Mental Health Policy

Mental Health Policy

(including EYFS)

This applies to Junior School, Senior School and EYFS

We are a school with each individual at its heart, where are students are known and nutured. Our students well-being, therefore, is at the centre of everything we do. Our strategic plan is to continue on your journey to become a hub for understanding the well-being of high achieving girls.  The concept of wellbeing comprises many aspects of life, including physical and mental health, emotional intelligence and resilience: the skills to be able to respond to the challenges of life and to know how to ask for help when it’s needed. 

The GROW Programme explores all aspects of mental health and is prioritised with the curriculum and by staff as practioners and tutors.  The physical, mental and emotional health benefits ofexercise are well documented and the school actively encourages sport for all. As well as sport we believe wholeheartedly in the importance of our partnership & trip programmes in allowing our students to seek different perspectives on their, and other people's, lives. 

Mental health issues can and should be de-stigmatised by educating pupils, staff and parents. This is done through form time, assemblies and GROW with students, through staff study days and through our GROW Parent Programme. Positive mental health is also promoted through strong pastoral care both for the whole school community and individual girls.

State of the nation 2022:  children and young people's wellbeing (Feb 2023)

This policy aims to:

• describe the School’s approach to mental health issues
• increase understanding and awareness of mental health issues so as to facilitate early intervention in the case of possible problems
• alert staff to warning signs and risk factors
• provide support and guidance to all staff, including non-teaching staff and governors, for working with and supporting pupils who suffer from mental health issues
• provide guidance and support to pupils who suffer from mental health issues, their peers and parents/carers

Child Protection Responsibilities

Wimbledon High School is committed to safeguarding and promoting the welfare of children and young people, including their mental health and emotional wellbeing, and expects all staff, Governors and volunteers to share this commitment. We recognise that children have a fundamental right to be protected from harm and that pupils cannot learn effectively unless they feel secure. We therefore aim to provide a school environment which promotes self-confidence, a feeling of self-worth and the knowledge that pupils’ concerns will be listened to and acted upon.

Ben Turner (Senior Deputy Head) is the Designated Safeguarding Lead with Claire Boyd leading  DSL, and responsible for EYFS, in the Junior School. There is a team of Deputy Safeguarding Leads (listed below). They are responsible for matters relating to child protection and welfare in their respective areas. Parents are welcome to approach the DSLs if they have any concerns about the welfare of any child in the school, whether these concerns relate to their own child or any other. As good mental health is vital to the safety and wellbeing of pupils, issues around mental health may be handled according to the school’s Safeguarding and Child Protection policy. 

^{* denotes specialist training as a Sexual Misconduct Liason Officer}

Background 

• 20% of adolescents may experience a mental health problem in any given year.¹
• 50% of mental health problems are established by age 14 and 75% by age 24.²
• 10% of children and young people (aged 5-16 years) have a clinically diagnosable mental.³ problem3, yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age. ⁴

The cost of the Covid pandemic on adolescents and teenagers as well as these underlying statistics means that there has never been a more important time for schools to put mental health at the heart of their provision and raise awareness of its importance within their communities. 

It is equally as vital that staff are trained to be alert to signs that a child might be suffering from mental health issues. As educators and adults who spend so much time with the young people in our care, it is important that we are proactive if we sense something is amiss or spot possible symptoms or a larger problem. In some cases, it also forms part of our safeguarding obligation, as per the school’s Safeguarding and Child Protection Policy.

Possible signs of a mental health concern:

• student is more withdrawn than usual, perhaps not sitting with friends, not participating
• student appears sad or tearful regularly
• student says, or looks like, she is not sleeping
• student complains regularly of tummy ache / head ache / general malaise
• student is evidently tense / nervous – signs could include hair twisting, nail biting / picking, protective body posture, lack of eye contact, avoids chatting
• student has lost / gained weight over a relatively short period of time
• student academic performance has dipped
• student seems distracted or distant / finds it hard to concentrate
• student is unusually irritable

Some of the more common, specific mental health disorders include:

• Anxiety & depression
• Eating disorders
• Deliberate Self-Harm or DSH (not a disorder, but an unhealthy coping strategy)

Further details about the above mental health issues can be found in appendices at the end of this document. 

