Self Harm and Suicidal Behaviour

Scope of this chapter

Note: This chapter should be read in conjunction with the East Riding Safeguarding Children Partnership - Suicide Prevention.

Regulations and Standards

The Positive Relationships Standard

The Protection of Children Standard

Related guidance

Amendment

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

May 28, 2026

1. Introduction

Many children and young people in residential care will have experienced significant trauma in their lives, and it is likely that these children will have multiple and complex needs and behavioural and emotional difficulties, which can lead to them acting in ways that place themselves in situations of high risk.

Definitions from the Mental Health Foundation (2003) are:

Deliberate self-harm is self-harm without suicidal intent, resulting in non-fatal injury;
Attempted suicide is self-harm with intent to take life, resulting in non-fatal injury;
Suicide is self-harm, resulting in death.

The term self-harm rather than deliberate self-harm is the preferred term as it a more neutral terminology recognising that whilst the act is intentional it is often not within the young person's ability to control it.

Self-harm is a common precursor to suicide, and children and young people who deliberately self-harm may kill themselves by accident.

Self-harm can be described as wide range of behaviours that someone does to themselves in a deliberate and usually hidden way. In the vast majority of cases self-harm remains a secretive behaviour that can go on for a long time without being discovered. Many children and young people may struggle to express their feelings in another way and will need a supportive response to assist them in exploring their feelings and behaviour and the possible outcomes for them.

2. Planning and Prevention

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

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

In situations where staff are involved with a child who is actively self-harming or feeling suicidal, they should, in consultation with other members of the team, ensure that all reasonable measures are taken to support the young person with aim of reducing or preventing the continuation of the behaviour. These measures may include providing additional supervision and support, referral to specialist agencies, confiscation of materials that may be used to self harm or, as a last resort, use of physical intervention or calling for assistance from the Emergency Services.

A plan should also be developed to manage any impact that an incident of self-harm or suicide may have on other children and young people in the home, as well as staff and family members.

Specialist advice or support (for example from CAMHS) should be sought.

3. Notifications, Recording and Review

3.1 Notifications of Self harm or Suicide Attempts

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

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

Consideration should be given as to whether the incident is a Notifiable Event, see Notification of Serious Events Procedure.

3.2 Recording and Review

All self harming must be recorded in the Home's Daily Log and relevant child's Daily Record.

An Incident Report must also be completed.

If First Aid is administered, details must be recorded.

A serious incident of self harm is likely to constitute a notifiable event (see Section 3.1, Notifications of Self harm or Suicide Attempts). However, it is important that staff in residential units consider the frequency of any self harm incidents and judge whether their cumulative effect makes notification appropriate even if in isolation each event would not warrant this. In particular staff should be alert to any patterns of behaviour or unusual behaviour which may indicate an increased risk to the child.

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