Self harm

This pathway relates to all children under 18 years who present with self-harm behaviour as follows:

Self-harm describes a wide range of things that people do 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. Self-harm can involve:

  • Attempted hanging;
  • Overdosing of tablets or medicines;
  • Cutting, often to the arms using razor blades, broken glass or knives;
  • Burning using cigarettes or caustic agents;
  • Punching and Bruising;
  • Inserting or swallowing objects;
  • Head banging;
  • Pulling out hair or eyelashes.

Self harm can sometimes be a coping mechanism with the aim of relieving emotional distress.  It must be recognised that the emotional distress that leads to self harm can also lead to suicidal thoughts and actions.

If a child is self harming, professionals should make a brief assessment and follow the pathway.

The following factors should be used when considering whether a child is in need of urgent medical treatment / psychological support and should be taken to a Hospital Emergency Department:

  • Has declared or is suspected to have overdosed on illegal or prescription drugs
  • Has consumed large volumes of alcohol
  • Has injuries i.e. cuts, broken bones that require medical attention
  • Has declared or is suspected of attempted asphyxiation / hanging
  • Is actively suicidal, i.e. continues to state that they will commit suicide and needs to be prevented from doing so.

Consider also completing a Safeguarding referral alongside calling other agencies, if:

  • Noteworthy safeguarding concerns exist
  • There are less specific, but active concerns about safeguarding, in particular relating to Child Sexual, or Criminal Exploitation

Pathway for management of child who is self harming

Local contacts details