Supporting improved responses to self-harm: A reflection and improvement tool

Supporting improved responses to self-harm: A reflection and improvement tool

About this tool

This tool is designed to help leaders consider and support local improvement in response to self-harm, in line with the Scottish Government and COSLA Self-Harm Strategy and Action Plan.

In this context ‘a leader’ refers to someone, regardless of formal role or authority, who is working to improve practice in relation to self-harm. This includes professionals across sectors such as, education, social work, health and social care, policing, training and development, service management and strategic planning. This is in recognition that making change requires a shared commitment across the system, with clear goals and collaborative working.

The tool provides high level reflective questions to encourage consideration of self-harm across relevant professions and structures. It does not set out a national standard (e.g. a standardised set of reporting, evaluation tool or methodology everyone must use in the same way) as we recognise the need for flexibility for different professionals and services. The tool draws specifically on the principles of Time, Space, Compassion and trauma informed practice, recognising these as supporting positive interventions, both at the time they take place, and in preventing re-traumatisation supporting future engagement with services.

The tool was co-developed with the SHAPE group, which includes people with lived experience of self-harm and services that support them.

How can it be used?

The tool aims to help leaders to undertake a rapid, high-level assessment of their local practices related to self-harm and help identify manageable, meaningful improvement which supports compassionate, recovery-focused support, without fear of stigma or discrimination. It is structured around the 3 priorities from the national strategy and encourages thoughtful reflection through guided questions. We estimate it should take 30 minutes to complete and should be repeated annually, or as appropriate aligned to local review and improvement processes.

It can be used:

• individually or in teams
• jointly, across professions to collectively consider joint/joined up responses recognising the importance of joint work and consistent approaches. This approach is encouraged
• as a stand-alone tool or alongside existing improvement frameworks
• as part of regular reviews, planning meetings, or learning and development sessions

Partnership Working

The value of joint work in supporting improvement is recognised and consideration of responses to self-harm at a partnership level is encouraged. However, it is acknowledged that the full level of detail within the questions provided may be challenging to consider across partnerships and some single agencies may have and require different levels of knowledge. Those utilising the tool are encouraged to do so in the way that best supports their work and high-level questions have been highlighted within the document that partnerships may wish to focus on.

Key messages

• anyone who has self-harmed or is thinking of self-harming, should receive compassionate, recovery-focused support, without fear of stigma or discrimination
• all public services that support people, can play a role in achieving this by considering how they respond to self-harm
• evidence on self-harm is limited and continues to develop. However, current evidence suggests the following groups may be at increased risk:
  • young people (especially young women)
  • neurodivergent people
  • LGBT+
  • care experience
  • experience of the justice system
  • people with severe or enduring mental illness
  • people with experience of trauma or Adverse Childhood Experiences
  • areas of deprivation
• barriers that may limit access to services include previous experiences of stigma or discrimination, and language barriers

Next Steps

Based on your answers you might want to consider:

• identifying one or two priority areas for improvement based on your reflections
• involving colleagues, communities, including people with lived experience in reviewing current practices
• create a plan to monitor and embed improvements, ensuring this accounts for developing evidence on self-harm and appropriate responses, recognising the evidence base around self-harm is limited and evolving