Upcoming changes for this guidance
This content will be strengthened so it more completely reflects our commitment to practice framed by te Tiriti o Waitangi, based on a mana-enhancing paradigm for practice, and drawing from Te Ao Māori principles of oranga to support mana tamaiti, whakapapa and whanaungatanga. We each need to consider how we can apply these principles to our practice when reading this guidance. The following resources provide support:
Practice for working effectively with Māori
Our practice shift
When we assess suicide risk
When te tamaiti or rangatahi tells us that they’ve had thoughts of killing themselves, or te tamaiti is identified as being at risk of dying by suicide, we assess their immediate safety and wellbeing.
1 Create safety
We work with the parents, whānau or family, caregivers, Towards Wellbeing and other agencies (for example, school, the Police, mental health providers) to develop and agree on a plan to monitor and manage the risk to te tamaiti or rangatahi. This might include increased supervision, reduced access to the means of killing themselves, and reduced access to alcohol and drugs.
2 Complete the SKS screens and notify Towards Wellbeing
Within 24 hours of identifying suicide risk for te tamaiti or rangatahi, we:
- complete the Substances and Choices Scale (SACs) and Kessler and Suicide (SKS) screening tool and add a suicide person characteristic in CYRAS – this will record the risk on the CYRAS record of te tamaiti or rangatahi
- contact a Towards Wellbeing advisor to refer the concern to or seek advice.
Even if te tamaiti or rangatahi is already engaged with a mental health service, we refer them to Towards Wellbeing so that we can coordinate and plan our approach for immediate and longer-term support.
3 Advise and consult
- keep everyone involved and informed about the suicide risk of te tamaiti or rangatahi, their unique risk factors and triggers, and the Towards Wellbeing involvement – include other Oranga Tamariki staff (for example, youth justice, care and protection residential staff), whānau or family, caregivers, general practitioners, school staff, counsellors, mental health, the Police (especially if te tamaiti goes missing) and other agencies
- consult with our supervisor and consider any issues regarding the legal status of te tamaiti or rangatahi (if we don't have custody or guardianship, we support the parents (who do); if we do have custody or guardianship then we have obligations under legislation to respond)
- seek clear and specific commitments from agencies and copies of written reports.
What to consider when making a plan
When making a suicide risk management plan, we take into account the specific needs and circumstances of each tamaiti or rangatahi. We include te tamaiti or rangatahi and, where appropriate, supportive whānau or family caregivers and other professionals in our planning. Link any plans made to te tamaiti or rangatahi All About Me plan. We consider the following:
- What do we need to do straight away to clarify the risk, seek information for further planning and reduce the immediate risk of self-harm?
- Who else should be involved – Towards Wellbeing, mental health services, alcohol and drug services, whānau or family, caregivers, other staff and other professionals?
- How will these groups work together and communicate over time?
- How will we agree and monitor the plan?
- Who is responsible for completing the actions in the plan and by when? If te tamaiti or rangatahi is currently monitored by Towards Wellbeing then they can help with planning.
- Placement issues – does the current placement support the plan for te tamaiti or rangatahi? Are additional supports required? Should another placement be arranged?
- What specific instructions should be given to the whānau or family and caregivers?
- Which other professionals may be able to help te tamaiti or rangatahi? This could include:
- mental health and other specialists such as a paediatrician, a particular treatment centre or ACC counselling
- drug and alcohol assessment and counselling practitioners
- general practitioners to review both physical and mental health and treat te tamaiti or rangatahi – particularly if te tamaiti does not meet the criteria for referral to mental health services
- formal, whānau or family and community support services such as cultural groups, mentors, church and other religious organisations
- other areas related to general wellbeing or supporting personal strengths such as education, cultural support, health and sport.
4 Review the plan and monitor suicide risk
We review the suicide management plan every 3 months to monitor the progress of te tamaiti or rangatahi.
We monitor the suicide risk by:
- talking with te tamaiti or rangatahi (and others important to them) about what is causing their distress and how to manage this
- working on supporting and developing the strengths of te tamaiti or rangatahi
- maintaining contact with te tamaiti or rangatahi or agencies at agreed intervals
- keeping clear and up-to-date notes on CYRAS – this ensures that Towards Wellbeing, afterhours and duty social workers and supervisors have accurate information
- using review meetings involving whānau or family and professionals to make sure the risk is monitored and addressed by all parties.
We alert the main agencies involved with te tamaiti and rangatahi to any change in risk level and request that they do the same.
When we see a reduction in suicide risk, we may agree with Towards Wellbeing that a suicide management plan is no longer necessary.