North Yorkshire Self-Harm and Suicidal Ideation Pathway Overview

North Yorkshire Pathway of support for children and young people with self harming behaviour and/or suicidal ideation

Who is the document for?

This document and pathway is split into multiple sections, each aimed at specific groups:

• Part One – Self Harm and Suicidal Ideation Pathway Overview is a universal document for everyone
• Part Two – Guidance for schools
• Part Three – Guidance for those working with children and young people
• Part Four – Information children and young people
• Part Five – Information for parents and carers

This information has been produced by North Yorkshire Safeguarding Children Partnership (NYSCP) – North Yorkshire Social Emotional Mental Health (NY SEMH) steering group, Suicide Prevention Subgroup (SPSG)

What does self-harm mean?

This pathway will use the definition as defined by the National Institute of Clinical Excellence
(NICE) as self-harm being:

“…self-poisoning or self-injury, irrespective of the apparent purpose of the act”

https://www.nice.org.uk/guidance/qs34/chapter/Introduction-and-overview

What does suicidal ideation mean?

Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting thoughts, to extensive thoughts, to detailed planning, role playing, and incomplete attempts, which may be deliberately constructed to not complete or to be discovered, or may be fully intended to result in death, but the individual survives.

What does crisis mean?

A crisis is:

“…a perception or experience of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms.”

(James and Gilliland, 2001)

When in crisis a person may need urgent help and support from others restore their own coping problems solving abilities or skills.

How to assist children in crisis

• Be a good listener
• Assist with practical needs such safety, care
• Encourage child and family to seek professional help.

Why have a pathway?

The purpose of the pathway is to improve the referral processes, and the co-ordination of information, advice, support and treatment that is provided to children and young people who self-harm and/or experience suicidal ideation.

If this is achieved the benefits experienced by children, young people and their families will be evidenced by them reporting a high level of satisfaction with:

• The speed in obtaining a response to their concerns
• The appropriateness of the information, advice, support or treatment that is provided
• The positive changes to the child/ young person’s self-harming behaviour and emotional wellbeing

Improvements will be evidenced by:

• A decrease in the number of reported incidents of self-harm
• A decrease in the seriousness of the self-harm that is reported
• A decrease in the numbers of presentations as a result of self-harm at Accident and Emergency departments
• A decrease in the number of repeat referrals
• A reduction in the numbers of requests for home tuition or alternative educational provision as a result of mental health problems
• A decrease in the number of deaths as a result of self-inflicted injuries

Severity and the risk and/or impact of self-harming

The severity and impact of the self- harming behaviour on the safety and emotional wellbeing of the child/young person should inform decisions about the support or treatment that is provided.

This document should form a guide for practitioners but should always be used alongside any previous knowledge and information available to inform the decision process.

The pathway makes clear where children and young people and/or families and practitioners can access advice and support as concerns about the severity and/or impact associated with self-harming increases.