Introduction

Deliberate self-harm and suicide are defined, by the Mental Health Foundation (2003), as:

• deliberate self-harm is self-harm without suicidal intent, resulting in non-fatal injury
• attempted suicide is self-harm with intent to take life, resulting in non-fatal injury
• suicide is self-harm, resulting in death.

The difference between suicide and deliberate self-harm is not always so clear. For example, deliberate self-harm is a common precursor to suicide. Also children and young people who deliberately self-harm may kill themselves by accident.

Suicidal behaviour ranges from experiencing suicidal thoughts, to developing a plan, to a suicide attempt, to taking your own life. Many people experience suicidal thoughts but never take their own lives.

What research tells us

Suicide is statistically an uncommon event however the impact of one death both in human and economic terms is massive.

Suicide is often the end point of a complex history of risk factors and distressing events.

The suicide rate among teenagers is below that in the general population. However, young people are vulnerable to suicidal feelings. The risk is greater when they have mental health problems or behavioural disorders, misuse substances, have experienced family breakdown, abuse, neglect or mental health problems or suicide in the family. The risk may also increase when young people identify with people who have taken their own life, such as a high-profile celebrity or another young person.

There is no one factor and what leads someone to take their own life; it is complex.

There are a number of high risk groups including young men, looked after children, care leavers and children and young people in the Youth Justice System.

Possible suicide warning signs

The following are signals that a young person may be thinking of suicide.

• direct and indirect statements about suicide
• suicide notes and plans
• prior suicidal behaviour
• making final arrangements (giving away possessions)
• preoccupation with death
• changes in appearance, thoughts and/or feelings
• anything that is out of character.

What to do

Young people who are suicidal are frequently unlikely to seek help directly. Parents, teachers and peers can recognise the warning signs and take immediate action to keep them safe. The following actions should be taken:

• ask openly and directly ‘Are you thinking about suicide?’
• actively listen, remain calm and non judgemental, be polite and respectful, acknowledge the feelings expressed, try not to give advice
• if they are thinking about suicide, continue listening and ask open questions about whether they have a current plan, whether they have attempted suicide before, and do they have the means to take their own life
• if a young person has overdosed, or has injuries which put their health at risk, it is important to seek immediate help by arranging for them to be taken safely to Accident and Emergency - call 999
• remove means if it is safe to do so
• ensure your own safety
• ensure the young person is not left alone
• seek immediate help – phone their GP and ask for an emergency home visit, or call 999, or take the young person to Accident and Emergency, or take them to their GP, or call NHS Direct, or call the Samaritans
• focus on concern for their wellbeing. If they are consuming alcohol or drugs encourage them to stop
• reassure them that help is available.

School-based suicide prevention strategy

An effective school-based suicide prevention strategy would include:

• a co-ordinated school response to people at risk and staff training;
• awareness among staff to help identify high risk signs or behaviours (depression, drugs, self-harm) and protocols on how to respond;
• signposting parents to sources of information on signs of emotional problems and risk;
• clear referral routes to specialist mental health services.

Further information

Local training

The ERSCP offers a selection of eLearning and face-to-face training, via their Learner Management System (LMS).

Youth Mental Health First Aid courses in the East Riding

Youth Mental Health First Aid (YMHFA) is a national two day course aimed at people working or living with young people (aged 11-18) who may be experiencing mental health problems. This also covers suicide prevention.

For more information or to register your interest in future courses:

Email Sue Youngson Sue.Youngson@eastriding.gov.uk