British Journal of Guidance and Counselling, 34(2), May 2006, pp.161-174.
Publisher:
Taylor and Francis
Acts of deliberate self-harm (DSH) by adolescents are thought to be on the increase. Many of those who self-harm are of school age and it is to be expected that schools (and their teachers) will be aware of the problem and will respond appropriately as part of their pastoral-care provision. However, a recent survey of research in pastoral care and personal-social education undertaken of the concept of deliberate self-harm, the need for a cautious raising of awareness, and the importance of supervision for front-line workers in schools are amongst the issues considered.
Acts of deliberate self-harm (DSH) by adolescents are thought to be on the increase. Many of those who self-harm are of school age and it is to be expected that schools (and their teachers) will be aware of the problem and will respond appropriately as part of their pastoral-care provision. However, a recent survey of research in pastoral care and personal-social education undertaken by the author found virtually no reference to DSH. It appears that empirical evidence about schools’ experience of, and responses to, DSH does not exist. This paper reports some of the findings of a Nuffield Foundation-funded study undertaken in England in 2003/2004. A variety of self-harming behaviours, from cutting to unnecessary risk-taking, were reported by the 34 teachers and other professionals interviewed in schools, pupil referral units and support agencies such as child and adolescent mental health services (CAMHS). The findings indicate that teachers’ awareness of DSH is patchy and that their reactions are often those of shock, panic and anxiety. The implications of the findings for those in education are considered in the context of a discussion of the literature. The contested status of the concept of deliberate self-harm, the need for a cautious raising of awareness, and the importance of supervision for front-line workers in schools are amongst the issues considered.
Subject terms:
self-harm, school children, adolescence, child and adolescent mental health services;
The provision of on-call assessments for young people admitted to hospital following self-harm incidents is a key component of CAMHS provision. A project was set up at a tier 3 CAMH service to assess the demand this activity placed on services to inform the organisation of the resource requirement to meet the need. Data were collected over a 12-month period. A total of 45 young people were
The provision of on-call assessments for young people admitted to hospital following self-harm incidents is a key component of CAMHS provision. A project was set up at a tier 3 CAMH service to assess the demand this activity placed on services to inform the organisation of the resource requirement to meet the need. Data were collected over a 12-month period. A total of 45 young people were assessed. The majority were female, aged 11 to 17 years, and half were found to be open cases to community CAMHS at the time of admission. Two thirds were discharged from the ward for follow up by CAMHS in the community. The final third were re-assessed before community discharge. Very few were considered to have needs that required transfer to a tier 4 service. The findings were consistent with other studies and national guidelines.
Subject terms:
self-harm, young people, child and adolescent mental health services, community mental health services, discharge;
Psychiatric Bulletin, 29(7), July 2005, pp.262-265.
Publisher:
Royal College of Psychiatrists
... to different presenting problems, their modification by ‘contextual factors’ and acceptable waiting times for the service. Mental disorder, self-harm, child abuse and complex cases require greatest priority. Needs of referrers must be considered when deciding priorities for specialist CAMHS, however diverse these appear. If youth mental health needs are to be addressed, better communication between services,
This study aimed to assess how referrers to specialist child and adolescent mental health services (CAMHS) wanted priorities to be determined. Postal questionnaires were sent to practitioners referring to the service in the Bridgend district. Nearly three-quarters of the questionnaires were returned (n=184). There was wide variation between professional groups in the priority attributed to different presenting problems, their modification by ‘contextual factors’ and acceptable waiting times for the service. Mental disorder, self-harm, child abuse and complex cases require greatest priority. Needs of referrers must be considered when deciding priorities for specialist CAMHS, however diverse these appear. If youth mental health needs are to be addressed, better communication between services, and clearer definition of the role of specialist CAMHS is imperative.
Subject terms:
needs, referral, self-harm, social care provision, child and adolescent mental health services;
Journal of Forensic Practice, 21(4), 2019, pp.228-239.
Publisher:
Emerald
Purpose: Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services which has been adopted across most Child and Adolescent Mental Health Services (CAMHS) across Wales. The paper aims to discuss this issue. Design/methodology/approach: An online survey was disseminated to National Health Service clinicians in CAMHS to evaluate their perceptions of the use and effectiveness of WARRN. Data from 88 clinicians were analysed with both quantitative and qualitative methods. Findings: Clinicians reported increased clinical skills, increased confidence in their assessment and management of risk and in safety planning, the increased safety of service users and the general public, and a belief that WARRN had saved lives. The qualitative data showed that clinicians thought a common risk evaluation instrument across Wales and different agencies had created a common language and understanding that improved communication. Practical implications: WARRN appears well accepted in CAMHS services with the view that it is having a very positive effect on service user well-being and safety and could be implemented in other services. Originality/value: This is the first report of a formulation-based approach to the management of serious problem behaviours in CAMHS services.
