Self-Harm Guidance: Development, Collaboration, and Impact on Children and Young People 

 Read the guidance in full at Kent and Medway Self-Harm Guidance. 

Overview

i-THRIVE Champions in Kent and Medway identified that understanding self-harm and navigating support for children and young people was inconsistent and difficult across the system. A task and finish group was formed to explore these issues in depth and develop clearer system-wide responses. During this process, updated NICE guidance on self-harm was released, calling for a more integrated approach, shared responsibility across services, and a stronger role for schools. The group therefore used the guidance as a framework to review the early intervention system first, before considering how it links with primary and acute care.

Key Features of the Guidance

The guidance promotes a consistent understanding of self-harm as a sign of emotional distress and includes:

• A clear definition and explanation of the cycle of self-harm, including risk factors and indicators.
• Consistent guidance for practitioners, pathway leads, schools, parents, and young people.
• Practical support and intervention strategies—from initial conversations to ongoing care and family engagement.
• Training information and accessible resources for professionals.

i-THRIVE in Action

• Needs-Led Approach: The work began with a detailed scoping exercise, analysing local data—including hospital admissions, mental health referrals, and feedback from schools and young people—to understand the scale, patterns, and needs related to self-harm in the area.
• THRIVE and Whole System Service Design: The guidance was created to provide clear, consistent pathways for supporting children and young people who self-harm. Instead of relying on separate policies across schools and services, stakeholders collaborated to develop a single, evidence-informed document shaped by best practice and lived experience. Through collaboration across Kent and Medway, the guidance aims to ensure that all young people have access to the same level of care and support. Whether a child discloses self-harm to a teacher, a youth worker, or a healthcare professional, the response should be informed by the guidance.

• Partnership Working: Development was strengthened by broad multi-agency involvement. Contributors included specialist mental health teams, local authority staff, schools, VCSE organisations, youth workers, early help professionals, the suicide prevention forum, and young people and families.

Drafts were circulated widely for review through workshops and consultations. This process helped refine language, clarify expectations, and ensure accessibility. Differences in terminology and approach required coordination, therefore facilitated discussion took place to ascertain agreement. For example, one counselling service reported increased confidence in supporting young people after self-harm training.

The multi-agency approach outlined in the guidance promotes better communication among professionals and with families. Coordinated care planning ensures that young people’s needs are met holistically, addressing both their mental and physical wellbeing.

• Outcome informed: At its heart, the guidance aims to ensure that every child or young person who is struggling with self-harm receives a timely, compassionate, and effective response—regardless of where they seek help.

• Proactive Prevention and Promotion: Clear identification strategies and risk formulation enable professionals to intervene earlier, reducing the risk of escalation or repeated self-harm. By promoting open conversations and reducing stigma, the guidance encourages young people to ask for help sooner.

• Children and Young People’s Voice: By involving young people in the development and review of the guidance, their voices are central to the approach. The guidance emphasises respectful, person-centred conversations and shared decision-making, helping young people feel seen and heard.

Conclusion and Next Steps

The Kent and Medway Self-Harm Guidance stands as a testament to what can be achieved through the i-THRIVE champions. By collaborating and a complete commitment to children and young people’s wellbeing. By providing a clear and consistent framework, supporting professionals, and centring the needs and voices of young people, the guidance promises to make a meaningful difference—helping those at risk of self-harm to feel safer, supported, and hopeful for the future.

Families often feel powerless or unsure of how to respond to a child’s self-harm. The guidance includes information and signposting for parents and carers, empowering them to support their children effectively and access further help when needed.

Training and clear protocols mean that staff across sectors feel more confident in recognising and responding to self-harm. This reduces uncertainty and anxiety among professionals and ensures that young people benefit from skilled, compassionate support.

The guidance is subject to ongoing review. Feedback from professionals, young people, and families continues to shape updates, ensuring the guidance remains relevant and effective in a changing landscape. Further work has been completed to support clinical settings and Health Care partnerships to implement the guidance.