Managing Customers Suicide and Self Harm Declarations – policy
framework for managers
Contents
Introduction
Background
Planning & Preparing Yourself and Your Staff
Actions & Responsibilities for Managers
Local Procedures
Additional support available for Jobcentre Plus, Customer Services
Directorate
Managing Customer’s Suicide & Self-Harm Declarations
What to do if a customer says they will harm themselves or kill themselves:
What to do in an Emergency:
What to do after an incident of declaration of intention to self harm or commit
suicide:
Declarations of Suicide & Self Harm - The 6 point plan
Referral and emergency support details
Useful Telephone Numbers
Introduction
This framework introduces a new policy for all DWP businesses, to help them
manage suicide and self harm declarations from customers.
Managers, in all DWP businesses who work with customers, are required to
develop suitable arrangements to suit their own working environments, to help
staff deal effectively and safely with customer declarations of suicide and self
harm.
The framework summarises the plans and procedures that must be in place,
as well as current best practice, advice and guidelines.
The framework will be subject to regular review to ensure it continues to meet
its objectives, as outlined above, and for continuous improvement purposes.
Management information will be collected from business managers
periodically, at a national level, to facilitate the review process.
Background
From time to time it is possible that a member of staff will hear a customer
make a statement of intent to harm or kill themselves. Declarations of this
nature can cause distress for those concerned, but there are some important
points a member of staff should know that can help resolution. Both the
distress and the chance of an outcome where everyone is safe are best
managed by being prepared and knowing in advance how to respond.
It is important to be clear that if a customer states they will harm themselves
they may well do so and our procedures and actions have to be organised
around that assumption.
For the member of staff concerned, the key to responding effectively is to plan
ahead so they know what to do before someone says they intend to harm
themselves. Systems, procedures, and responses need to be in place, ready
to apply to ensure an appropriate response.
There are two things to be considered:
1. What the response should be, and
2. The capability of the individual officers to respond appropriately
Planning & Preparing Yourself and Your Staff
Managers must consider the attached six point plan and decide what
arrangements will be appropriate in your office. This includes appropriate
responses for all face to face contact staff, telephony teams, any out-of-office
services, and for visiting staff. Some elements may not be appropriate but the
important factor is ensuring arrangements are in place that suit the individual
officer’s working environment.
Local procedures must be developed in consultation with your local trade
union side.
DWP staff are not counsellors. The aim is, by having suitable arrangements in
place, to help staff deal effectively and safely in these situations to achieve a
safe outcome for themselves and the customer.
Arrangements must also be put in place for a debriefing after the event to
provide the necessary support for the member of staff concerned.
Actions & Responsibilities for Managers
Local managers must determine:
The procedures to have in place to make the six point plan work. (See
Local Procedures Below)
The sources of advice to draw upon for help
How the plan is to be kept up to date, operational and communicated to
staff
Local Procedures
Local Procedures need to cover:
Staff training (initial and refresher) covering action to take at the time of
the incident (bearing in mind that intentions can be stated in writing, or
verbally), the local procedures that are in place and roles and
responsibilities. The training will vary according to the roles and
responsibilities agreed. DWP is not a counselling organisation, but
recognises that customers have varied needs and will seek appropriate
support for them.
A signalling system within the office: so the member of staff concerned
can summon support (the support partner) and trigger local procedures
whilst maintaining contact with the customer. This principle must be
extended to consider what action would be suitable in the event the
member of staff and customer are off-site (for example, in the
customer’s home).
The arrangements to ensure the member of staff dealing with the
customer has no further interruptions.
The arrangements to ensure the support partner is active in supporting
the member of staff. They will assist in assessing the nature of the risk
present and organising the relevant action according to local
procedures. They will also tactfully and unobtrusively monitor the
contact for the well-being of both the member of staff and the
customer. This frees the member of staff to gather relevant information
and give the customer their undivided attention. The support partner
will most likely be the line manager as they will be in the best position
to assist.
Additional support available for Jobcentre Plus, Customer Services
Directorate
Jobcentre Plus, Customer Services Directorate, because of their customer-
facing role, have District-office based specialist services available to support
staff in their day to day dealings with customers who have particular needs.
Their expertise can also be used to help staff deal effectively with customer
declarations of suicide and self harm and help managers formulate their six
point plans.
Jobcentre Plus Work Psychologist
In Jobcentre Plus offices, managers and staff may contact their District Work
Psychologist for support and advice around any vulnerable customer groups.
The Work Psychologist will provide specific advice and guidance around
individual customers that staff wish to discuss to ensure the welfare of that
customer, to support the adviser in what to do and to ensure referral to
appropriate services.
