Self harm strategy and action plan 2023 to 2027

Action Plan

Priority 1: Continue to expand and deepen knowledge and embed compassionate understanding of self-harm and tackle stigma and discrimination.

1. Provide learning for people, communities, services and healthcare settings using existing networks and building upon the bespoke self-harm resources^[22] already created which align with Trauma Informed and Time, Space, Compassion approaches. Our learning priorities will:

a. Provide information and increase compassionate understanding about self-harm

b. Dispel myths about self-harm

c. Challenge stigma and discriminatory practices

d. Increase compassion and confidence in responding and supporting someone who has self-harmed in a non-judgemental way

e. Share information about online aspects of self-harm including the role and influence of online platforms in the lives of those who self-harm, supports available, unique risks posed, and ways to manage risk

f. Promote the uptake of wellbeing support for people who care for someone who has self-harmed.

2. Explore further opportunities to include safe and evidence-based self-harm learning content and materials in:

a. Core training and continuous professional development for key professional groups

b. Schools and further and higher education

c. Parenting and family support programmes and resources.

Priority 2: Continue to build person-centred support and services across Scotland to meet the needs of people affected by self-harm.

1. Work with key partners, including with people with diverse lived experience, to tailor and disseminate national resources and support to ensure they effectively reach communities who are at higher risk of self-harm. This work will support local approaches and seek to tackle stigma and discriminatory practices. There will be an initial focus on:

a. Children, young people and families, including care experienced children and young people.

b. Marginalised groups where self-harm may be more prevalent, initially LGBT+ and neurodiverse people.

c. People who may face additional barriers to getting the help they need. For example, people experiencing trauma and those with severe and enduring mental illness.

d. People in higher risk settings, (such as, care experienced children and young people, people in prisons, or those experiencing homelessness.)

2. Share and encourage uptake of self-harm resources and support, including online and peer support. We will give specific consideration to people who support someone who self-harms, in whatever their role, with an initial focus on:

a. Informal support networks including friends and family members such as, parents and carers, and partners

b. Staff and volunteers who are likely to provide self-harm support to someone though the course of their work.

3. Continue to build compassionate responses for people accessing clinical services (including as part of assessment and treatment).

This will include:

a. Working with first responders, for example emergency services and unscheduled care, and staff working in other healthcare settings such as, primary care, mental health services, liaison psychiatry, and the Child and Adolescent Mental Health Service (CAMHS).

b. Providing evidence and support to services to embed the NICE/NCISH self-harm guidelines and recommendations, relevant to the Scottish context. This could include psychosocial assessments, safety planning, provision of psychosocial interventions and psychological therapies in line with the Psychological Therapies Matrix. This will ensure that people in suicidal crisis are identified early and provided with appropriate support.

c. Providing specialist support and interventions for those with severe and enduring mental illness and more complex needs, through interface services such as liaison psychiatry.

d. Investigating opportunities to improve post self-harm care to address medical and broader health and wellbeing needs resulting from self-harm.

4. Encouraging all partners including people with lived experience, to work together to provide person-centred and compassionate care with a focus on recovery. To achieve this we will:

a. Develop a professional ‘self-harm community of support’ that provides opportunities to make connections, share good practice and learning between communities, various settings and healthcare services. This will include hosting a self-harm conference and taking action to grow the existing self-harm network.

b. Encourage cross-sector communication and collaboration between support organisations and service partners. This includes with services and settings that support people who engage in other forms of health-harming behaviours (that might be considered self-harm) for example, eating disorders, substance use, alcohol use and gambling.

c. Use GIRFEC and GIRFE tools to support multi-agency approaches, where relevant.

d. Identify and open up opportunities for practitioners to inform relevant national and local policies to strengthen links and share learning and good practice.

Priority 3: Review, improve, and share data and evidence to drive improvements in support and service responses for people who have self- harmed, or are at increased risk of doing so.

1. Identify what data (including equalities data) is routinely collected on self-harm across a range of settings (e.g. primary care, secondary care, unscheduled care, social care, justice and education) and identify what is missing and seek ways to improve this: This could include:

a. Scrutinising the quality and relevance of the data collected.

b. Establishing how this data is currently being used and whether there is transferable learning that can be used for other settings.

c. Identifying what data and evidence is missing about self-harm and seek ways to improve.

2. Take steps to gather existing and new data and evidence on self-harm to improve support and service responses for people. This could include:

a. Identifying existing and new research and learning on self-harm, ensuring this is shared and incorporated into support and service practice, where relevant.

b. Exploring early intervention approaches and investigating what support would be beneficial to people considering self-harm, (i.e., to prevent first episode of self-harm or reduce repetition of self-harm).

c. Continuing to identify what factors put people at increased risk of self-harm and what can be done to mitigate risks and increase help-seeking with a specific focus on racialised and other marginalised communities.

d. Continuing to improve understanding of self-harm within the digital landscape including how online platforms are accessed as a means of support and their role in the lives of those who self-harm. Build awareness of their potential to increase risk, and the mechanisms driving harmful impacts. Monitor the use and impact of the Online Safety Act 2023 self-harm offence as a means to keep people safe from harm.

e. Using learning from the Self-Harm Network Scotland to inform developments in peer and online support.

f. Investigating if self-harm can be a barrier to accessing support and services and what measures can be taken to overcome these barriers.