Self Harm and Suicide Alertness for professionals working children & young people three month followup survey June 2017 October 2017 Jonny Reay Training Administrator
An online survey was sent out to all participants who had attended the half day Self-Harm & Suicide alertness training for professionals working with children and young people over the period of June to October 2017 who had agreed to further contact. Participants were encouraged to complete the feedback with the incentive of a High Street voucher draw and there was a reminder email also sent out. Twenty-eight surveys were completed. Findings were as follows with all raw data included in the appendix 1
The survey consisted of the following questions: 1. How would you rate your knowledge prior to the start of the course? 2. How would you rate your knowledge now? 3. After the training, do you feel more confident in talking about self-harm and suicide? 4. After the training, do you feel more comfortable in talking about self-harm and suicide? 5. Are you now more confident asking directly about thoughts of suicide? 6. Are you more aware of the pathways and resources which are available both locally and nationally? 7. Do you think there has been any change in your behaviour /practice since attending the course? 8. Do you have any impact examples of how your knowledge/understanding has affected your behaviour in any situation or any other example where you have used this in working with a young person? 9. Are there any other actions you have put into practice (or plan to) as a result of the training? 10. Any improvements you could suggest? 11. Any further comments? Participants were asked to expand on Q3-Q6 and Q7-11 were purely qualitative responses 2
Q1: How would you rate your knowledge prior to the start of the course? On a scale of 1 to 5, where 1 is poor and five is excellent Q2: How would you rate your knowledge now? On a scale of 1 to 5, where 1 is poor and five is excellent 3
Q3: After the training, do you feel more confident in talking about selfharm and suicide? Please expand on your answer: I feel more confident in being able to talk to people about suicide and help people who are suffering from self-harm. I am more confident in my ability to safeguard people who are self-harming or having suicidal thoughts by putting appropriate measures in place. I now know how important it is that people should talk about the issues they are facing so that help can be provided. Before the course I would struggle to stay calm about the subject matter - now I see it is best to talk about things - not a scary taboo subject. Useful reminder about recognising young people's invitations to talk about suicidal thoughts and feelings I feel I would know how to make a child feel safe when making sensitive disclosures but also how to ensure my own professional and personal safety. I also feel that I could direct them to appropriate support. It was very illuminating to know that asking directly if someone felt suicidal or had suicidal thoughts did not put these ideas in their head. I have worked with young people for a number of years now and to have the extra support through the course and additional services I was made aware of I feel better equipped to support the students I work with. It was also good to be in an environment where we could share good practice with other agencies and pick up tips from other professionals, also to validate what I already do. 4
Q4: After the training do you feel more comfortable talking about selfharm and suicide? Please expand on your answer: If you have some knowledge you feel more confident to be able to talk about this subject. If you don't talk about it may increase the chance of the client harming themselves. I am aware I can speak plainly about these topics without fear of causing harm. I feel that in our setting, it is no longer a 'taboo' subject and we are supported in discussing any concerns Suicide and self-harm, particularly self-harm are on the 'taboo' scale of issues that people generally do not wish to talk about. Suicide destroys families and is considered a selfish act by many, with the consequential 'if only we could have done more' scenario being talked about, rather than spotting the early signs if at all possible. And with Self-harm; it is such a private, inward, introvert act of dealing with emotional issues that it is not likely to get openly discussed by those effected. Now, I am more equipped to talk about these issued freely when needed. I felt that I might embarrass students by mentioning self-harm but now believe they might feel relieved to talk about it with someone who does not judge them. Listening to other people s experiences was helpful. Thinking about being helpfully nosey helps a lot. 5
Q:5 Are you now more confident asking directly about thoughts of suicide? Please expand on your answer I am not afraid to talk about suicide and raise the question of self-harm. I know I will not "put the thought" in the person's mind by speaking of it. Training reinforces the facts that talking about it does not make it more likely to happen I feel I would be but have not been in this situation to actually do this yet My approach was enhanced by using more appropriate language. It was good to hear of other people s experiences and now have more knowledge about where I can signpost clients to for further information and the options of what other services are available for support 6