Work Psychologists may also be able to help managers to implement local
procedures, around this policy framework to help staff feel confident in
applying the principles and practice.
Possible options for expanding the role of the Work Psychologist beyond the
Jobcentre Plus Customer Service Directorate are being explored.
Mental Health Co-ordinators
A Mental Health Co-ordinator role was introduced in all Jobcentre Plus
districts from October 2009. The Mental Health Co-ordinator role is to:
Improve and facilitate links between local mental health and
employment services,
Identify the availability of local support (both internal and external) that
Jobcentre Plus advisers may signpost customers to
Provide a support role to Jobcentre Plus advisers (particularly New
Jobseeker Interview advisers) who are working with customers with
mental health conditions via regular team meetings, awareness
sessions etc
Influence local partners to consider whether the help currently available
for those with mental health conditions satisfies local needs and
encourage them to address any gaps or shortfall in provision.
Managing Customer’s Suicide & Self-Harm Declarations
Information and advice for Managers and Staff
What to do to anticipate risk of self harm or suicide:
The risk of a suicide declaration can sometimes be anticipated prior to
customer contact. The best information to help with this is a history of
previous attempts or previous stated intention. However incidents can
sometimes arise unexpectedly during the course of normal business. Local
plans and procedures will need to be fit-for-purpose for both eventualities.
Expressions of suicidal thoughts are common amongst the general
population. This does not mean that they are never serious statements of
intent.
It is a mistake to assume that suicide and mental illness are always closely
linked, they are not. While we can be fairly certain that those who attempt
suicide are distressed, we cannot assume that they are ‘mentally ill’ nor
should we assume that those who are mentally ill are at risk of suicide. Some
people who kill themselves have had no contact with mental health services.
Where contact is to be made with a customer having a known high risk of
suicide or self harm it is good practice to arrange for third parties to be
present – either a customer representative/relative and/or a specialist such as
Work Psychologist in Jobcentre Plus offices. Depending on circumstances it
may make sense to rearrange a home visit or a telephone contact to an office
based visit with the above third parties present.
Information you have on a customer before you see them may allow you to be
better prepared.
Where it is evident that customers stating suicide intent should be referred to
external specialists, local managers should determine the contact
arrangements and roles and responsibilities.
As part of the planning process for JCP Customer Services Directorate,
discuss with the Mental Health Co-ordinator the services that are available
locally in the District to support customers in these circumstances. These will
have identified as part of their mapping of mental health services function.
Record the access route into them.
What to do if a customer says they will harm themselves or kill
themselves:
Some customers may say they intend to self harm or kill themselves as a
threat or a tactic to “persuade”, others will mean it. It is very hard to
distinguish between the two and especially on the telephone. For this reason
all declarations must be taken seriously. The member of staff should follow
the six point plan to talk to the customer to find out how well formed their
plans are, if they have tried to harm themselves previously, and how imminent
is the intention.
If the discussion suggests there is a risk that the customer will self harm or
attempt suicide the customer should be encouraged to contact their health
related support: focus on ascertaining if the customer has a GP and strongly
suggest that they make an emergency appointment for today. Alternatively
advise them to contact their local Community Mental Health Team (CMHT) for
an assessment between 9.00am – 5.00pm. If there is an arrangement locally
offer to make contact for them.
The member of staff should establish if the customer is in contact with any
other services, or community based healthcare professional, or establish who
their main carer is, e.g., who they live with, who their friends are. This is
particularly important if the intention to self harm is made during a home visit.
Help them make plans to go and see their GP or healthcare professional.
With the customer’s permission you may contact these people on the
customer’s behalf.
This permission and action should be recorded as per the six point plan. In
the case of the home visit the officer should contact their line manager as
soon as possible to brief them on the situation, the actions taken and they
should make a written record as soon as possible after the event. The
recorded details should be kept by the line manager.
What to do in an Emergency:
If the customer reveals they have already taken self harm action (taken
tablets, cut themselves badly, etc) or if they are in a position of danger where
self harm could be actioned easily (for example, next to heavy traffic, or in a
high place) the officer should inform their manager, in line with the six point
plan, who should contact the relevant emergency services.
You do not need the customers consent to contact the emergency services.
The details of this information and decision making should be recorded and
retained.
What to do after an incident of declaration of intention to self harm or
commit suicide:
The following are essential steps to take following an incident:
1. Record the customer incident details for future reference. Monitor customer
well-being for future contacts.
2. Gather detailed information of what happened. Line managers must keep
these records as they may be needed in future for legal and system review
purposes.
