Confidentiality & Duty of Care
Knowing what to do if a member of staff is suicidal or self harming is a legal requirement for your business.
In most situations the conversations you have with someone are confidential. However, the only situation in which you can, and in fact must break confidentiality, is when they there is a risk to themselves and/or others. You will need to share information with the appropriate people/agencies.
For example: they disclose they have self-harmed or you observed indications of self-harming, they have said that they are suicidal or are at risk of hurting themselves or others.
If there is immediate risk to life, you then have a duty of care and must call 999 for the immediate presence of a medical professional and ALWAYS stay with them until help arrives, even if they want to go to the toilet.
It’s important to note that whilst asking someone you suspect may be self-harming or suicidal the direct question, “Are you self-harming?” or “Have you been suicidal?”, is part of your Duty of Care to protect that person and others, it must only ever be done whilst you are face-to-face with them.
If you are working remotely and suspect that person may pose that immediate risk to themselves or others, you can call 101 and raise a “Welfare Concern” for a professional from the appropriate authorities to visit their house and ensure the relevant support is put in place as well as making your HR or People Team aware so they can contact their Emergency Contact.
Self Harm & Self-Injury
Self-injury or Self-harm can be a difficult thing to deal with, so feel free to reach out to us if you have any questions. Remember, if you think that someone is at risk it’s okay to break confidentiality to speak with appropriate people or agencies about the situation.
Self-injury or Self-harm is typically defined as purposeful, physical harm to oneself. There are lot’s of different reasons why someone begins and continues to self-harm but it is typically used as a way of coping with complex and intense emotion.
It’s not about attention seeking but it is to transform those difficult to cope with emotions into something that is physical.
Self Injurious Behaviour
Self-injurious behaviour is slightly different to the physical action of self-harming. This is where someone engages in activities that can purposefully put themselves in harms way. This could include purposefully taking drugs and alcohol out of moderation through to walking too close to a road or driving without a seat belt. If the intent is to potentially cause themselves harm, this can be seen as self-injurious behaviour.
Signs of Self-Harming/Injury or Self Injurious Behaviour
There are a variety of signs that can pose a risk that someone may be self-harming. Some of these could be;
- unusual scarring and burns or unexplained injuries
- wearing long sleeves in hot weather where they typically wouldn’t
- keeping sharp objects nearby – you might in an office situation notice them taking scissors into the bathroom or noticing unusual/a lot of sharp objects in a drawer
- unusual behaviour that can be a suggestion of something else going on
- becoming withdrawn, irritable and lacking interactivity
- being sick frequently and sweating and shaking can be signs of alcohol and drug abuse.
Identifying & Supporting a Suicidal Employee
There are many reasons why someone may be suicidal, whether it’s the anniversary of a traumatic life event or a series of negativity in their lives. Knowing how to spot it and what to do about it at work is key to helping that person get the help they need.
Any of the following could be potential warning signs for suicide:
- Excessive sadness which is long-lasting including potential mood-swings or out-of-the-blue severe aggressiveness
- Appearing hopeless, maybe displaying a deep sense of hopelessness about the future without a view of it improving
- Excessive sleep problems
- Sudden calmness or peacefulness – following a period of depression or mood swings, this calmness or peacefulness could be a sign that the person has made a decision to end their life
- Withdrawal – Choosing to be alone and avoiding friends or social activities also are possible symptoms of depression, a leading cause of suicide. This includes the loss of interest or pleasure in activities the person previously enjoyed
- Changes in personality and/or appearance – A person who is considering suicide might exhibit a change in attitude or behaviour, such as speaking or moving with unusual speed or slowness. In addition, the person might suddenly become less concerned about their personal appearance.
- Dangerous or self injurious behaviour – Potentially dangerous behaviour, such as reckless driving, engaging in unsafe sex, and increased use of drugs and/or alcohol might indicate that the person no longer values their life
- Recent trauma or life crisis – A major life crises might trigger a suicide attempt. Crises include the death of a loved one or pet, divorce or break-up of a relationship, diagnosis of a major illness, loss of a job, or serious financial problems
- Making preparations – Often, a person considering suicide will begin to put their personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up their room or home. Some people will write a note before committing suicide. Some may buy preparation means like poison or rope
- Threatening or talking about suicide – From 50% to 75% of those considering suicide will give someone like a friend, relative or colleague, a warning sign. However, not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it.
Treat every threat of suicide seriously and take decisive action.
If you pick up any of the signs, ask them…”Have you been self-harming?” and “Have you thought of self-harming?” or “Are you suicidal?”
- It is important to only ask these in a face-to-face situation in case the answer is yes
- If they disclose that they are self-harming or suicidal, they need to be seen by a professional straight away
- If you feel that they are under any immediate risk to themselves or others, and you are not face-to-face call 999 and raise a “Welfare concern” for a professional from the appropriate authorities to visit their house or come to see them with you to ensure the relevant support is put in place
- Do not leave them alone, even for a toilet visit, call 999 and explain the situation
- Be supportive, reassuring and non-judgemental by keeping them informed of what actions you have to take to ensure they are supported properly
- Do not say to them that they should stop self-harming, that it is attention seeking or that they should think of you as family
- They may need the on-going support of a first aider internally until they have built healthier coping strategies with healthcare professions to a point where they are at less risk and self-managing
- Inform the HR or People Team – they will need to let their emergency contact know
- You may want to move to a different area in order to respect their privacy, away from the main office, for easy access for the medical professionals and be mindful that you MUST STAY WITH THEM AT ALL TIMES, until the medical professionals arrive.
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