Q.6: Are you more aware of the pathways and resources which are available both locally and nationally? The leaflet information was very good. I am aware of appropriate services and organisations to signpost to. I wasn't aware of some of the resources available I keep the hand out with all the available supports in my diary I was less aware of the up to date pathways & support services. There is very limited support available to children and young people who have active thoughts and actions relating to suicide or self-harm within Cumbria. 7
Q7: Do you think there has been any change in your behaviour /practice since attending the course? Yes, don't be frightened to ask the questions you want to ask. Before I might have been frightened to ask in case I put the thought into their head, now I know through research that's not true. When interacting with young people especially I am more aware of their mental health issues and will listen to their concerns more readily. I tune in more on the topic in the media Continuing same but affirmed and more confident I have an increasing confidence to discuss concerns with colleagues as I am aware of some of the support available. I feel more confident in addressing the issue of self-harm More helpfully nosey I feel more Mental Health First Aid is a step in the right direction, but then 'what next or who next?' CAMHS support is incredibly hard to access, unless a child or young person actually harms themselves. Yes, I now know that cannot 'fix' the person and just by listening to them that this can help. The language I use has improved and I am more confident when I have to have these difficult conversations with students and parents/carers 8
Q.8: Do you have any impact examples of how your knowledge /understanding has affected your behaviour in any situation or any other example where you have used this in working with a young person? I am not afraid to ask direct questions I haven't dealt with this situation since the training I was able to ask a young woman directly if she was having thoughts of self-harm in a recent situation and that she could be frank with me. I have asked them directly if they have self-harmed or had thoughts or attempts at suicide. I was able to refer these children to the right professional from this. I have recently dealt with an anti-social behaviour case where the victim's teenage child was self-harming. this helped me better to understand the issues and to deal with the case in a more sympathetic way than I would have previously. My daughter self-harms and I can see this in the light of the bigger picture. It has helped me on a personal level to feel less alone I still feel I have a limited resource to practical resources to support young people. But if I do then I'm stepping over the 'First Aid' threshold and into mental health support, which is not my role, but there are no other agencies to refer to. 9
Q.9: Are there any other actions you have put into practice (or plan to) as a result of the training? I have shared the material provided on self-harm with colleagues. Encourage other members of staff to talk about it openly Just my vocabulary and toolkit of knowledge Training for my staff team- 20 people, organised for January Keep speaking out about the fact that although there are NICE guidelines for Mental Health support for young people in Cumbria they appear to be ignored as they are only 'guidelines'! Q.10 Any improvements you could suggest? No, I found the course to be very informative and it has been of great help. No, good, informal presentation with not too much PowerPoint. Keep doing what you do! No, very enjoyable informative day Non that I could think of Significantly improve resources in Cumbria regarding mental health support for childrenand young people. Implement the NICE guidelines in the County. Develop the 'what's next' step following any First Aid provision. In physical health there is GP or A&E, there is a dearth of similar practical support for Mental Health for children and young people. Q.11 Any further comment? Thank you for running the course and helping raise awareness. Even though my knowledge on the subject was quite good I learnt more about what support is available which is always of value. it was valuable training that can save lives. Good trainers and relaxed format. 10
Appendix all responses Q3: After the training, do you feel more confident in talking about self-harm and suicide? I am armed with more information and contacts in the form of leaflets and phone numbers if I need to have them. I feel more confident in being able to talk to people about suicide and help people who are suffering from self-harm. I am more confident in my ability to safeguard people who are self-harming or having suicidal thoughts by putting appropriate measures in place. I now know how important it is that people should talk about the issues they are facing so that help can be provided. Before the course I would struggle to stay calm about the subject matter - now I see it is best to talk about things - not a scary taboo subject. It wasn't something that I had a problem with before but it always helps talking about it when your knowledge is good. Talking about self-harm and suicide is necessary and important to help those suffering with their mental health. increased knowledge gives increased confidence I'm aware that it's ok for me to be frank and speak openly about people's problems. Confirmed some information that I already knew and continued to build on that knowledge which increased my confidence Useful reminder about recognising young people's invitations to talk about suicidal thoughts and feelings I feel I would know how to make a child feel safe when making sensitive