El desarrollo de la normativa y su aplicación en el sector de la construcción

Following consultation with key stakeholders to determine the requirements, the project team were given the task of collating information that would be useful for a universal level service provider when working with a young person who self harms or is feeling suicidal. The key themes collated for a series of work force consultation events are presented below. These were used as a framework around which the structure of the resource was developed.

The resource was developed using the available evidence base and included a section on implementing good practice guidelines and a resource to help the service provider remain engaged with the young person. A problem solving cycle was presented as an easy to use resource with a favourable evidence base when applied to working with a young person who self harms or is feeling suicidal. Guidance was also included with regard to when Child and Adolescent Mental Health Service input may be required, or safety concerns about the

young person’s wellbeing are raised.

This was presented to key stakeholders (identified in the introduction) and through a process of negotiation the resource was agreed and is due for distribution to key universal service providers.

Staff Consultation Event: Collated themes

On the 4th October 2012 Celeste Foster and Gillian Rayner facilitated three one hour consultations with staff. 15 members of staff attended from the following settings;

Rights and participation Community colleges CAMHS

Youth offending services Family First

Self assessment team Social care

CID KOOTH

Staff were encouraged to network and this seemed a really important aspect of the sessions as they were able to spend time with staff from other services that they may be referring

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young people to. The staff were asked about their experiences working with young people who self harm and any challenges or dilemmas. Then they were also asked about which information would be useful to themselves and their teams and also which format this could take and if there were any other issues they would like to discuss.

Each group was typed up separately and then the following key themes emerged. Generally the groups agreed over most of these.

Box 4. Key Themes from Practitioner Consultation Events

 Staff thought that generally young people and staff needed to understand that self harm was "nothing to be ashamed of" and that they were "not alone"

 Staff need to recognise the importance of being the first person that the young person may have spoken to about this issue, regardless of workplace setting. They also need to be confident that they can listen and talk to the person without making things worse. They need to understand when they need to refer on and when they can just help in their current relationship.

 Staff need to understand why people self harm and which questions to ask using the correct language. Some clear questions to ask would be useful.

 Staff need help with decision making, what to do next.

 Staff need to understand that self harm and suicide are different and how to work out if the person is suicidal.

 Staff need to understand what services are available and also what an appropriate referral is for that service. They need to understand that self harm doesn't mean that the person has a mental illness or needs to be referred to CAMHS services. Staff need to know what a mental illness and personality disorder is and which services will help. They need clear referral routes and to understand the health Tier systems.

 Staff need to know definitions of self harm, examples and also what the research/ literature recommends.

 Staff need to be able to understand that repetition of self harm is not personal or means that the service has failed, but that this is the persons coping strategy. Also repetition does not mean that the person has a mental illness.

 Staff need supportive compassionate management who do not immediately blame the staff. The staff need space to reflect on their reactions and think about future interventions or responses.

 The staff need to know if to involve parents or not.

 Staff need a phone line to CAMHS where they can ask questions about referral and also hopefully gain some support on managing risk in other services.

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The staff consulted all agreed that a pocket sized laminated z card would be useful. They would also like a web resource but recognised the problems with this. They compromised on having an emailed version of the card that could be printed out in future. They also liked the idea of having further reading, such as a summary of the literature review and suggested further reading. This could also be emailed around to the staff.

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Chapter 3: Reflective Learning Sets