Student self-harm prevention and intervention in secondary schools: current provision and future need

Transcription

1 Student self-harm prevention and intervention in secondary schools: current provision and future need Abigail Russell, Astrid Janssens, Rhiannon Evans, and the Self-harm and Suicide in Schools GW4 Research

2 Self-harm in the UK Self-harm refers to any act with a non-fatal outcome where an individual engages in a behaviour or ingests a substance with the intention of causing harm to themselves Prevalence in UK adolescents estimated at 6.9% to 18.8%. Hospital admissions for self-harm in under-25 s increased 68% between 2001 and Although not all people who self-harm will attempt suicide, self-harm is a risk factor for both suicidal ideation and completed suicide Recent Cochrane review commented on the paucity of evidence for interventions for children and young people who engage in self-harm

3 Aim: to assess current provision for prevention and intervention in self-harm, and explore barriers and facilitators to implementing strategies to address self-harm in schools GW4 collaboration (Bath, Bristol, Cardiff, Exeter, and Swansea) Data collected in Wales and South West England

4 Participants 153 survey responses Schools invited to complete survey: n= 112 Schools invited to complete survey: n= 100 Survey responses received: n=94 Survey responses received: n= 59 8 focus groups with 47 staff Schools invited to take part in focus group : n=5 Schools invited to take part in focus group: n=7 Schools taking part in focus group: n=4 Schools taking part in focus group: n=4 Case-study schools in qualitative analysis: n=8

5 Who delivers current self-harm provision? Pastoral teams Nurse, counsellors, CAMHS Deliver self-harm provisions (%) Teacher (n=120) Teaching support staff (n=121) Pastoral care team (n=149) Senior management (n=134) Students (n=110) School nurse (n=140) School counsellor (n=146) CAMHS (n=152) Other health professional (n=74) Voluntary sector (n=74)

6 Barriers to prevention or intervention Students fail to engage with the topic (n=149) School not an appropriate place (n=150) Lack of time in curriculum to deliver activities (n=150) Lack of available resources (n=150) Fear of encouraging students (n=150) Inadequate training for school staff (n=151) Lack of staff time to deliver activities (n=150) Other health topics given higher priority (n=150) Not seen as problem by teachers (n=150) Not seen as a problem by senior management (n=150) Major Barrier (%) Minor Barrier (%) Not a Barrier (%)

7 Qualitative findings: current provision It s about enjoying life you know, and about managing your mental health managing how you feel, how to cope with it if you don t They were given like a credit size card, with pictures [of] who they could go to, to, feel safe At the moment [named person] is our safeguarding member of staff so I would report anything I am concerned about to him and then we deal with it as we see fit If they re at risk of overdosing for example, we would put severe and very stringent things in place, so their teachers are aware, the pastoral teams [are] aware

8 Barriers and facilitators We had a conversation with CAMHS about whether they should come in and speak to all of them about the perils of taking medication. I feel really uneasy about that because most of the kids in year 11 aren t doing that, I don t want to put that idea into their heads. I also think that we don t have the expertise within us to be able to talk about selfharm the idea is that CAMHS will come in and do training with staff about mental health in general We have a duty of care to tell the parents so we re stuck between a rock and a hard place. If we don t tell the parents and they go home and have an overdose, we you know, we haven t followed the legal process. And if we do, it can make it worse regular self-harmers that aren t being picked up because they ve not taken it to the extremes we ve not got the expertise but they are not being picked up by CAMHS

9 GW4 Self-harm and Suicide in Schools research collaboration Astrid Janssens, Rhiannon Evans, Lucy Biddle, Tamsin Ford, David Gunnell, Nina Jacob, Ann John, Judi Kidger, Franki Mathews, Becky Mars, Christabel Owens, Rachel Parker, Jonathan Scourfield and Paul Stallard Access the full report: (GW4 project)

10 References Muehlenkamp JJ, Kerr PL. (2010) Untangling a complex web: how non-suicidal self- injury and suicide differ. Prev Res, 17:8 Ougriattempts n D, Tranah T, Leigh E, Asarnow JR.(2012) Practitioner review: Self-harm in adolescents. J Child Psychol Psychiatry. 53:337 Mars B, Heron J, Crane C, Hawton K, Kidger J, Lewis G, et al. (2014) Differences in risk factors for selfharm with and without suicidal intent: Findings from the ALSPAC cohort. J Affective Disorders. 168:407 Kidger J, Heron J, Lewis G, Evans J, Gunnell D. (2012) Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England. BMC Psychiatry. 12:69. Hawton K, Harriss L. (2007) Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital. J Clin Psychiat. 68: Hawton K, Rodham K, Evans E, Weatherall R Deliberate self-harm in adolescents: self-report survey in schools in England. BMJ. 325:1207. Morey C, Corcoran P, Arensman E, Perry IJ The prevalence of self-reported deliberate self-harm in Irish adolescents. BMC Public Health. 8:79 Connor R, Rasmussen S, Miles J, Hawton K Self-harm in adolescents: self-report survey in schools in Scotland. Brit J Psychiat. 194:68-72 Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Townsend E, van Heeringen K, Hazell P Interventions for self-harm in children and adolescents. Cochrane.