(Publisher abstract)
Purpose: Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services which has been adopted across most Child and Adolescent Mental Health Services (CAMHS) across Wales. The paper aims to discuss this issue. Design/methodology/approach: An online survey was disseminated to National Health Service clinicians in CAMHS to evaluate their perceptions of the use and effectiveness of WARRN. Data from 88 clinicians were analysed with both quantitative and qualitative methods. Findings: Clinicians reported increased clinical skills, increased confidence in their assessment and management of risk and in safety planning, the increased safety of service users and the general public, and a belief that WARRN had saved lives. The qualitative data showed that clinicians thought a common risk evaluation instrument across Wales and different agencies had created a common language and understanding that improved communication. Practical implications: WARRN appears well accepted in CAMHS services with the view that it is having a very positive effect on service user well-being and safety and could be implemented in other services. Originality/value: This is the first report of a formulation-based approach to the management of serious problem behaviours in CAMHS services.
(Publisher abstract)
Subject terms:
child and adolescent mental health services, risk assessment, safety, wellbeing, instruments, violence, self-harm;
NATIONAL SOCIETY FOR THE PREVENTION OF CRUELTY TO CHILDREN
Publisher:
National Society for the Prevention of Cruelty to Children
Publication year:
2017
Place of publication:
London
Drawing on case reviews published since 2015, this online briefing highlights lessons for practitioners working in child and adolescent mental health services (CAMHS) to improve safeguarding practice. In these case reviews, children died or suffered serious harm as a result of suicide or self-harm. Issues covered include: listening to young people, working with young people who don't want
(Edited publisher abstract)
Drawing on case reviews published since 2015, this online briefing highlights lessons for practitioners working in child and adolescent mental health services (CAMHS) to improve safeguarding practice. In these case reviews, children died or suffered serious harm as a result of suicide or self-harm. Issues covered include: listening to young people, working with young people who don't want to engage, working with parents and carers, interagency working and information sharing, and organisational and leadership issues.
(Edited publisher abstract)
Subject terms:
child and adolescent mental health services, serious case reviews, suicide, self-harm, safeguarding children, young people;
Northern Ireland Assembly. Research and Information Service
Publication year:
2017
Pagination:
54
Place of publication:
Belfast
This paper provides an overview of mental health and illness in Northern Ireland, including the issues of self-harm and suicide. It highlights the relevant overarching strategies and policies and those specific to mental health, mental illness and suicide for Northern Ireland; describes the care pathway for treating mental health problems, including an overview of the stepped care model
(Edited publisher abstract)
This paper provides an overview of mental health and illness in Northern Ireland, including the issues of self-harm and suicide. It highlights the relevant overarching strategies and policies and those specific to mental health, mental illness and suicide for Northern Ireland; describes the care pathway for treating mental health problems, including an overview of the stepped care model and recovery model; looks at provision of child and adolescent mental health services (CAMHS); and discusses evaluations of mental health service provision in NI in terms of accessing services and barriers to access. It also highlights relevant initiatives in England, Wales, Scotland and the Republic of Ireland relating to accessing mental health services.
(Edited publisher abstract)
Subject terms:
mental health problems, suicide, access to services, self-harm, government policy, care pathways, child and adolescent mental health services;
Young Minds Magazine, 97, November 2008, pp.30-32.
Publisher:
YoungMinds
Reports on the findings of interviews with young people and professionals about self-harm services within the West Midlands. Areas for improvement identified include: the need for greater understanding in professionals, the need for better defined care pathways and more training in the management of young people who self-harm.
Reports on the findings of interviews with young people and professionals about self-harm services within the West Midlands. Areas for improvement identified include: the need for greater understanding in professionals, the need for better defined care pathways and more training in the management of young people who self-harm.
Subject terms:
self-harm, user views, young people, child and adolescent mental health services, care pathways, general practitioners;
Psychiatric Bulletin, 31(6), June 2007, pp.224-226.