Two important elements enabling the School to identify mental health issues are the effective use of data (i.e. monitoring changes in pupils’ patterns of attendance/academic achievement) and an effective pastoral system whereby staff know pupils well and can identify unusual behaviour. Regular one-to-one conversations between teachers and pupils aim to ensure that issues are identified early or, where warning signs may be present, monitoring can be put in place.

Procedures for raising a concern

Staff who have a concern about the mental health of a student must raise it immediately and parents in a similar position are encouraged to do so. Depending upon the severity of the concern, appropriate people to contact would be the student's Tutor, Year Team, Assistant Head Pastoral. If the concern is of a safeguarding or child protection nature (the pupil in question is at serious risk of coming to harm), it must be raised with the DSL, before the end of the school day. For lower level concerns, an email outlining the nature of the concern to the relevant teacher may be appropriate.

When discussing concerns about mental health with parents, it is often best to have a face-to-face conversation where possible. The sensitivity of such conversations for parents must never be underestimated. In the case that time is limited and important information must be conveyed before a face-to-face conversation can be arranged, a telephone call would be the next best option. The first conversation about a mental health concern should never happen by email, though it may be appropriate to use email to initiate the need for a conversation or it may be used to share updates once the lines of communication have been opened on the topic. In all cases, the details of the concern and any communication with the girl herself, the parents or other professionals must be recorded on CPOMS for future reference.

Confidentiality & information sharing

Students may choose to confide in a member of school staff if they are concerned about their own welfare or that of a peer. Students should be made aware that it may not be possible for staff to offer confidentiality. If a member of staff considers a pupil is at serious risk of causing themselves harm then confidentiality cannot be kept; this must be regarded as a safeguarding matter and brought to the attention of the DSL immediately. It is important not to make promises of confidentiality that cannot be kept even if a pupil puts pressure on a member of staff to do so. 

If a student is working with an agency or professional outside school, the School will seek to work with them to establish the best possible arrangement for supporting the pupil. It is important that all the professionals supporting that young person are working in the same direction and not at cross-purposes. Except in the case of serious safeguarding concerns, permission from the student would always be sought before liaising or sharing information and only information that would be helpful to the student's care and wellbeing would be shared.

It is possible that a student will present at the Medical Team  in the first instance. Young people with mental health problems sometimes visit the Medical Room more than their peers, often presenting with physical concerns. This gives the Medical Team and designated First Aiders key roles in identifying mental health issues early. The confidentiality of visits to the Nurse will be maintained, within the boundaries of safeguarding the pupil (in which cases the Nurse or First Aider will refer to the DSL). If a student confides in the Nurse or First Aider, then they should be encouraged to speak to their Tutor or Head of Year or asked for permission for the Nurse to do so. The Pastoral Leadership Team may decide to share relevant information with certain colleagues on a need to know basis, if it is deemed to be in the best interests of the welfare of the student. Parents should be involved wherever possible, although the student's wishes should always be taken into account, according to the principles of safeguarding and Gillick competence.

Parents are likely to know if something is amiss with their child's mental health, whether there is a diagnosed disorder or just something not quite right. Parents should never feel that there is any embarrassment about discussing such issues with the school, nor any stigma or judgement attached to their daughter after such a disclosure. It is vital that parents disclose to the School (Head, Deputy/Assistant Head Pastoral, Medical Team, Year Team, or Tutor) any known mental health problem or any concerns they may have about a student's mental health or emotional wellbeing. This includes any changes in family circumstances that may impact the student's wellbeing. If the School considers that the presence of a student in school is having a detrimental effect on the wellbeing and safety of other members of the community or that a student's mental health concern cannot be managed effectively and safely within the school, the Head (or Deputy Head Pastoral in proxy) reserves the right to request that parents withdraw their child temporarily until appropriate reassurances have been met or measures put in place.

For any student identified as having a diagnosed mental health condition, the School will consider whether the student will benefit from having special access arrangements for examinations and whether any other adaptations would be appropriate to support their learning.

Preventative & Supportive Measures

A proactive approach to wellbeing is a thread running through all aspects of provision at Wimbledon High School. Below is a list of some key aspects of ongoing wellbeing. These important aspects of life are reinforced through many initiatives, curriculum teaching, school culture and the overarching ethos of pastoral care in the school.

