To guide child protection workers in responding to children, young people and adults with suicidal thoughts and behaviours, and those who self-harm.
PMH Emergency Department Contact Process for Children in CareAcute Response Team - Referral Pathway
Suicide is where a person has died as a result of a deliberate act to cause his or her own death.
Child protection workers will have contact with children, young people and adults who express suicidal thoughts and behaviours. All suicidal thoughts and behaviours must be taken seriously, assessed and appropriately responded to.
Children and young people in the CEO's care or who otherwise come into contact with us may have increased suicide risk factors, given their life experiences, and the potential for cumulative harm from physical, sexual, psychological and emotional abuse, and/or neglect.
An imminent risk of suicide may include one or more of the following:
Refer to the Suicide Information Sheet and Suicide and Aboriginal People (in related resources) for more information on suicide risks.
Particular times child protection workers should be mindful of suicide concerns include when:
Some funerals or Sorry events may be conducted with high levels of alcohol and drug misuse and the Aboriginal practice leader can advise on relevant family and community considerations relating to the event. This provides critical contextual information for decision making when balancing child safety with cultural considerations and obligations.
If contacted about a child or young person’s suicidal thoughts or behaviours, child protection workers should:
Personal Levels of Concerns About Suicide (in related resources) outlines specific questions that can be used to assist with the above process. This document can also assist with:
The team leader must be informed if a child or young person expresses any suicidal thoughts or behaviours. The senior practice development officer, district psychologist, district director, and Aboriginal practice leader may also be consulted. In the absence of an Aboriginal practice leader, the AEC directorate can also be contacted.
Where possible an actively suicidal child or young person should be appropriately supervised while these processes are underway.
Child protection workers can assist children and young people to access a formal risk assessment through the following individuals and agencies:
The Aboriginal Medical Services (AMS) or other Aboriginal health service may also be able to undertake a risk assessment.
After an assessment, the child protection worker should work with the individual or agency who conducted the risk assessment, the team leader, district psychologist, district director, and where Aboriginal children are involved, the Aboriginal practice leader to determine next steps.
Child protection workers must be mindful of their safety and the safety of a child or young person when transporting them to a risk assessment. Wherever possible, two adults should travel in the car in the event the child or young person needs to be restrained. Doors should be centrally locked to prevent the child from attempting to jump from a moving vehicle. If the child is aggressive or impulsive do not transport but contact the Acute Response Team or police.
Suicide or Non-suicidal self-injury (self-harm) risk assessment for a child or young person who has an acute mental health episode
The Acute Response Team (ART) is a metropolitan service that operates 24 hours per day, seven days a week. The service conducts acute mental health assessments in emergency departments and community settings.
The ART can be a first response option when a child or young person is self-injuring or at suicidal risk and a child protection worker believes the child or young person requires immediate mental health assessment. The ART can be contacted on 1800 048 636.
Two flowcharts are available in related resources that step out the process:
Child protection workers must make appropriate referrals and check whether appropriate arrangements have been offered and followed up for children or young people with suicide concerns. If children are not in the CEO's care, permission must be sought from parents. Child protection workers should work in partnership with other agencies to assist them in developing plans to address a child or young person’s suicide concerns.
Refer to Mental Health Services for Young People in Western Australia (in related resources) and Chapter 4.2: Engaging with private practitioners for treatment/therapeutic services for information on services and supports available (in some cases, district psychologists will work therapeutically with a child or young person).
Child protection workers should also work in partnership with residential care workers, where relevant, to develop a Residential Care Service Safety Plan to address a child or young person’s suicide concerns.
If a plan is not in place to respond to a child or young person’s suicide concerns, the child protection worker should consider developing one, including:
If medical attention is required following a self-injury or suicide attempt, a medical practitioner should be involved to provide immediate attention or as part of review and follow-up.
Child protection workers should advise a child or young person’s parents of any suicide concerns, unless there is good reason not to (for example, when revealing the information could compromise the safety of the child).
Information sharing is critical for promoting the safety of children and young people in relation to suicide. Information sharing considerations are outlined below:
Parents and caregivers in contact with us may also be at risk of suicide. The suicide of a family member will impact on a child or young person’s wellbeing.
Child protection workers should consider and plan for the potential impact on vulnerable parents and caregivers when protective action is being undertaken. However, the safety of the child is the primary consideration and cannot be compromised due to a parent’s or caregiver’s threat of suicide.
Particular times child protection workers should be mindful include:
When working with parents and caregivers in these circumstances, child protection workers can:
If a suicide threat is made, child protection workers should:
If the child or young person is in the care of a parent or caregiver who is expressing suicidal thoughts or behaviours, child safety must be assessed. Refer to Chapter 1.4: Mental health issues for further information about working with parents with these concerns.
Once the immediate safety of a child has been achieved, the Signs of Safety Child Protection Framework should be used to identify appropriate next steps for the family.
Suicide can affect all involved. Child protection workers or other staff may feel traumatised by the event or feel guilty at not preventing self-injury or suicide. Knowing someone who has attempted or completed suicide is a risk factor for suicide. The district director must arrange appropriate supports for staff and carers.
Support available includes:
Staff - regular supervision, targeted debriefing activities, involvement of the district psychologist or Chief Psychologist, or the Employee Assistance Program.
NSSI (also referred to as self-harm) may be an issue for children and young people who are in contact with us. NSSI refers to the attempt to inflict physical harm to one’s self and is often done in secret. The intent behind self-injury is often different to suicide, but is a risk factor for suicide. Refer to Non-suicidal Self-injury and Suicide (in related resources) for more information.