3. The member of staff and line manager should reflect on what happened.
Discuss how the incident was handled. Review the procedures in place and
determine if there are any lessons to be learned for future handling and
responses. Keep a record of this review process.
4. Copies of the records should also be retained by the manager in the office
who is responsible for developing and reviewing local plans, to enable them to
ensure they remain effective.
5. Line managers must provide support to the officer after the incident.
Provide the necessary practical and listening support (e.g., to give the officer
time away, to listen to their concerns). Ensure the officer is aware of the
counselling services available under the Employee Assistance Programme
(EAP). The EAP also has a management support service to help line
managers themselves deal with these conversations with their members of
staff.
Declarations of Suicide & Self Harm
The 6 point plan
Take the statement to Listen carefully and clarify. Check your
self harm or suicide understanding of what was said.
seriously
Suspend all other activities you are carrying out.
Summon a colleague Workplace procedures must be in place and you
must know how to summon support from a
colleague who will act as your ‘support partner’.
This is most likely to be your line manager
Your support partner is there for two reasons – to
assist you as you help the customer, and to act as
a witness to what was said. They will need to be
able to hear, or listen into the conversation, as
best they can and record key points as it
progresses.
Gather information • You need to make some assessment on the
degree of risk, by working through the following
steps.
• You should remain calm, as this will help the
customer gain perspective on their situation.
• Clarify and confirm that the customer has said
they intend to self-harm or commit suicide.
• Determine if they tried to harm themselves
before and if they received treatment or are
currently receiving treatment
• Let the customer talk about their plans to self
harm or commit suicide.
• Find out specifically what is planned, when it is
planned for, and whether the customer has the
means to hand?
• Find out if action has already been taken, e.g.
have tablets or something else been taken? If so,
find out What? and When?
• Keep the customer talking and record key
information, including their location and any plans
they have for going elsewhere to harm
themselves. This will be important should you
need to inform other services.
Provide referral advice • Encourage the customer to speak to someone
who can help them
• Have relevant telephone numbers to hand
• Ask the customer about their GP, or health care
team – find out about their location and contact
arrangements.
• If the situation is non-urgent (i.e., general
distress but no immediate plans or means-to-
hand) help the customer to contact their support
team or encourage them to contact their GP
immediately.
Summon Emergency • If the customer is distressed and is in immediate
help danger summon emergency help.
• You do not need their consent to do so, but it is
important to advise the customer about what is
happening and why
• Inform your line manager, who should arrange
contact with the emergency services
• Let the emergency services know the location
and any other relevant details you have
uncovered.
Review Whilst this experience can be upsetting you need
to look after yourself and be reassured that you
have done what you can to help the customer.
After the incident you may have thoughts and
feelings about the situation. This is all part of the
process of coping with the experience and is
normal.
Seek support from your colleagues and line
manager
Your line manager must review the incident with
you. This is your opportunity to reflect on the event
and ask to agree on any further support for you.
As part of this process, you should also review
your written records with your line manager and
check that office procedures were operational and
useful. Pass a copy of your notes to your line
manager.
Line managers must retain the notes and issue a
copy to the manager in your particular office who
is responsible for developing and reviewing local
plans.
Managers should ensure that any member of staff
who has managed an incident are provided with
further opportunities to discuss the impact and
how they are feeling.
An independent, confidential counselling service is
also available under the Employee Assistance
Programme, if necessary.
Referral and emergency support details
Community Mental Health Team
It may well be that, locally, the Crisis Resolution Team only takes referrals
from the GP or Community Mental Health Trust. If advisers are to have
contacts, names and phone numbers of Mental Health Services then, it is
important that arrangements are put in place, at a local level, with CMHT
managers, so they are prepared to receive calls from DWP staff and the
reason for this. Duty workers in CMHTs need to be primed for possible
emergency calls from DWP staff and know how to act.
In general, Community Mental Health Teams do not provide crisis
intervention, however they normally have a duty officer/desk clerk who will be
able to provide advice if this has been arranged.
If you work in a contact centre environment and therefore do not have
information about local community services, all you can reasonably do is
advise the customer to contact their GP, community mental health team, or
find out the contact details from them.
Crisis referral should ordinarily be referred back to the client’s general
practitioner.
If the customer is distressed and is in immediate danger summon the
emergency services. You do not need their consent to do so.
Find out now how to contact the local community mental health teams and
hospitals and record the details.
Contact name Address Telephone(s)
Other useful numbers are:
Samaritans: 24hrs 08457 90 90 90
MIND: 08457 660163
Breathing Space (Scotland only): 0800 838587
Get connected (a free helpline for young people): 0808 808 4994
Record any other appropriate numbers here so you have them to hand.