Staff from 153 schools in Wales and South-West England took part in a survey consultation to gather information on schools’ experience of students who self-harm, including self-harm provisions and barriers to addressing self-harm. This was followed by focus groups in eight schools to explore these issues in more depth.
The survey revealed that schools do not have a common or unified approach towards dealing with self-harm, but instead employ a variety of ad-hoc strategies including applying first aid and informing their safeguarding lead. 81% of survey respondents listed inadequate staff training as a barrier to addressing self-harm, and 79% said a lack of time in the curriculum was a problem.
Staff also expressed fears that delivering a specific programme on self-harm might encourage more students to self-harm by ‘putting ideas in their head’. The potential negative impact of social media on self-harm was another concern. The majority of staff said that they would rather focus on mental health promotion programmes, as they felt that positive mental health and wellbeing would prevent the onset of self-harm.
When students do self-harm, those that school staff consider to be in need of specialist intervention do not always meet the thresholds for access to specialist services such as Child and Adolescent Mental Health Services (CAMHS). Many staff reported feeling under-equipped to manage the young person while waiting for specialist treatment.
Dr Astrid Janssens, one of two Principle Investigators on the project, said:
"As campaigns are encouraging people to open up and talk about mental health, we also need to be teaching people how to listen to them. Teachers feel they are not confident or competent to deal with a young person who is self-harming, but they are often in a position to help just by being available to listen.
"There is work to be done in helping teachers to feel able to support those young people who may be self-harming but don’t meet the threshold for referral to CAMHS."
Self-harm and suicide in young people are important mental health priorities which share common risk factors. A recent University of Bristol study found that nearly two out of ten 16-17 year olds self-harmed. Meanwhile World Health Organization data indicates that suicide is the second leading cause of death for 15-29 year olds. The need for evidence-based support for self-harm and suicide in young people has never been more vital.
Based on the survey findings, the research team recommended that self-harm training should be mandatory for all school staff, include specific policies about what to do if a young person self-harms, and empower staff to feel able to ask a young person if they are self-harming as part of a supportive, non-judgemental conversation.
Provision of more mental health specialists in schools is needed, the research reports: counsellors are seen as one of the most helpful in-school resources but they are often over-burdened with cases.
The study highlighted an urgent need for evidence about ‘social contagion’ in self-harm, to reassure schools that prevention and awareness activities can be safely implemented.
Dr Janssens said:
"I was quite surprised by how difficult teachers found it to talk about self-harm – there’s this myth that if you mention it to students, they will engage in it. The same was said of suicide in the past, yet today there’s clear evidence that asking questions and showing compassion is the best way to help someone who is thinking of killing themselves. Naming the behaviour and sensitively addressing its cause is much better than talking around it."
The collaboration has recently secured an ESRC-funded PhD studentship to progress the learning from the GW4 consultation, and to find out how young people and staff feel that schools’ practices and policies influences self-harm.
In their final report, the team made recommendations for policy changes in CAMHS and other specialist services, the Department for Education and the Department of Health. Specialist services should advise schools of the threshold for service access and signpost them to alternative sources of help for young people whose difficulties do not meet treatment thresholds.
GPs should be more aware of self-harm, and should take on the responsibility of referring a young person to CAMHS rather than sending families back to schools to ask for a referral.
Find out more about the recommendations and the project findings on the Self-harm and Suicide in Schools project page.