, for the situation, for the other person)

Stress Self Help: download or print this page (PDF)

Self Help for Stress - video

Overcoming Stress

An Introduction to Coping with Stress

Mindfulness for Health: A practical guide to relieving pain, reducing stress and restoring wellbeing

Full Catastrophe Living, Revised Edition: How to cope with stress, pain and illness using mindfulness meditation

Mindfulness: A practical guide to finding peace in a frantic world

Learn effective skills online - The Decider Skills for Self Help online course.

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Stress Self Help | Get.gg - Getselfhelp.co.uk

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Self help guide for Stress, using effective CBT strategies. Make sense of your stress, then learn how to make positive changes Learn effective skills online - The Decider Skills for Self Help online course. Stress is our psychological, emotional and physical response to pressure.

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Exam Stress | How To Deal with Exam Stress

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It's normal to feel a bit worried about exams, but sometimes they can make you feel anxious or depressed. Find out how you can deal with exam stress.

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What is body image?

Body image is how we think and feel about ourselves physically, and how we believe others see us.

When we talk about body image, there are lots of ways we can think about our body and the way we look. You might find that there are times when you like your body, or parts of your body, and times when you struggle with how you look.

Instagram artwork by @allbodiesart. On top of a light green square it reads in capitals: 'My body is good', with a list in lower case describing how your body is good regardless of your doubts.

Body image is not just about our weight, it can also be things like:

comparing how you look with friends or people you follow on social media

struggling to love and accept your body

feeling as though your body shape is not represented in the media

hiding your body because you feel ashamed by it

struggling to find clothes for your body, particularly if you have a physical disability

feeling misunderstood about your body when people make assumptions about things like why you might need a wheelchair

feeling like you are not attractive enough

birthmarks, surgery scars or acne affecting how you feel about how you look

feeling as though your body does not match your gender. For information on this, have a look at our page on gender and mental health

Artwork credit: @jen.s. The artwork depicts text in red, yellow, green and blue which reads: 'we are all born beautiful'. The word 'beautiful' has lines around it to emphasise the word.

These thoughts about how we look are often influenced by things going on around us. It can be what we see every day on social media, what the characters we see on TV look like, or seeing adverts about 'improving how you look'. All of this can contribute to how we feel about our body.

Other influences might be:

the media promoting one type of body as 'fit and healthy' with little to no representation of different bodies

comments from friends or family about your body

social media promoting what should be the 'perfect body' image

clothes limited to fit certain body types

adverts, health campaigns or lessons at school on what is a ' healthy body'

If you feel that you are comparing your body with things you see every day, you are not alone. Lots of us are influenced by the things around us, which can impact our mental health.

The world is full of a spectrum of shapes and sizes. And we should all be represented in the media because unless we see this, it's almost like it doesn't exist.

Jada Sezer, YoungMinds ambassador

How can body image affect my mental health?

Text on a yellow background with the words 'struggle' and 'body image' highlighted in blue, the whole text reads: 'Men struggle with body image too'.

If you are having these thoughts and feelings about how you look, you might be struggling with your body image. You may find everyday tasks like eating, getting dressed or going out with friends becoming more difficult.

This can be at any point in your life or continuously throughout your life, but it is common to have these thoughts when you are going through puberty. During puberty, your body releases hormones which makes you more aware of how you look, and more aware of other people's bodies. These changes happen to everyone, and can sometimes make you feel out of control or anxious.

It can lead to feelings of:

Body dysmorphic disorder is when you constantly worry about flaws in your appearance, focus on specific areas of your body and compare yourself a lot to others.

Sometimes when you're struggling with your body image, you might change your eating habits as this can make you feel like you are in more control of how you look. This can be things like changing what you eat, how much and how often you are eating. If you are finding that your eating habits or relationship with food is taking over your life, you might be struggling with an eating problem.

We all worry about how we look at times during our lives and that's completely normal. If you are experiencing any of the above, know that there are people who can help you get through this. Things can get better.

Show/hide caption

Instagram artwork by @teabag.cartoon. There are cartoon people of all different shapes, sizes and colours holding hands and standing next to each other. Text above them reads, 'we need to learn to respect every body.'

It is completely normal to feel insecure about your body, and the majority of us will experience this at some point in our lives.

What to do if you're worried about how you look

It's important to remember that there isn't a single type of beauty - everyone sees it differently. And there simply isn't a right or a wrong way to look. But if you're struggling, here are some things you can do:

Our Activists share their experiences

If you feel unable to cope, or particularly worried about one part of your body, talk to your GP about how you're feeling. They can listen, tell you about local services and support groups, or they may suggest specific treatment for the way you're feeling.

Growing up, I was bullied a lot. I always stood out from the crowd and I hated that element about myself because I thought that if no one could accept and love me for who I am, then I couldn't either.

I hated the way I looked. I hated everything about myself, and because of this, I know exactly what it's like to hate the body you were born in. And this was the darkest time of my life.

Body positivity

Body positivity is a movement to accept all bodies no matter what type, shape or size. It promotes seeing different bodies on things like social media to encourage us to accept our body and the way we look. If you are struggling with your body image, body positivity can help you feel better about yourself. By thinking positively about how you look, you can feel more comfortable and confident.

Changing the way we think about our body and how we look can take time. It can feel difficult on some days more than others. That's okay. Accepting your body is a process. Our Activists share how a positive body image can help you feel better about yourself:

How you can support a friend struggling with body image

A hand-drawn person in a blue top and blue trousers stands in front of a mirror smiling. To the right of the person there are four speech bubbles. They read: 'thank you eyes for helping me see, thank you lips for helping me talk, thank you hips for helping me move, thank you legs for helping me walk.'

If you have a friend or family member who is struggling with their body image, here are some ways that your support can help.

Talk to them and encourage them to focus on what they like about themselves and what they can do - not just how they look. Help them to see all their good points and the things you like about them - these can be simple things, like being a good sport, a caring friend or making people laugh.

If you're finding it difficult to know what to say, writing their good points as a list together can be another way to help them. They can keep the list for the days they are struggling as a reminder of all the good things they like about themselves.

Sit with your friend in front of a mirror. Together, thank your body for all the positive things it does. You and your friend might find this strange at first, but by doing this together, you can encourage your friend and show them how to see positives in their body. It can help them to learn to love themselves.

Support your friend to have a positive online space. If you know that your friend is struggling, you could send them a message to let them know they matter and remind your friend how brilliant they are.

If you think they're feeling overwhelmed, encourage them to see their GP for professional help.

Your body is enough, and you are enough, always.

Get help now

If you're struggling with how you feel about the way you look, you're not alone. Here are some services that can really help.

You might also find this helpful

More tips, advice and real stories on what to do if you're struggling with your body image.

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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Sometimes, we worry about how we look or what our friends think about our body. If you're struggling with body image, here's some advice that can help you.

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Stop.Breathe.Think is a game changing mental health service based in the UK. We give young people access to free counselling and support.

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Kooth is your online mental wellbeing community. Access free, safe and anonymous

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Liverpool CAMHS Self-Harm Practice Guidance