1. Proper sleep patterns

2. Making time for exercise

3. Eating healthily at regular intervals

4. Making time to relax

5. Emotional resilience

6. A sense of humour

7. A sense of perspective

^{(Sleep is at the top of this list for a reason. Sleep deprivation can play a significant role in poor mental health, particularly in anxiety and depression. Teenagers need to get between 8 and 10 hours per night of sleep. They rarely get close to this and many operate on 5 – 6 hours as a norm. It is vital that we reinforce, regularly, the importance of sleep and encourage parents to ensure their daughters are exercising good ‘sleep hygiene’ before bedtime.)}

The good mental health of all students is a top priority for Wimbledon High and we work hard to help children develop the understanding, resilience and resourcefulness to feel empowered to take care of their own mental health and to be helpful to those around them. Issues around mental health are covered in a range of ways within the school under the GROW Programme.  We work in partnership with external organisations and individuals who have areas of expertise and who work with students and parents, as are our own well-qualified and experienced team of counsellors. Students in the Junior School have access to their own specialist counsellor. Those students who may need continued support during their time in the Senior School, are introduced to Senior counselling service before they make that transition. As well as providing support immediately, it also increases the chances that the child will continue to access that support when they move into the Senior School through being comfortable and familiar with the counsellors.

The GROW curriculum is reviewed annually and modified according to need and feedback from students who express that they really value learning about mental health issues. Our Lead Counsellor runs our Peer Counsellor Programme. Our Heads of Peer Counselling sit on the Student Leadership Team and their team of Sixth Formers run sessions with the Lower School and Middle School students in form times on Wednesdays (A Weeks). Peer Counselling is an umbrella for wider student voice about mental health matters and issues that students are concerned about are brought up from student leadership across the school. Often, students choose to support mental health charities such as Papyrus as their Year Group charity and co-ordinate awareness raising activities. Students inform initiatives like our Golden Digital Rules, as evidence is growing about the link between social media use and self-esteem / mental health, this is a specific area we seek to bring to the attention to our students, who are vulnerable to spending many hours scrolling through Instagram feeds and group chats.

It is vital that, as a community, we reinforce the need to talk about mental health issues responsibly. Teenagers can fixate and loose perspective about the natural highs and lows of adolescence and can fall into a pattern of using grandiose or over-medicalised terms when they are not appropriate or warranted, or of glorifying the idea of being mentally unwell in an attempt for attention or to appear to know more about another student than others. All of these things hinder rather than help those who are truly in need. Whilst speaking openly about mental health is vital, students must be taught about how to speak sensitively, proportionately and in a manner that is helpful rather than hurtful. Students must also be taught about the limits of the support that they can expect from peers who are not equipped to handle the burden of the serious problem friend is experiencing, nor do they have the skill or expertise to give that friend the help they need. Both the friend suffering and the friend supporting must understand the importance of getting help from a trusted adult and neither one should begrudge the other from taking this responsible step. It is important to always reinforce boundaries of care around any individual and for everyone to play a qualified role in that care. 

In addition to the Pastoral Leadership Team, all students have access to the counselling service. Students can refer themselves to the Lead Counsellor and can sign themselves up for appointments without anyone else knowing. Confidentiality is important as students need to feel that the counsellor is a safe place for them to share anything (subject to safeguarding obligations.) The counsellors can be particularly helpful at advising other members of the school community about how best to work with a student who might be finding things difficult and they work with the Pastoral Leadership Team on the delivery of various aspects of the GROW programme. More details about the work of the counsellors can be found in the Counsellor Policy.

^{1. WHO (2003). Caring for children and adolescents with mental disorders: Setting WHO directions. [online] Geneva: World Health Organization. Available at: http://www.who.int/mental_health/media/en/785.pdf [Accessed 14 Sep. 2015].}

^{2.  Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62 (6) pp. 593-602. doi:10.1001/archpsyc.62.6.593.}

^{3.  Green,H., Mcginnity, A., Meltzer, Ford, T., Goodman,R. 2005 Mental Health of Children and Young People in Great Britain: 2004. Office for National Statistics.}

^{4.  Children’s Society (2008) The Good Childhood Inquiry: health research evidence. London: Children’s Society.}

Appendix 1: Suicide 

Whilst suicide is a part of the broader topic of Mental Health, it is important to address it specifically. By doing so, the School seeks to protect the health and wellbeing of all pupils by having in place proactive and reactive procedures to assess the risk of, intervene in, respond to and, as much as possible, prevent suicide in our community.

