Document ID self-harm	Title Protocol for When Student Talks of Self-Harm and/or Suicide	Print Date 09/08/22
Revision 1.0	Prepared By Rick Hammes – Health, Wellness, and Safety Coordinator	Date Prepared 10/21/2021
Effective Date 11/12/2021	Reviewed By  EC	Date Reviewed 11/12/2021

A Protocol for EC to Use When Students Talk of Self-Harm and/or Suicide

If you become aware of a student who is at risk of self harm or has verbalized past, present or future self harm, it is important that some type of intervention/action take place.  Any such talk or behavior on the part of students must be taken seriously.  As school staff, we do not have the luxury of knowing if the student’s claim of self harm is real or not or how severe the threat is.  Even if you believe the student is attention seeking, we still must take threats and talk of self harm seriously. It is important for students to know that we take all such threats seriously.  

Below is the process of what actions should be taken.  

• Take the threat seriously, do not disregard or ignore what the student says or what someone may tell you about the student.
• If you hear of a student’s self harm intention either directly or indirectly, talk with the student if you are comfortable with that.  If you are not comfortable having that discussion and/or you know of a staff person with whom the student feels comfortable, inform that person.  If  you are not sure who the student is comfortable with, inform the Health, Wellness and Safety Coordinator and (s)he will talk with the student.  
• The student must be talked with that same day if at all possible.
• If it is not possible to talk with the student that day, contact the parents/guardians and inform them of the situation.
• Assess the level of risk by asking questions (see the action plan guideline)
• If you believe the student is in immediate danger of self harm, contact Dane County Human Services or the Madison Police.  Offer to make the call with the student present.
• If such a call is necessary, inform the student of your intentions and that their safety is paramount.  You are willing to risk the student being upset in order to ensure their safety.
• Contact parents and inform them of what is occurring including what steps you have taken.  Offer to make the call with the student present.  
• Stay with the student, Do NOT leave the student alone.  If they need to use the restroom, someone must accompany them.  
• Be honest with the student and do not be judgemental
• Do not make promises you cannot keep
• After the situation, write up what took place and give a copy to the Health, Wellness and Safety Coordinator.  Discuss what took place in order to debrief from the situation.  

Action Plan Guideline

• Talk with the student about what you have heard, seen
• Ask the student if (s)he is suicidal.  It is good to talk in plain and honest terms
• Ask the student if they have a plan or what type of self harm they have done in the past
• Ask the student if they are currently seeing a mental health therapist.  
• Allow  the student to talk
• If the student is willing, use the suicide screening tool (https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/SAK%20screener%20computerised%20updated.pdf)
• Inform the student that you need to make a call.  The priority is to ensure the safety of the student
• If you believe the student is serious and there is a level of threat, call Dane County Human Services or the Madison Police.  (Dane County Human Services – 608-261-5437; Madison Police Mental Health Unit – 608-261-5579)
• Once human services or the police make a determination as to severity and plan of action, ask who will be contacting parents and when.  Depending on the circumstances, it is important that the parents/guardians hear from the school at some point
• If the threat is not imminent, call and inform parents/guardians of the situation.  Encourage them to seek help for their child.
• Write up the incident and give it to the Health, Wellness, and Safety Coordinator.  Discuss the situation with him/her/them for debriefing
• Follow up with the student the following day.  It may be necessary to write up a safety plan for the student.  The student should be encouraged to be a part of this plan.  If the parents/guardians are not involved with the development of the safety plan, call and share the plan with them.
• If the student is working with a mental health therapist, the Health, Wellness and Safety Coordinator should make contact with the therapist and involve this person in the development of a safety plan.  It may be necessary to have the parents/guardians sign a release of information form which would allow for communication between the school and the therapist.  

Additional information

The following is mostly taken from and is based on the booklet Young People Who Self-Harm: A Guide for School Staff, which was developed by researchers at the University of Oxford.  Portions have been added by Rick Hammes, Health, Wellness and Safety Coordinator

Levels of Concern

While all self-harm is of concern, it is important to establish what level of concern there should be about the student’s self-harming in order to decide appropriate action, such as contacting mental health professionals. There may be a higher risk of self-harm or on-going mental health problems if the student has self-harmed and any of the following are present:

• Low mood – particularly a recent change in mood.
• Behaviour change – some students may become withdrawn and isolated, others may become disruptive.
• Expressing hopelessness, for example saying that they cannot see a future.
• Low self-worth or self-hatred.
• Lack of family support or distant family relationships.
• Expressing suicidal feelings, explicitly – “I want to kill myself” – or more subtly – “I don’t want to be here anymore”. It is important to note that it is okay to ask students about suicidal thoughts and that doing so will not “put the idea into a young person’s head”.
• Previous self-harm.
• Bullying, including cyber-bullying.
• Serious difficulties around gender or sexual identity.
• Excessive use of drugs or alcohol.
• Recent history of self-harm or suicide in a friend or family member.
• Bereavement, especially recent loss.

Listen to your intuition. If you believe that a student may be at risk, you may well be right. If you are concerned about a high risk, or are not sure about the level of concern, it may be helpful to talk with  the school’s counselor to gain another opinion of the level of risk and/or steps that need to be taken.

If you are worried that self-harm or other behaviours may be due to abuse or exploitation, this will need to be reported to Dane County Human Services or the Madison Police.  If you suspect any type of abuse, contact human services or police and not the parents as they could be a part of any abuse and an investigation will need to be conducted by the proper authorities.  The authorities will assume responsibility for contacting the parents.

Supporting other Students

In schools, one student’s self-harming behaviour can sometimes affect other students. This can occur particularly with self-cutting and is more common among girls. If a student comes to you with concerns about a friend’s self-harm, reassure them that telling you is the right thing to have done and that they have been a good friend. Offer them the opportunity to speak to a trusted staff person and/or the school counselor (Rick at MDS)

If more than one student has self-harmed, it is important not to panic (self-harm can be “contagious” in social groups). Be observant and raise awareness of how students can get help when they are struggling with difficult emotions. Continue to provide support, separately, for young people who are self-harming – this is preferable to raising the issue in large school groups such as school assembly.

Taking Care of Yourself

It is important to recognise that self-harm can be distressing for school staff. Be honest with yourself about your emotions – it is common to experience sadness, shock, anger, fear, disgust, frustration and helplessness. And because self-harm is self-inflicted, it can be more difficult to empathise with the person. Discuss your feelings with colleagues or managers, seek support and make sure that you prioritise your own health and wellbeing.

Confidentiality

Confidentiality is very important and, while you should respect the wishes of the student around confidentiality where possible, their health, safety and welfare are paramount. If you become aware that a student is self-harming, you are obliged to share this with your school’s counselor, health, wellness and safety coordinator. This information would usually be shared with the parents/guardians too, but you should discuss the need to do this with the student and listen carefully to any fears they may have.

Students should be informed when the school contacts their parents/guardians, in particular because self-harm can be a way of feeling in control – by not involving the student, the school may exacerbate their level of distress. It may be helpful to invite the parents or carers into school to talk with staff and the student together, to try and make sense of the self-harming behaviour and think about ways of supporting the student.