A School’s role in supporting children who...
Transcript of A School’s role in supporting children who...
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A School’s role in supporting children who Self-Harm
NESSie
Northherts Emotionalhealth in Schools ServIcE Supporting, Training, Co-ordinating and Quality Assuring access to Mental Health Services for Schools
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What is your current role in school?
What are you hoping to get from today?
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Today we would like to:
· Develop an insight relating to triggers, thought & emotions
· Become aware of the journey towards SH
· Support your understanding of your school’s collaborative approach to keeping
students safe and on the path to recovery
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Self harm facts Selfharm.uk
It’s almost impossible to say how many young people are
self-harming. This is because very few teenagers tell anyone
what's going on, so it's incredibly difficult to keep records or
have an accurate idea of scale. It is thought that around 13%
of young people may try to hurt themselves on purpose at
some point between the ages of 11 and 16, but the actual
figure could be much higher.
In 2014, figures were published suggesting a 70% increase
in 10-14 year olds attending A&E for self-harm related
reasons over the preceding 2 years.
Girls are thought to be more likely to self-harm than boys,
but this could be because boys are more likely to engage in
behaviours such as punching a wall, which isn't always
recognised as self-harm or doesn’t come to the attention of
hospitals. In reality self-harm doesn't happen to one type of
person, it can't be predicted and scarily, we don't really know
how many people are going through it.
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Some truths and misconceptions about Self-harm
Is attention seeking
Is a sign of a mental health issue
Private
Something that affects a
person for life
Is a failed suicide
attempt
Is unhealthy
Is Manipulative
Is contagious
Only something that teenage
girls do
Common in affluent societies
Is healthy
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What is Self-Harm?
Scratching or cutting with a blade/pin/knife (usually on
the arms or legs)
Self harm is a deliberate act to a specific need. It can involve:
Punching/bruising body
Head banging
Restricting or overeating (binge eating)
Pulling out hair or eyebrows
Burning with cigarettes or matches
Overdose with tablets or medicine
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● Friendship issues
● Poor self esteem
● Difficult family relationships
● Unsettled home life
● Bereavement
● Exam pressure
● Bullying
● Online pressure/ Social media
Self harm is likely to be a response to:
● Risk taking
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What causes a child to self harm?
Self-Harm can have a number of functions:
● Release of tension
● Outlet for anger & upset
● Alternative pain release – physical v emotional
● Feeling of control
● Distraction from feelings
● Self punishment - self dislike
● Experimentation
● Emotional moderation
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the Cycle of self harm
Emotional upset:
sadness anger, despair
Inability to cope with
distress
Act of Self Harm
Positive response: sense of
relief, release of
tension
Negative effect-
feeling of shame and
guilt over SH act
At what point do you
feel that you have
something in your
school to interrupt this
cycle?
Developing emotional
literacy - encouraging
pupils to notice and
understand feelings
Someone in school
to talk to:
Mentor, Counsellor
Promoting a ‘it’s ok to not
feel ok’ ethos
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http://www.youngminds.org.uk/noharmdone
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‘The Gatekeeper Model’ - Three simple steps
1. Thank them for coming to you
2. Choose an appropriate Time & place to talk. Make sure you take responsibility
for the organising ie ‘I will see you at Lunch today’ - ‘where will you be?’
3. Is there anything I can do for you right now? Fix one small practical thing
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Simple Do’s
● Maintain rapport and a calm ‘non-judgemental’ response
● Check that they do not require medical help
● Let the young person know that you will need to tell your DSP
● Safeguarding policies (ROC)
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……. And Dont’s
● Brush them off and suggest that they talk to someone else
● Tell them that they shouldn’t be doing it
● Tell them that they have no reason to Self-Harm
● Assume that they are attention seeking
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Areas to consider before first follow up meeting
● Is there a developed role in school to support you - someone that you can
talk to and seek advice?
● What is your school’s safeguarding policy? Who
are you DSP’s?
● Do you have the capacity should this child
continue to want to talk to you?
● Do you feel that this is within your remit?
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Safety plans Discuss and develop a ‘keeping safe’
plan together so that both the student
and yourself feel secure about their
actions & behaviour in between
meetings.
Agree on who else could be informed;
DSP, parents , school counsellor,
other staff? Discuss together how this
will be done. Needs to be collaborative
Formalise your plan so that you both
know the next steps and have a clear
view forward. This would include a
commitment from the student to work
towards feeling better.
Safety Plan
● With whom?
(you, school mentor, school counsellor)
● Who will be informed & how
(DSP, Parents, other staff)
● Time & place of next meeting
● Keeping safe strategy to support before a
next meeting (staff / pupil actions)
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Safety Plan
Time and place of next meeting
With whom
Who will be informed and how?
Keeping safe strategies to support before next meeting
NESSie Northherts Emotionalhealth in Schools ServIcE
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Anna freud common room 2016
History - what have you been doing
and for how long?
Home - Are parents/carers supportive
at home?
Hopelessness - How do you see
things turning out in the future?
How much do you think this will
change?
● Suicidal Intent - Did you want to die?
● Suicidal ideas - What did you hope
would happen? Did you think it might kill
you?
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Disclosure of Self Harm & Anxiety
First response: calm, reassuring, provide a good listening space
Assess risk: Do they need medical help - bleeding or infected? Have they SH more than once and do they think they will they be doing it again?
No immediate safety concerns - discus plan together: when to meet next,
who will be informed (parents, other adults) and how this will be done.
Inform DSP and follow advice.
You observe and have concerns of heightened risk and sense of
ongoing anxiety
Approach and reassure with calm and attentive response. Provide private
listening space and opportunity to open up
Assess risk: Use of H's: History (how often)
Home (supportive or not) Hopelessness
(highest level of concern & risk)
Consideration of safety plan - including who and when to meet next. ROC to be
completed and school DSP alerted
Immediate concerns regarding safety
Continue to reassure and put at ease. Response to recent act and/or
assessment of current safety
Immediate referral to next level of support in school (DSP) and follow
advice
Access to professional links: School counsellor, GP. Possible Referral to
CAMHS./ Family support/etc?
No
Yes
Disclosure response & Risk assessment
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Me
Mum
Best friend
Aunt
Sister
School Counsellor
Teacher
Sports coach
Cousin
Site manager
MY SUPPORT NETWORK
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What Helps What make it worse!
Listening
to music
Walking
my dog
Dancing Drawing
Singing
being
creative
Not having
anyone to
talk to
Arguing
with
parents
Being on
social
media
Having
someone
to talk to
Feeling
isolated
Being with
my friends
Pressure of
exams
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You are not condoning, you are giving them an opportunity to
engage …...hence the Gatekeeper response
The worst thing you can do is nothing!