Context:

• Suicide is the leading cause of death in young people
• Schools play a vital role in helping to prevent young suicide

Wimbledon High School (WHS) recognises that:

• Suicidal ideation can be common amongst young people
• Stigma surrounding suicide and mental illness creates barriers to seeking or offering help. WHS will promote open, sensitive language that does not stigmatise or perpetuate taboos.
• Talking responsibly about suicide does not create or worsen risk. We will provide students with opportunities to speak openly about their worries with people who are ready, willing and able to support them.
• Suicide is part of the wider topic of Mental Health and prevention of suicide is part of the wider aim of safeguarding children through being alert to and supporting students’ mental health during their time at Wimbledon. 

Guidance for teachers and support staff during or following a disclosure:

• Stay calm and try not to appear shocked or make any sort of judgement
• Don’t dismiss what they are saying; they are asking for help
• Recognise that a disclosure may not include the word ‘suicide’: phrases such as ‘I just don’t see the point anymore’ or ‘I just don’t want to go on’ should raise concern and prompt questions (see below)
• If you feel comfortable, ask the student if they are thinking of suicide? If they are not, they will tell you so. If they are, listen and allow them to express their feelings. Be assured that you can’t make it worse by asking the question. If you feel comfortable, you could also ask questions such as ‘Have you talked about this with anyone else?’ or ‘How long have you been feeling this way?’ ‘Can you tell me a little more about your thinking?’
• Reassure them that they are not alone; there is help and hope and you are going to help them get support
• Inform the student that you will need to share the information with others
• Inform the DSL immediately then write it up according to safeguarding procedures

*If there is imminent risk of death or harm?

• Do not leave the student alone; go together to see the DSL, Medical Team, Lead Counsellor or Year Team. 
• It may be necessary to call ‘999’ (for instance if a friend has disclosed a worry about a pupil at imminent risk somewhere outside of school)

If the student does not want to talk whilst waiting for assistance, reassure them that this is fine and that you will remain with them in supportive silence. Your reassurance will help the student to feel understood and safe.

Appendix 2: Anxiety & Depression 

Anxiety Disorders 

Anxiety is a natural, normal feeling we all experience from time to time. It can vary in severity from mild uneasiness through to a terrifying panic attack. It can vary in how long it lasts, from a few moments to many years.

All children and young people get anxious at times; this is a normal part of their development as they grow up and develop their ‘survival skills’ so they can face challenges in the wider world. In the same way that progressive resistance builds physical muscle, facing increasingly trying circumstances as they grow older helps young people develop their skills and increase their ability to cope with the difficulties life will throw at them as adults. In addition, we all have different levels of stress we can cope with - some people are just naturally more anxious than others, and are quicker to get stressed or worried.

It is important not to treat all ‘anxiety’ as something to be feared or as a cause for concern and, as educators, we have a role to play in helping young people to put their stress or worries into perspective, develop strategies and giving them cause for optimism that they can and will learn to cope with the tough bits of normal life.

In cases where anxiety becomes unmanageable, concerns are raised when anxiety is getting in the way of a child’s day-to-day life, slowing down their development, or having a significant effect on their schooling or relationships.

Anxiety disorders include:

• Generalised anxiety disorder (GAD)

• Panic disorder and agoraphobia

• Acute stress disorder (ASD)

• Separation anxiety

• Post-traumatic stress disorder (PTSD)

• Obsessive-compulsive disorder (OCD)

• Phobic disorders

• Social anxiety

Symptoms of an anxiety disorder can include: 

Physical effects:

• Cardiovascular – palpitations, chest pain, rapid, heartbeat, flushing

• Respiratory – hyperventilation, shortness of breath

• Neurological – dizziness, headache, sweating, tingling and numbness

• Gastrointestinal – choking, dry mouth, nausea, vomiting, diarrhoea

• Musculoskeletal – muscle aches and pains, restlessness, tremor and shaking

Psychological effects:

• Unrealistic and/or excessive fear and worry (about past or future events)

• Mind racing or going blank

• Decreased concentration and memory

• Difficulty making decisions

• Irritability, impatience, anger

• Confusion

• Restlessness or feeling on edge, nervousness

• Tiredness, sleep disturbances, vivid dreams

• Unwanted unpleasant repetitive thoughts

Behavioural effects:

• Avoidance of situations

• Repetitive compulsive behaviour e.g. excessive checking

• Distress in social situations

• Urges to escape situations that cause discomfort (phobic behaviour)

How to help a student who is having a panic attack

If you are at all unsure whether the child is having a panic attack, a heart attack or an asthma attack, and/or the person is in severe distress, call an ambulance straight away.