Publisher:
Royal College of Psychiatrists
This paper describes the development and initial audit of a protocol for the assessment of young people up to the age of 18 years who presented to the accident and emergency department (A&E) with self-harm. A key part of the project was education and training. Regular training of senior house officers (SHOs) in A&E may have contributed to an increase in young people being admitted
This paper describes the development and initial audit of a protocol for the assessment of young people up to the age of 18 years who presented to the accident and emergency department (A&E) with self-harm. A key part of the project was education and training. Regular training of senior house officers (SHOs) in A&E may have contributed to an increase in young people being admitted to a bed for proper assessment (as per the protocol), but psychosocial assessments undertaken by SHOs in A&E were still only partial, and there was no apparent use of the mental state examination. Child and adolescent mental health services have an important role to play in liaising with local A&E departments in training of junior staff in psychosocial assessment and the use of the mental state examination. This is especially relevant in the light of the new training requirements of the foundation years.
Subject terms:
psychosocial approach, self-harm, training, assessment, child and adolescent mental health services, emergency health services;
Journal of Social Work Practice, 18(1), March 2004, pp.19-32.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
Describes the findings of qualitative clinical research into risk-taking, dangerous behaviour in childhood using a post-Kleinian psychoanalytic approach undertaken by a Child Psychotherapist working in a local CAMHS. The purpose of the research was to find a way of understanding this behaviour using psychoanalytic thinking and comparing material from a number of cases across a wide age range (grouped into three age bands). Three different situations were identified in which risk-taking, dangerous behaviour occurred and these were named no-haven, illusory-haven and perilous-haven. All three havens are dangerous for children. For each haven there is a different prognosis and a different strategy.
Describes the findings of qualitative clinical research into risk-taking, dangerous behaviour in childhood using a post-Kleinian psychoanalytic approach undertaken by a Child Psychotherapist working in a local CAMHS. The purpose of the research was to find a way of understanding this behaviour using psychoanalytic thinking and comparing material from a number of cases across a wide age range (grouped into three age bands). Three different situations were identified in which risk-taking, dangerous behaviour occurred and these were named no-haven, illusory-haven and perilous-haven. All three havens are dangerous for children. For each haven there is a different prognosis and a different strategy.
Subject terms:
risk, self-harm, vulnerable children, behaviour, case studies, child and adolescent mental health services, children;
Child and Adolescent Mental Health, 25(3), 2020, pp.157-164.
Publisher:
Wiley-Blackwell
Background: Self-harm amongst young people is an increasing problem, with looked-after young people at higher risk. Despite this, little research exists on what young people who self-harm find helpful. Method: One hundred and twenty-six 11–21 year olds (53 who had experience of the care system and 73 who did not) were recruited from the community and NHS. All participants had self-harmed CAMHS, Accident and Emergency (A&E) and Social services. For non-looked-after young people, CAMHS, counselling and Harmless (user-led support service for self-harm) were most helpful and CAMHS, cognitive behavioural therapy (CBT) and general practitioner (GP) were the least. Compared with the other group, more looked-after young people had received help from A&E and CAMHS, whereas more non-looked-after young people had accessed GPs, parents, psychological therapies, self-help books and websites. More looked-after young people found support groups helpful, and more non-looked-after young people reported that distraction techniques, medication and their siblings were helpful. Conclusion: Young people who self-harm have mixed views about CAMHS. Differences in the pattern of access and preferences
(Edited publisher abstract)
Background: Self-harm amongst young people is an increasing problem, with looked-after young people at higher risk. Despite this, little research exists on what young people who self-harm find helpful. Method: One hundred and twenty-six 11–21 year olds (53 who had experience of the care system and 73 who did not) were recruited from the community and NHS. All participants had self-harmed in the past 6 months. Participants completed an Audio Computer-Assisted Self-interview (ACASI) regarding their views about the support they had received, how helpful it was, and what further help they felt they needed. Results: Looked-after young people reported the three most helpful sources of support were Child and Adolescent Mental Health Services (CAMHS), friends and pets and the least helpful were CAMHS, Accident and Emergency (A&E) and Social services. For non-looked-after young people, CAMHS, counselling and Harmless (user-led support service for self-harm) were most helpful and CAMHS, cognitive behavioural therapy (CBT) and general practitioner (GP) were the least. Compared with the other group, more looked-after young people had received help from A&E and CAMHS, whereas more non-looked-after young people had accessed GPs, parents, psychological therapies, self-help books and websites. More looked-after young people found support groups helpful, and more non-looked-after young people reported that distraction techniques, medication and their siblings were helpful. Conclusion: Young people who self-harm have mixed views about CAMHS. Differences in the pattern of access and preferences for support between looked-after and non-looked-after young people should be reflected in service availability and commissioning.
(Edited publisher abstract)
Subject terms:
young people, looked after children, self-harm, comparative studies, user views, service provision, child and adolescent mental health services, mental health, access to services;