disclosures but also how to ensure my own professional and personal safety. I also feel that I could direct them to appropriate support. I have worked in adult mental health for the past 26 years and have supported both in my work capacity and personally the training put my knowledge of adult mental ill health into perspective and gave me insight into issues for young people. it was really helpful in my work which has changed from adult and small child to include up to the age of 19yrs. It was very illuminating to know that asking directly if someone felt suicidal or had suicidal thoughts did not put these ideas in their head. Having worked in housing over 25 years and having been aware of most issues; self-harm and suicide is not a subject that I had previously come into contact with, especially in young people. I had been aware of a number of people that I knew personally who had taken their own lives sadly, so that provided me with a more personal perspective. The 11
course has helped with awareness, with a wider knowledge of this issue and to prepare me for dealing with such issues in my working life. I have more of a background regarding who is affected and the issues surrounding it. The only gap to me is how to help people with these issues, there was less information on this. It is always a difficult subject to raise but the course gave me more confidence to raise it anyway, even if the person had not had that ideation. Greater understanding of the issues I have worked with young people for a number of years now and to have the extra support through the course and additional services I was made aware of I feel better equipped to support the students I work with. It was also good to be in an environment where we could share good practice with other agencies and pick up tips from other professionals, also to validate what I already do. Q4: After the training do you feel more comfortable talking about self-harm and suicide? If you have some knowledge you feel more confident to be able to talk about this subject. As per previous answer. People need to talk so that others can understand how they are feeling and we can offer support. It has made me see that just by raising the issue will not cause a person to harm themselves. If you don't talk about it may increase the chance of the client harming themselves. I am aware I can speak plainly about these topics without fear of causing harm. already felt comfortable talking about this subject I know that I should not be afraid to ask questions about self-harm and suicidal intentions. I feel that in our setting, it is no longer a 'taboo' subject and we are supported in discussing any concerns As previous I now feel it is not a taboo subject Suicide and self-harm, particularly self-harm are on the 'taboo' scale of issues that people generally do not wish to talk about. Suicide destroys families and is considered a selfish act by many, with the consequential 'if only we could have done more' scenario being talked about, rather than spotting the early signs if at all possible. And with Self-harm; it is such a private, inward, introvert act of dealing with emotional issues that it is not likely to get openly discussed by those effected. Now, I am more equipped to talk about these issued freely when needed. I feel I have more confidence to provide detailed information to colleagues. 12
13 CYP Self-Harm & Suicide Alertness 3-month survey report I felt that I might embarrass students by mentioning self-harm but now believe they might feel relieved to talk about it with someone who does not judge them. Listening to other people s experiences was helpful. Thinking about being helpfully nosey helps a lot. As previous I feel more confident about talking about self-harm because I know how to word things properly Q.5 Are you now more confident asking directly about thoughts of suicide? I have learned that it is good to listen to people if they feel they need to talk about this subject and not to judge them. I would not feel uncomfortable asking direct questions It is only by directly asking the question you know how serious the situation is. I am not afraid to talk about suicide and raise the question of self-harm. It wasn't a problem before the training I know I will not "put the thought" in the person's mind by speaking of it. was already confident in doing this. The training was affirming of my own understanding Training reinforces the facts that talking about it does not make it more likely to happen As previous I feel I would be but have not been in this situation to actually do this yet Having had some previous of knowing 3 people who have taken their own lives and the impact it has had on their family & friends, and also having attended the training which joined up some of the dots in between has given me more confidence in talking about it dealing with it. feel I am unlikely to say the wrong thing As stated already My approach was enhanced by using more appropriate language. It was good to hear of other people s experiences and now have more knowledge about where I can signpost clients to for further information and the options of what other services are available for support Yes, because I know about the different emotions and the symptoms of suicide thoughts Q.6: Are you more aware of the pathways and resources which are available both locally and nationally? The leaflet information was very good. I am aware of appropriate services and organisations to signpost to. At the training in our pack we were provided with a Mental Health Resources sheet with a list of contacts available.
