Steps SI
What is step 1?
1 - Stabilize the situation
What is considered a low risk indicator?
Recent crisis or loss
Symptoms of depression (e.g. sleep and appetite disturbances, diminished concentration)
Loss of interest and energy, feelings of guilt or worthlessness)
Infrequent, vague thoughts of suicide
No specific plans for suicide
No access to the means for suicide
No known previous attempts
Has some interpersonal support
Evidence of hope or plans for the future
Willing to accept help
What are some symptoms of Suicide?
Withdrawing from social contact,wanting to be left alone, Having mood swings, being preoccupied with death, dying or violence, feeling trapped or hopeless, increasing use of alcohol or drugs, changing normal routine
What is self-injury?
Self-Injury (or self-harm) is deliberate, self-afflicted bodily harm done without suicidal intent and carried out to reduce or communicate psychological distress. It can include but is not limited to cutting, scratching, burning, picking skin/wounds, head-banging, hair-pulling and bruising.
Name 2 action steps when supporting a student displaying self-injury?
Stay calm & supportive, provide 1st aid, ensure student safety, validate feelings, listen, offer emotional support, use CPI training.
What is Step 2?
2 - Assess the Risk
What is considered a potential moderate risk?
Recent distress, crisis or loss
Symptoms of depression (e.g. sleep and appetite disturbances, diminished, concentration, loss of interest and energy, feelings of guilt or worthlessness)
High level of agitation
Delusions or hallucinations
Substance abuseSpecific and/or persistent thoughts of suicide
Has a plan for suicide
Has access to the means for suicide
Known previous attempts
Family history of suicide
No or little interpersonal support
Hopelessness
Impulsive or reckless
Change in mood or appearance
Making final plans, giving away prized-possessions, saying good-bye
Unwilling to seek or receive further help
What is one of the main factors in Suicidal Ideation?
Feeling like you can't cope when you're faced with what seems to be an overwhelming life situation.
What are some risk factors?
Mental health disorders including depression and eating disorders
Drug/alcohol abuse, and other risk-taking behaviour
Recent trauma e.g. death of relative, parental divorce
Negative thought patterns, and low self-esteem
Bullying
Abuse: sexual, physical and emotional
Sudden changes in behaviour and academic performance
Exposure to peers or social media about self-injury
Extreme agitation or rage and pattern of self-soothing through acts of self-injury
Once a student is regulated, what are your next steps?
Support completion of a “Preventing a Crisis” form (or reasonable adaptation) to identify alternative/healthier ways of coping, including identifying support networks, identifying triggers and improving environmental safety.
What is Step 3?
3 - Use appropriate risk procedure
What would be an example of a high-risk indicator?
If the student will not relinquish a dangerous instrument or suicide attempt is in progress and student will not stop and/or their life is in danger
What are some risk factors of Suicidal Ideation?
Having a psychiatric disorder, loss or conflict with close friends or family members, physical/ sexual abuse, alcohol or drug problems, becoming pregnant.
Reasons students might self-injure?
To communicate emotional distress
To cope with anxiety or depression
To cope with loss, trauma, violence, or other difficult situations
To turn emotional pain into physical pain
To feel ‘real’ and counter feelings of emptiness or numbness
To feel euphoria or natural rush of endorphins
To improve mood
To regain control of their bodies
People who self-injure are not trying to end their lives, but they can experience those thoughts. When they self-injure, they are trying to cope with difficult or overwhelming thoughts or feelings.
What would follow up include?
Report incidents according to Claro procedure, record incidents or reported incidents of self-injury on the appropriate incident form by end of shift, debrief with team, support follow through on plan to promote replacement behaviour
What is Step 4?
4 - Report
What is the first step if you assess a student at High Risk? What is the subsequent step?
Call TEAM, follow CPI training.
Subsequently, have another staff member call 911
What is Suicidal Ideation?
Thoughts, images, or actions which hinge around committing suicide.
What would be considered Direct Self-Injury?
Stereotypic self-injury
Repetitive, rhythmic, monotonous, self-stimulating behaviours (e.g skin picking, self-biting, head-banging).
Major self-injury
Dramatic acts that cause significant damage. Rare and tends to be an isolated incident.
Compulsive self-injury
Repetitive, compulsive, habit-driven behaviours (e.g. hair-pulling, skin picking, nail-biting, obsessive hand-washing).
Impulsive self-injury
Direct, intentional, means to cope with emotional pain. Common self-injury includes: scratching, interfering with wound healing (picking), cutting, carving, punching, bitting, burning, hitting.
What does reporting look like?
Complete an NCIR/CIR - within 24 hours
Inform PD immediately
Tell parent in person
Email Kleos teacher, CM within 12 hours
What is Step 5?
5 - Follow Up
Resource(s) for students to access support?
Crisis Line, Child and Youth Mental Health, Counsellor and/or Family Physician, Kids Helpline, other...
What would be considered Indirect self-injury?
Substance misuse
Eating disorders
Risk-taking behaviours
Support & Referrals?
MCFD, Family GP, CYMH, Kids Helpline,