• If you are sure that the pupil is having a panic attack, move them to a quiet safe place if possible.

• Help to calm the pupil by encouraging slow, relaxed breathing in unison with your own. Encourage them to breathe in for 3 seconds, hold for 3 seconds and then breathe out for 3 seconds.

• Be a good listener, without judging.

• Explain to the pupil that they are experiencing a panic attack and not something life threatening such as a heart attack.

• Explain that the attack will soon stop and that they will recover fully.

• Assure the pupil that someone will stay with them and keep them safe until the attack stops.

Many young people with anxiety problems do not fit neatly into a particular type of anxiety disorder. It is common for people to have some features of several anxiety disorders. A high level of anxiety over a long period can often lead to depression and long periods of depression can provide symptoms of anxiety. Many young people have a mixture of symptoms of anxiety and depression as a result.

Depression 

A clinical depression is one that lasts for at least 2 weeks, affects behaviour and has physical, emotional and cognitive effects. It interferes with the ability to study, work and have satisfying relationships. Depression is a common but serious illness and can be recurrent.

Depression in young people often occurs with other mental disorders, and recognition and diagnosis of the disorder may be more difficult in children because the way symptoms are expressed varies with the developmental age of the individual. In addition to this, stigma associated with mental illness may obscure diagnosis.

Risk Factors:

• Experiencing other mental or emotional problems

• Upheaval in home life

• Perceived poor achievement at school

• Bullying

• Developing a long term physical illness

• Death of someone close

• Break up of a relationship

Some people will develop depression as a result of a distressing situation, whereas others in the same situation will not. Depression can also develop when there seem to be no igniting factors. It can appear to come out of the blue.

Symptoms: 

Effects on emotion: sadness, anxiety, guilt, anger, mood swings, lack of emotional responsiveness, helplessness, hopelessness

Effects on thinking: frequent self-criticism, self-blame, worry, pessimism, impaired memory and concentration, indecisiveness and confusion, tendency to believe others see you in a negative light, thoughts of death or suicide

Effects on behaviour: crying spells, withdrawal from others, neglect of responsibilities, loss of interest in personal appearance, loss of motivation. Engaging in risk taking behaviours such as self-harm, misuse of alcohol and other substances, risk-taking sexual behaviour.

Physical effects: chronic fatigue, lack of energy, sleeping too much or too little, overeating or loss of appetite, constipation, weight loss or gain, irregular menstrual cycle, unexplained aches and pains.

How to help a person with anxiety or depression: 

The most important role school staff can play is to familiarise themselves with the risk factors and warning signs outlined above and to make the a member of the Pastoral Leadership Team aware of any child causing concern.

Following the report, the PLT will decide on the appropriate course of action.

This may include:

• Contacting parents/carers

• Arranging professional assistance e.g. doctor, nurse

• Arranging an appointment with a counsellor

• Arranging a referral to CAMHS or private referral – with parental consent

• Giving advice to parents, teachers and other pupils about how to be supportive / helpful

Students may choose to confide in a member of school staff if they are concerned about their own welfare, or that of a peer. Students need to be made aware that it may not be possible for staff to offer complete confidentiality. If you consider a student is at serious risk of causing themselves harm then confidentiality cannot be kept.

Appendix 3: Disordered Eating & Eating Disorders

Anyone can get an eating disorder regardless of their age, gender or cultural background. People with eating disorders are preoccupied with food and/or their weight and body shape, and are usually highly dissatisfied with their appearance. The majority of eating disorders involve low self-esteem, shame, secrecy and denial.

Anorexia nervosa and bulimia nervosa are the two most prevalent eating disorders. People with anorexia live at a low body weight, beyond the point of slimness and in an endless pursuit of thinness by restricting what they eat and sometimes compulsively over-exercising. In contrast, people with bulimia have intense cravings for food, secretively overeat and then purge to prevent weight gain (by vomiting or use of laxatives, for example).

