Guidance
Preventing suicide and self-harm
We screen and assess tamariki and rangatahi who are at risk of killing or harming themselves. We build our understanding and create plans with tamariki, rangatahi and whānau or family that pursue improved and sustained oranga, particularly safety.Updates made to this guidance
Changes have been made to a number of pages on the Practice Centre to align with the practice approach. Specific changes include:
- Tiaki Oranga replaces the safety and risk screen, and is now being used throughout the life of a case, across service lines whenever we need to understand current safety.
- All references to the Tuituia domains and subdomains have been removed and we now promote the use of Te Puna Oranga and our models, tools and resources to build and deepen our understanding.
- The Tuituia report has been replaced with the assessment report.
Being aware of suicide risk factors
Tamariki and rangatahi we work with often have complex emotional needs and issues, so it’s important we:
- are aware of the suicide risk factors
- know how to work with tamariki and rangatahi to understand this risk
- develop plans that strengthen safety and work towards oranga.
Knowing the risk factors, triggers and indicators of suicide is important when building an understanding of the safety of tamariki and rangatahi. This knowledge also supports the development of plans that address the issues and supports oranga.
Towards Wellbeing resources | Clinical Advisory Services Aotearoa (CASA)
Suicide: worried about someone? | Mental Health Foundation
Tihei mauri ora: Supporting whānau through suicide distress | HealthEd
We also need to use our own supports and engage in kaimahi ora when talking about suicide by:
- using supervision and practising self-care
- working as a team
- using consults
- considering who else needs to be involved.
Preventing suicide and self-harm
When we are concerned about te tamaiti or rangatahi because we recognise suicide risk factors, we work with te tamaiti or rangatahi, whānau or family and wider support networks to develop a plan that is focused on safety and aims to improve oranga.
2 Screen and assess for suicide
We use one or more of the following screening and assessment tools.
Tiaki Oranga
When we have concerns (and we recognise the signals that te tamaiti or rangatahi may be at risk of self-harm, suicide, alcohol or drug abuse, or psychological distress) or someone else has raised a concern about the safety and wellbeing of te tamaiti or rangatahi, we use Tiaki Oranga to understand current safety and identify whether immediate action is required to secure their safety.
SACs, Kessler and Suicide screens
When we’re worried that te tamaiti or rangatahi may have thoughts about suicide, we use our main suicide screening tool – the Substances and Choices Scale (SACS) and Kessler and Suicide (SKS) screens – to build and deepen our understanding with te tamaiti or rangatahi about their suicidal ideation.
The suicide screen helps to identify whether te tamaiti or rangatahi has active thoughts of suicide and includes questions and prompts that we can ask directly to te tamaiti or rangatahi. This screen does not determine the risk level – it helps us to decide whether we need a more thorough assessment, identify the level of help and support needed, and how urgently we need to act.
When a suicide risk is identified, we place a suicide alert on CYRAS in the person characteristics section in the details tab for te tamaiti or rangatahi. We then notify the Towards Wellbeing team for follow-up and planning.
Policy: Assessment – Suicide, psychological distress and substance abuse (SKS) screens
Suicide risk tool – question prompt examples
Towards Wellbeing
Towards Wellbeing is a suicide risk assessment and monitoring programme that is delivered by Clinical Advisory Services Aotearoa (CASA). Towards Wellbeing aims to reduce the number of suicides and suicide attempts by tamariki and rangatahi in our care.
Email the Towards Wellbeing programme or contact the Towards Wellbeing clinical advisor in your area.
Email: help@twb.org.nz
3 What we do when suicide risk is identified
When suicide risk is identified, we work with te tamaiti or rangatahi, their whānau or family and other professionals to create an immediate safety plan for te tamaiti or rangatahi and then develop a longer-term plan to safely restore their wellbeing.