We were given info on what is about locally and info on a place that gives out kits - for a safer way to self-harm. I wasn't aware of some of the resources available I have kept all the notes and handouts for future reference I know about mental health referral agencies Could do more work around this. Aware of the services in Carlisle. I keep the hand out with all the available supports in my diary The training helped to sign-post help and advice I feel I need a bit more information on this as it isn't clear. The reality is that there is little support available locally I was less aware of the up to date pathways & support services. yes - Kooth was new to me There is very limited support available to children and young people who have active thoughts and actions relating to suicide or self-harm within Cumbria. Previous answer I know about the different organisations that you can go to if you need help or if you are feeling suicidal. Q7: Do you think there has been any change in your behaviour /practice since attending the course? Not necessarily When interacting with young people especially I am more aware of their mental health issues and will listen to their concerns more readily. Yes, don't be frightened to ask the questions you want to ask. Before I might have been frightened to ask in case I put the thought into their head, now I know through research that's not true. Yes. Not really No as of yet I tune in more on the topic in the media Mainly in the way I speak to people. Continuing same but affirmed and more confident Yes, I am not afraid to ask questions, especially related to suicidal thoughts. I learnt that just because you speak about this does not mean that you could be putting these ideas in their head if they were not already there. Useful reminder to always be aware when in contact with troubled young people 14
I have an increasing confidence to discuss concerns with colleagues as I am aware of some of the support available. No. I am always understanding to the person s needs. I might be more aware and look for other signs I feel more confident in addressing the issue of self-harm I have been more aware of these issues, and knowing what to look for in my day to day work. more awareness and confidence Yes More helpfully nosey I feel more Mental Health First Aid is a step in the right direction, but then 'what next or who next?' CAMHS support is incredibly hard to access, unless a child or young person actually harms themselves. Yes, I now know that cannot 'fix' the person and just by listening to them that this can help. The language I use has improved and I am more confident when I have to have these difficult conversations with students and parents/carers To be more understanding with people who are upset because you don t know what has happened behind closed doors Q.8: Do you have any impact examples of how your knowledge /understanding has affected your behaviour in any situation or any other example where you have used this in working with a young person? Nothing to date. I often come across young people with cuts/scratches/bandages on their arms I am not afraid to ask direct questions I haven't dealt with this situation since the training not at the moment no I was able to ask a young woman directly if she was having thoughts of self-harm in a recent situation and that she could be frank with me. I have asked them directly if they have self-harmed or had thoughts or attempts at suicide. I was able to refer these children to the right professional from this. Not yet 15
I have recently dealt with an anti-social behaviour case where the victim's teenage child was self-harming. this helped me better to understand the issues and to deal with the case in a more sympathetic way than I would have previously. My daughter self-harms and I can see this in the light of the bigger picture. It has helped me on a personal level to feel less alone No specific examples so far. I still feel I have a limited resource to practical resources to support young people. But if I do then I'm stepping over the 'First Aid' threshold and into mental health support, which is not my role, but there are no other agencies to refer to. I haven t yet experienced this with a person yet. Q.9: Are there any other actions you have put into practice (or plan to) as a result of the training? Thankfully not so far. I have shared the material provided on self-harm with colleagues. Encourage other members of staff to talk about it openly No Sharing knowledge with colleagues, relevant school staff as appropriate Just my vocabulary and toolkit of knowledge I have since moved jobs; however, this may still be useful by looking out for the signs of self-harm. Nothing that I can think of; just be more aware. These issues are more on my radar than they were previously. Training for my staff team- 20 people, organised for January Not so far Sharing information Keep speaking out about the fact that although there are NICE guidelines for Mental Health support for young people in Cumbria they appear to be ignored as they are only 'guidelines'! Q.10: Any improvements you could suggest? None No, I found the course to be very informative and it has been of great help. 16
No No, good, informal presentation with not too much PowerPoint. Keep doing what you do! None No, very enjoyable informative day Non that I could think of more information on local help More training for a wider staff group across college perhaps CYP Self-Harm & Suicide Alertness 3-month survey report Significantly improve resources in Cumbria regarding mental health support for children and young people. Implement the NICE guidelines in the County. Develop the 'what's next' step following any First Aid provision. In physical health there is GP or A&E, there is a dearth of similar practical support for Mental Health for children and young people. Would have liked to have received a certificate to show that I attended the training. No, it was a good training day Q.11 Any further comment? Thank you for running the course and helping raise awareness. Even though my knowledge on the subject was quite good I learnt more about what support is available which is always of value. it was valuable training that can save lives. Good trainers and relaxed format. No - thank you for the training. No No 17