Self Harm Prevention Policy

SELF HARM PREVENTION POLICY

School personnel should be prepared to identify self-harm in order to make a referral to the appropriate personnel member for a risk assessment. If it is reported that a student is engaging in self-harm, it is recommended that school personnel immediately refer the student to a school mental health professional (i.e., school psychologist, school counselor, social worker, or nurse) who is trained to assess the student for both self-harm and risk of suicide.

The components of a risk assessment shall include gaining information regarding:

• History: how long has the student been self-injuring.

• Frequency: how often the student is engaging in self-harming behavior(s).

• Method(s): what behavior the student is engaging in (i.e., cutting, scratching, etc.) and where,

on their bodies, they may injuring (i.e., arms, legs, abdomen, etc.).

• Triggers: identify patterns in what causes the student to self-harm.

• Psychological Purpose: determine the function of the self-harming behavior.

• Disclosure: identify whether the parents are aware. Remind the student of confidentiality and

the exception pertaining to their safety.

• Help Seeking & Support: discover whether the student has been treated for self-harming

behaviors in the past, or if they are currently in counseling. Inquire about the student’s perceived

support system.

• History and/or current presence of suicidal ideation: ask the student if they have experienced

thoughts of ending their life. If the student answers yes, or if, the assessor’s clinical judgment

indicates that the student has experienced suicidal ideation then a suicide risk assessment

should follow (page 3.1).

The American School Counselor Association requires confidentiality between students and counselors except in the event that the student is at risk for harm of self or others.

For the recommended assessment tool from The Cornell Research Program on Self-harm and

Recovery see Appendix K, Non-Suicidal and Self-harm Assessment Tool (NSSIAT).

The person conducting the self-harm assessment must notify the student’s parent(s)/guardians.

NOTIFICATION OF PARENTS/GUARDIANS

If a student has been identified as engaging in self-harm, parents/guardians must be notified. The American School Counselor Association requires confidentiality between students and counselors except for when a student is considered at risk for harm. Parent notification should occur even if the student is not deemed as being in imminent danger.

The person who contacts the family should be the personnel member who was responsible for

completing the risk assessment for self-harm with the student. For example, if a teacher refers a student to the school counselor and the school counselor meets with the student to determine their level of risk, the school counselor would then call the parent/guardian. It is recommend that personnel remain aware of and sensitive towards the family’s culture, including attitudes towards suicide, mental health, privacy, and help-seeking. The person contacting the family may notify parents via telephone or request for the parent/guardian to come to the school to meet in person. The following guidelines outline steps to take when contacting parents to inform of self-harm:

1. Notify the parents about how the student was referred to you (i.e., was it a peer referral, personnel referral, social media post).

2. Explain the importance of removing dangerous items from the home (i.e., tools with which the

student has demonstrated history of self-harm).

3. Share any plans to support student well-being and safety while at school.

4. Discuss available options for individual and/or family therapy. Provide the parents with the contact information of mental health service providers in the community. If possible, call and make an appointment while the parents are with you.

5. Ask the parents to sign the Parent Contact Acknowledgment Form confirming that they were

notified of their child’s risk and received referrals to treatment. Attach the Parent Fact Sheet

(located on page 1.41 of this handbook) for parent’s reference.

6. Tell the parents that you will follow up with them in a specified number of days. If this follow-

up conversation reveals that the parent has not contacted a mental health provider, revisit

SELF-HARM: NEXT STEPS FOR SUPPORT

In addition to following guidelines for parent notification, it is recommended that school teams consider the need for additional support while at school to maintain student safety and continued access to education.

When a general education student has displayed behavior that indicates heightened social-emotional distress or increasing mental health need, such as self-harming, the following is recommended:

Schedule a Student Study Team (SST) prior to the student’s return to school in order to provide

supports needed to ensure safety and well-being at school. This may include implementation of general education intervention supports and/or development of a safety plan and/or Care Card (page 3.12-3.13) contingent upon parent consent. An SST may not delay a student’s return to school. If the school is not able to schedule an SST prior to the student’s return, it is recommended to schedule a meeting to discuss re-entry with the appropriate school personnel. This meeting, which may include the parent, the student, the school administrator, and/or mental health personnel in order to immediately provide supports as needed until the SST is held. The SST meeting should:

• Discuss observations and concerns with parents and team members.

• Identify patterns of behavior in the home, or possible environmental factors which may impact

social-emotional wellbeing and/or behavior.

• Document areas of concern including areas of suspected disability, if applicable.

• Brainstorm interventions to support immediate needs as well as a plan for monitoring progress

and when/how the team will revisit effectiveness.

• Interventions must be individualized to meet the student’s need. Commonly used

interventions may include check-ins with supportive personnel, opportunity to learn and

practice new coping skills, short-term access to general education counseling support, etc.

• Lowest risk option: SST should recommend assessment for Special Education services to

include Educationally Related Mental Health Services (ERMHS) assessment.

• Provide continued access to necessary supports during the assessment period to maintain

Safety. If a student with an Individualized Education Program (IEP) is displaying emotional needs, including but not limited to self-harm, it is recommended that the IEP team convene to discuss if ERMHS are required. As with any other IEP related service, an assessment is required to identify areas of need to inform subsequent goals and services. The team may also consider the need for a Functional Behavior Assessment (FBA) and/or Behavior Intervention Plan (BIP). Please see the ERMHS Assessment section for more information. If ERMHS services are already in place, the team will determine if goals should be updated and services increased and/or changed to address the student’s escalating needs.

PARENT FACT SHEET

Self-Harm

What is Self-Harm?

Self-harm occurs when an individual chooses to inflict wounds upon themselves because of

psychological distress. Although it is difficult to understand, this behavior becomes a coping mechanism for some people. Feelings of anxiety and distress, being “outside” one’s body, and a need for self-punishment are among the reasons self-injurers cite for their behavior.

Why Do They Do It?

Research has not been able to clearly define the life factors that lead to self-harm. Some self-injurers come from loving homes. There is evidence that sexual and physical abuse, feeling invalidated, and sexual identity issues may play a role in the self-harm of some. The theme that is repeated throughout the research is that self-injurers are using the self-harm to relieve extremely uncomfortable feelings.

What Do I Do Now?

• Take a deep breath--this is tough, but it is better that you know about it.

• Realize that you cannot solve the problem, but you can access help.

• Access help!! Find a mental health professional and make an appointment as soon as possible.

• Do NOT tell your child that they must stop self-injuring. It won’t work and will just create

frustration.

• DO remove readily available items for cutting, but realize your child will probably find something else.

• DO immediately attend to physical damage and take your child to professional medical care

when needed.

• DO provide a listening ear when your child needs someone to talk to - create an accepting

atmosphere for him or her.

• DO help coordinate safety plans for your child between your mental health professional and the school mental health personnel.

• DO keep the school updated about any changes in your child’s intervention plan and his or her

overall status. Downloaded from www.EducatorsAndSelfInjury.com

ACKNOWLEDGMENT OF SELF-HARM

School_______________________________________________________________________

Personnel Member Completing the Form____________________________________________

Student______________________________________________________________________

This is to verify that I have spoken with personnel member _________________________ on

___________ (date), concerning my child’s self-harming behavior. I have been advised to seek the services of a mental health agency or therapist immediately.

I understand that _________________________________(name of personnel member) will follow up with me, my child, and the agency to whom my child has been referred for services within two weeks.

Parent Signature: _____________________________________________________________

Date______________________________

Personnel Member Signature: ___________________________________________________

Date: _____________________________

______(Initial) I have received the Parent Fact Sheet on Self-harm