Risk Factors

The following risk factors, particularly in combination, may make a young person more vulnerable to developing an eating disorder:

Individual Factors

• Difficulty expressing feelings and emotions

• A tendency to comply with other’s demands

• Very high expectations of achievement

• Participation in an activity where body size / shape is regularly emphasised 

Family Factors

• A home environment where food, eating, weight or appearance have a disproportionate significance

• An over-protective or over-controlling home environment

• Poor parental relationships and arguments

• Neglect or physical, sexual or emotional abuse

• Overly high family expectations of achievement

Social Factors

• Being bullied, teased or ridiculed due to weight or appearance

• Pressure to maintain a high level of fitness/low body weight for e.g. sport or dancing

Warning Signs 

School staff may become aware of warning signs which indicate a student is experiencing difficulties that may lead to an eating disorder. These warning signs should always be taken seriously and staff observing any of these warning signs should seek further advice from one of the designated teachers for safeguarding children or from the Medical Team.

Physical Signs

• Weight loss

• Regular dizziness, tiredness, fainting

• Regularly feeling cold more severely than would be expected

• Hair becomes dull or lifeless

• Sore throats / mouth ulcers

• Tooth decay

Behavioural Signs

• Restricted eating

• Skipping meals

• Scheduling activities during lunch

• Strange behaviour around food

• Wearing baggy clothes or several layers of clothing (to hide physique)

• Excessive chewing of gum/drinking of water

• Increasing isolation / loss of friends

• Believes she is fat when she is not

• Secretive behaviour

• Visits the toilet frequently, possibly immediately after meals

• Excessive exercise

Psychological Signs

• Preoccupation with food

• Sensitivity about eating

• Denial of hunger despite lack of food

• Feeling distressed or guilty after eating

• Self dislike

• Fear of gaining weight

• Moodiness

• Excessive perfectionism

Staff role

The most important role school staff can play is to familiarise themselves with the risk factors and warning signs outlined above and to make the approriate Pastoral Leadership Team and Deputy Head Pastoral (DSL) aware of any child causing concern.

It is important to encourage pupils to let staff know if one of their group is in trouble, upset or showing signs of an eating disorder. Friends can worry about betraying confidences so they need to know that eating disorders can be very dangerous and that by seeking help and advice for a friend they are taking responsible action and being a good friend. They should also be aware that their friend will be treated in a caring and supportive manner.

Following the report, the Pastoral Leadership Team will decide on the appropriate course of action.

This may include:

• Contacting parents/carers

• Arranging professional assistance e.g. doctor, nurse

• Arranging an appointment with a counsellor

• Arranging a referral to CAMHS or private referral – with parental consent

• Giving advice to parents, teachers and other pupils

As part of the care plan, the Medical Team may offer to weigh the pupil and to monitor their weight on a regular basis but this is usually deferred to an external agency. Students may choose to confide in a member of school staff if they are concerned about their own welfare or that of a peer. Students need to be made aware that it may not be possible for staff to offer complete confidentiality. If you consider a student is at serious risk of causing themselves harm then confidentiality cannot be kept.

Pupils Undergoing Treatment for/ Recovering from Eating Disorders

The decision about how, or if, to proceed with a student's schooling while they are suffering from an eating disorder should be made on a case by case basis. Input for this decision should come from discussion with the student, their parents, school staff and members of the multi-disciplinary team treating the pupil.

The reintegration of a student into school following a period of absence should be handled sensitively and carefully and again, the student, their parents, school staff and members of the multi-disciplinary team treating the pupil should be consulted during both the planning and reintegration phase.

The needs of the student concerned will, of course, be at the centre of any discussion, but the impact on other students, staff and the wider school community must also be considered when establishing care plans and involvement in school activities.

Appendix 4: Deliberate Self-Harm (DSH) 

Introduction

Recent research indicates that up to one in ten young people in the UK engage in self-harming behaviours. Girls are more likely to self-harm than boys. School staff can play an important role in preventing self-harm and also in supporting pupils, peers and parents of pupils currently engaging in self-harm.

