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Information on how education and care services manage and support children and young people that self-harm or attempt suicide; as well as information to support children and young people when someone in the education or care community suicides.
Self-harm is a deliberate act of self-inflicted injury intended to cause physical pain as a means of managing difficult emotions, or as a way of communicating distress to others. Self-harm is different from suicidal behaviour, but some people who self-harm are also suicidal or can become suicidal. Acts of self-harm should always be taken seriously as this can be physically dangerous and may also indicate an underlying mental health problem.
Suicidal ideation refers to thoughts that life isn’t worth living. It can range in intensity, from fleeting thoughts to concrete, well thought-out plans for killing oneself or a complete preoccupation with wanting to die. Suicidal ideation does not always lead to suicide or attempted suicide, but should always be taken seriously.
Attempted suicide refers to self-inflicted harm where death does not occur, but where the intent was to cause death. In some cases it can be difficult to determine if individual acts of self-injury were intended to result in death. The person themselves may be unsure exactly why they undertook the act.
According to the World Health Organisation, suicide is the act of deliberately killing oneself.
For a death to be considered a suicide, three criteria need to be met:
1. The death must be due to unnatural causes, such as injury, poisoning or suffocation rather than an illness;
2. The actions which result in death must be self-inflicted; and
3. The person who injures himself or herself must have had the intention to die.
An emotional wellbeing care plan HSP400 (DOC 111KB) can be developed by a treating health professional in consultation with parents to describe additional care or supports required for children and young people that are at risk of self-harm and suicidality in education and care services.
Education and care services can assist through proactive self-harm and suicide prevention responses including:
- social and emotional learning programs to teach communication skills, coping skills and problem-solving skills
- promoting positive relationships and effective responses to bullying
- promoting help-seeking by children and families when concerns arise.
As self-harm and suicidal ideation are often kept very secret by children and young people, education and care services may be the first to notice these behaviours through natural observations.
Signs that may be noticed include:
- being withdrawn or depressed
- not participating in activities that require short sleeves or bathers
- high emotional reactivity
- unexplained cuts, scratches and bruises
- wearing clothing or jewellery to hide injuries
Education and care staff have a duty of care for every child and young person under their supervision and must take reasonable steps to protect them from a foreseeable risk of injury. It is the responsibility of the education or care service to pass on any concerns to parents or legal guardians if they become aware of children and young people who are self-harming or expressing thoughts of suicide.
Refer to the Student Wellbeing Leaders intranet site (requires staff login) for further information.
Education and care service leaders must contact the Social Work Incident Support Service (SWISS) team and the education director as soon as they are aware of a suicide death. SWISS can also support education and care services in how to respond to and support children and young people who are self-harming, experiencing suicidal ideation or have attempted suicide.
The Department for Education intranet (requires staff log on) has information for education and care services on:
Children and young people who have low levels of interoception, which means they are unable to understand or connect with their bodies in ways that would enable them to self-regulate. It is important to integrate the teaching of interoception activities to develop interoceptive awareness. Refer to interoception 101 (PDF 3MB): interoception explanation, interoception tracking sheet and interoception activities for strategies to incorporate interoception into class activities.
Site Support and Safety Plan
A site support and safety plan (staff login required) should be completed where a child or young person has attempted suicide, discloses suicidal thoughts or self-harms. The plan is completed by education or care staff in consultation with the child or young person, their parent or legal guardian and any mental health professional involved in their care.
The plan outlines how the child or young person will be supported in the education or care service and what steps need to be taken in the event there are concerns about their safety and wellbeing. Education or care services can contact SWISS for support in developing this plan.
Wellness, stress and distress questionnaire (WSDQ)
The wellness, stress and distress questionnaire (WSDQ) HSP426 (XLSX 264KB) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people and their teachers.
The 25 items in the WSDQ comprise 5 scales of 5 items each. The scales include:
- emotional symptoms subscale
- conduct problems subscale
- hyperactivity/inattention subscale
- peer relationships problem subscale
- prosocial behaviour subscale.
The WSDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening.
An emotional wellbeing care plan HSP400 (DOC 111KB) may be completed by a health professional in consultation with parents or legal guardians for children and young people with requiring support in education and care services. A mental health care plan that a health professional has developed to support the child or young person to access community mental health services is not appropriate to be used in education and care services as this contains confidential, personal information that is not relevant for education and care staff.
Health support agreement
A health support agreement HSP120 (DOC 243KB) and safety and risk management plan HSP121 (DOC 147KB) may be completed where a parent indicates their child requires additional support and assistance. There does not need to be a care plan completed by a health professional in place. The support agreement is completed by the parent and education or care service to document specific risk minimisation strategies, individualised management and treatment for the child in the context of the education or care service.
The guide to planning health support – HSP125 can assist in the development of the health support agreement by prompting through a series of questions and considerations.
The health support agreement should clearly identify cultural, spiritual and language needs.
The following external services and resources are available to assist education and care staff to support children and young people that self-harm or attempt suicide include:
Conversations Matter resources for discussing suicide.
- Understanding suicide, suicide attempts and self-harm in primary school aged children
- Returning to school following self-harm or attempted suicide
- MythBuster: Sorting fact from fiction on self-harm
- Identifying risk factors and warning signs for suicide
Kids Helpline @ school. Free, early intervention and prevention sessions that allow primary schools in Australia to invite counsellors into their classroom
- Self-harm and primary school children
- KidsMatter Schools
- KidsMatter Primary
- KidsMatter Early Childhood
Mental Health First Aid Australia
Mental Health First Aid Australia guidelines about a range of developing mental disorders and mental health crisis situations.
- Responding to incidents of self-harm flowchart
- Suicide prevention
- The MindMatters mental health framework (online modules)
RUOK? in Education have resources for primary and secondary schools, aligned to the curriculum, that introduce and emphasise the value of close connections and strong relationships.
Children and young people that self-harm, have suicidal ideation or attempt suicide, and their families, must be encouraged to seek support.
An emotional wellbeing care plan HSP400 (DOC 11KB) can be developed by a treating health professional in consultation with parents to describe additional care or supports required for children and young people in education and care services.
Parents and legal guardians can access a Mental Health Care Plan from their treating health professional which is required to access community mental health support services. Private psychologists and Headspace require children and young people to have a mental health care plan. CAMHS do not require a mental health care plan to access their services. A Mental Health Care Plan is not appropriate to be used in education and care services as this contains confidential, personal information that is not relevant for education and care staff.
The following agencies and services can support children, young people and families with resources, online chat and helplines:
Child and Adolescent Mental Health Services (CAMHS)
- Website Child and Adolescent Mental Health Services
- CAMHS brochure for locations and contact details
- Phone 1800 551 800
- Email counsellor [at] kidshelpline.com.au
- Webchat https://kidshelpline.com.au/get-help/webchat-counselling
- I’m thinking about suicide – teens 13-17 years; young adults 18-25
- Self-harm – teens 13-17 years; young adults 18-25
- Supporting a child who is thinking of suicide – parents
- Self-harm explained - parents
- Phone 13 11 14
- Webchat https://www.lifeline.org.au/get-help/online-services/crisis-chat
- Preventing suicide
- Helping someone at risk of suicide toolkit
- Phone 1800 650 890
- Webchat https://headspace.org.au/eheadspace/
- Understanding self-harm – for young people
- What is self-harm in children – parents
- Phone 1300 224 636
- Webchat https://online.beyondblue.org.au/WebModules/Chat/InitialInformation.aspx
- Online forums
- Suicide prevention
- Self-harm and self-injury
Refer to suicide postvention (staff login required).
External services that provide information to support schools to respond to suicide in the school community:
- Support after suicide – guidelines for schools
Disability and complex needs team
Phone: 8226 3620
Email: education.health [at] sa.gov.au