Managing Self-Harm in North Tyneside Schools
Northumbria Healthcare NHS Foundation Trust
Northumbria delivers integrated acute and community health and social care to the residents of Northumberland and North Tyneside. It is the largest geographical Trust in the UK covering 2000+ square miles.
Employing over 9000 staff – together each year we:
– Care for over 73,000 patients and families on our wards.
– Provide treatment to around 167,000 patients in our A&E departments and minor injuries units.
– Perform almost 27,000 operations.
– See more than 45,000 people for day-case procedures.
– Carry out around 1.3 million appointments with patients outside of hospital.
– Provide adult social care support during 70,000 home visits.
The project was developed from a locally identified need. The aim was to look at how self-harm could be managed in schools for all children and young people equally. Therefore, it included our children and young people with learning disabilities in our special school systems. All resources and materials developed were adapted by members of the project group including CAMHS nurses, Community Learning Disability Nurses, Educational Psychology, Education Staff, Young Minds Charity and special school nurses. This ensured that these resources would be useful to Children and Young People with Learning disabilities.
This innovative project was developed by a multi-agency group of staff across North Tyneside with the aim being to implement a whole school approach to managing self-harm in children and young people in schools across the borough. The need for the project was based on national research showing that suicide attempts in adolescents have risen threefold in the last twenty years and that admissions to hospital through self-injury continue to increase year on year, as well as a locally identified need.
The professionals involved in the project worked together to develop training, resources and guides for the management of self-harm across all school systems in North Tyneside, with findings including increased awareness of self-harm, clear processes for the management of self-harm and building resilience amongst children and young people.
The collaborative approach across agencies in North Tyneside also contributed to the success and sustainability of this project. It brought together professionals who were all struggling to manage a significant issue and enabled them to pool resources, skills and knowledge to develop the training and resources for use in practice.
Research shows that in the United Kingdom, suicide attempts in adolescents have risen threefold in the last twenty years, and that admissions to hospital through self-injury continue to increase year on year. One in twelve children and young people are said to self-harm (*1). Patient safety is at the core of all nursing care. CAMHS nursing was able to lead on a project alongside a multi-agency group of professionals to look at reducing harm for these children and young people.
During 2013, this multi-agency group of staff in North Tyneside gained funding to deliver an early intervention project. The project aim was to implement a whole school approach to managing self-harm in children and young people in schools across the borough of North Tyneside. The project was fully inclusive to all children and young people and included our special schools for children and young people with learning disabilities.
Early detection of the problem and provision of resources and training to manage risk and ongoing care needs was the key focus. The project was based on the NICE Guidance CG16, ‘The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care’.
*1 Mental Health Foundation (2006) Truth Hurts report of the National inquiry into self-harm among young people. London. Mental Health Foundation.
The initiative involved a collaborative approach bringing together Health, Education and Young Minds Charitable Services. Young People from a local school were also fully involved in the project.
The project included:
Raising awareness of self-harm management within schools and amongst children and young people achieved through:
– Development and delivery of a training package (multi-agency developed and delivered including staff from Young Minds Charity and several teams across NHCFT) for the early identification of self-harm and the management of self-harm.
– Development and implementation of resources for use by education and health staff with children and young people where self-harming behaviours are identified.
– Resources for use by children and young people themselves.
– The development of a standardised process/guide for the management of self-harm across all school systems in North Tyneside.
All schools in North Tyneside (Middle and High school YR7 and above) – including the special schools – took part in the training, with a variety of staff attending including Teachers, Learning Mentors, Teaching Assistants, SENCO’s, Educational Psychologists, Public Health, School Nurses
A base line survey was undertaken at the initiation stage of the project to gain an understanding of school staff’s current awareness and management of self-harm in schools. This was followed by a post-training evaluation undertaken to identify if school staff felt their:
– Understanding of self-harm had increased
– Their confidence in managing self-harm had increased
– Their understanding of when and how to seek specialist support had increased.
The findings indicated that the school staff felt that we had been successful in achieving the above aims. Overall the project approach:
– Increased awareness of self-harm within North Tyneside for professionals, voluntary agencies, parents, carers, children and young people.
– Increased awareness within the Learning Disability Field to ensure self-harm is addressed in the same way as with everyone else.
– Provided a clear process for the management of self-harm through the guide developed.
– Increased knowledge and understanding of the services and agencies available to support the management of self-harm.
– Provided resources to support professionals to open up discussions with children and young people who are self-harming.
– Provided information on wider resources available for support.
– Built resilience amongst children and young people through awareness raising sessions.
Key Learning Points
Multi-agency working was key to the success of this project. Agencies need to understand their role in addressing the issue. Taking a multi-agency approach requires perseverance. It can take some time for all agencies to see the need for their input and initial attendance at meetings can be low. Looking at key people to link with and continuing to push forward with the project was eventually successful. The project needs a lead driving it and at least two or three other interested, motivated key people to enable it to progress. Admin support is also vital.