Definition of Self-Harm

Self-harm is not a disorder; it is an unhealthy coping strategy that can become addictive and dangerous. Self-harm is any behaviour where the intent is to deliberately cause harm to one’s own body for example:

• Cutting, scratching, scraping or picking skin

• Swallowing inedible objects

• Taking an overdose of prescription or non-prescription drugs

• Swallowing hazardous materials or substances

• Burning or scalding

• Hair-pulling

• Banging or hitting the head or other parts of the body

• Scouring or scrubbing the body excessively

Risk Factors

The following risk factors, particularly in combination, may make a young person vulnerable to self-harm:

Individual Factors:

• Depression/anxiety

• Poor communication skills

• Low self-esteem

• Poor problem-solving skills

• Hopelessness

• Impulsivity

• Drug or alcohol abuse

Family Factors

• Unreasonable expectations

• Neglect or physical, sexual or emotional abuse

• Poor parental relationships and arguments

• Depression, self-harm or suicide in the family

Social Factors

• Difficulty in making relationships/loneliness

• Being bullied or rejected by peers

Warning Signs:

School staff may become aware of warning signs which indicate a student is experiencing difficulties that may lead to thoughts of self-harm or suicide. These warning signs should always be taken seriously and staff observing any of these warning signs should seek further advice from the Pastoral Leadership Team. 

Possible warning signs include:

• Visible marks / cuts / injuries on the pupil’s body which look unlikely to be accidental

• Changes in eating/sleeping habits (e.g. pupil may appear overly tired if not sleeping well)

• Increased isolation from friends or family, becoming socially withdrawn

• Changes in activity and mood e.g. more aggressive or introverted than usual

• Lowering of academic achievement

• Talking or joking about self-harm or suicide

• Abusing drugs or alcohol

• Expressing feelings of failure, uselessness or loss of hope

• Changes in clothing e.g. always wearing long sleeves, even in very warm weather

• Unwillingness to participate in certain sports activities e.g. swimming

Staff Role

Students may choose to confide in a member of school staff if they are concerned about their own welfare or that of a peer. School staff may experience a range of feelings in response to self-harm in a student such as anger, sadness, shock, disbelief, guilt, helplessness, disgust and rejection. However, in order to offer the best possible help to students it is important to try and maintain a supportive and open attitude and not express alarm at the disclosure – a student who has chosen to discuss their concerns with a member of school staff is showing a considerable amount of courage and trust.

Students need to be made aware that it may not be possible for staff to offer complete confidentiality. If you consider a student is at serious risk of harming themselves then confidentiality cannot be kept.

• In the case of an acutely distressed pupil, the immediate safety of the student is paramount and an adult should remain with the student at all times

• If a student has self-harmed in school a first aider should be called for immediate help

• If a student discloses that they have taken an overdose or otherwise ingested something dangerous, medical help should be sought immediately

Any member of staff who is aware of a student engaging in or suspected to be at risk of engaging in self harm should consult the Pastoral Leaderhsip Team. 

Following the report, the Pastoral Leadership Team will decide on the appropriate course of action. This may include:

• Contacting parents / carers

• Arranging professional assistance e.g. doctor, nurse, social services

• Arranging an appointment with a counsellor

• Arranging a referral to CAMHS or private referral – with parental consent

• Immediately removing the pupil from lessons if their remaining in class is likely to cause further distress to themselves or their peers

It is important to encourage students to let staff know if one of their group is in trouble, upset or showing signs of self-harming. Friends can worry about betraying confidences so they need to know that self-harm can be very dangerous and that by seeking help and advice for a friend they are taking responsible action and being a good friend. They should also be aware that their friend will be treated in a caring and supportive manner.

The peer group of a young person who self-harms may value the opportunity to talk to a member of staff either individually or in a small group. Any member of staff wishing for further advice on this should consult the Pastoral Leadership Team. 

When a young person is self-harming it is important to be vigilant in case close contacts with the individual are also self-harming. Occasionally schools discover that a number of students in the same peer group are harming themselves. For this reason, the school takes seriously the importance of not allowing students to draw attention to any wounds or to discuss methods of self-harm. Any students with wounds will be asked to keep them covered and not to draw attention to them, for their own sake and for the sake of other students. They will also be asked not to discuss their self-harm widely within their peer group or post images / statements about it on social media. 

Further Reading and Useful Links

For acute mental health support (in lieu or A&E): https://www.nhs.uk/service-search/mental-health/find-an-urgentmental-health-helpline

Young Minds

Beat

Childline

Mind

NHS

Mental Health Foundation

Stem4

Royal College of Psychiatrists

DfE: Mental Health and behaviour in schools; November 2018