Self Injurious Behaviour (SIB)

Update: Today Riley told staff that she wants to die and kill herself. We have taken this seriously because she has had suicidal tendencies in the past and it happens especially in the summer. Her parents are aware of this. We know the triggers and are trying to sort this quickly. We have realised a slight change in her mood and behaviour, including more agitation and tiredness and severe mood swings. She's starting to isolate herself away from the students and most staff and doesn't tend to engage in conversation and if she does it is extremely limited. She has also been wearing her ear defenders a lot recently, like nearly all day everyday. She's not eating or drinking either. She's just not herself. And to top it off, her mother explained, TW, that she is starting to self harm which she hasn't done in a year, maybe two. How can we help her? We have people in tomorrow to talk to her, if she would like to and staff are always there for her aswell. It's just upsetting to see any of our students going through a difficult time and we want them to be happy and have the best outcome to life. 

Update: Today Riley told staff that she wants to die and kill herself. We have taken this seriously because she has had suicidal tendencies in the past and it happens especially in the summer. Her parents are aware of this. We know the triggers and are trying to sort this quickly. We have realised a slight change in her mood and behaviour, including more agitation and tiredness and severe mood swings. She's starting to isolate herself away from the students and most staff and doesn't tend to engage in conversation and if she does it is extremely limited. She has also been wearing her ear defenders a lot recently, like nearly all day everyday. She's not eating or drinking either. She's just not herself. And to top it off, her mother explained, TW, that she is starting to self harm which she hasn't done in a year, maybe two. How can we help her? We have people in tomorrow to talk to her, if she would like to and staff are always there for her aswell. It's just upsetting to see any of our students going through a difficult time and we want them to be happy and have the best outcome to life. 

Good Morning

I am very sorry to hear that ideation level behaviours are manifesting such asymmetry from the central learning & living experience. It seems from the text that these immediate thoughts accompany a history of such thought, curiously during the warmer months, with a self harm TW ? Foremost in school minds may be several profound ones i'd imagine when it comes to what becomes of the meaning of DOC concerning the service user. Do the circumstances still define a state where the school can facilitate a way through the dilemma ? If so what are the clinical boundary conditions from which you can source the delineation are the sort of questions that need to be asked. I feel i might understand school continues to walk the path of empathy. The desire is for meaningful special based balance within the school setting.

Perhaps so be it that there could be a requirement for a specialist chartered psychologist or not as matters develop or not. In that sense it feels like the school is aware of the paraconsistent nature that takes place when a care plan escalates into what is best described as a multi agency suicide watch. We are facing a fact that the support would be meaningless in most other ways, though some could disagree there. Nonetheless it is true that the state of evolution in qualitative & particularly quantitative research concerning 3-9 suicide ideation stressors is underdeveloped. This strongly indicates there is little hope that support would mean much else in the Uk at this time, it is reasonable to say that. Specifically the lack of knowledge linked to psychological drivers for S<I>B in this age range.

Thus while in effect there is the DOC requirement to follow procedures that are appropriate, in opposition a known archetypal sense of this place. Itself arguably DOC, with respect to the way involvement with mental health services could take over & pervade the service users life. While should matters continue to develop in this fashion, then a criticality effect, with regard to how the sea beneath the ice will shift matters to be realigned in a potential multi agency topology where service users special learning energy would indubitably be expended should the service user replicate in that setting. A course in life to the detriment of meaningful special education is a profound loss. On the other hand a psychopathological interest which urgently requires a categorisation for this self destruction narrative.

Whilst there would be a yet to be experienced nature to either course. We can see the dilemma, in all probability, brings with it these types of threshold potential. Hence if correct the DOC faces a known bifurcation, though the school prefers a path to fulfilling emotional regulation via means obstensibly in house it seems fair to say ?

There are two main research theories that study an area called Diathesis :

https://en.wikipedia.org/wiki/Diathesis–stress_model

https://en.wikipedia.org/wiki/Differential_susceptibility_hypothesis

With good reason assuming there is a worth in establishing a logical starting point perhaps. If so what is learned to prove mostly useful in the long run, there is far too much short term determinism around, and sometimes what is needed in the future has a harmonic balance with that required in the now - do not fear counter intuitions. it remains fortuitous that a school mindfulness directed toward the SU's concept of death, and the differential towards susceptibility. For example Trajectory and predispositional vulnerability data, should we have it ( just for instance ) could be influential. Should such data not be harvested, the worth of rational starting point created shall remain intact & be vital on that level as a minimum.

Simply as an ultra tentative remark not to be considered compatible with DOC :

In an ideal world one could suggest that a critical factor rests with lack of symmetry so as to speak, or heuristic markers concerning the service users ability to understand what death means on a perceptual level. If there is an incumbent heuristically triviality within service users psychopathological reasoning, then hypothetically one might argue that the suicidal narrative seems bereft of a imaginative scale conducive with physical self destruction. Thus one can reasonably gather a reassuring doubt, but this would require someone chartered to investigate it so that matters fall correctly within someones remit. If school had arrived at that engagement, one would request they also compile the mundane strategy for your staff during the session(s) for the purpose of bespoke guidance with emotional regulation furthermore within specific context, not simply a general meaning.

Clinical Psychology

One disadvantage in that way concerns how many independent chartered psychologists were local authority trained. LA's have value for money responsibilities, thus sensibly and compassionately streamline what they require from such psychologsts for a form of efficiency. This still does entail the need for those operative to gain accreditation. Therefore we end up with a somewhat accidental grey area.  Often they are not experienced in key areas that are vital to special needs children. This is only a top down effect that is reasonably applied, since for many service users it is appropriate, and LA's must deliver value for money. It does mean that in instances where there is a shortfall, then a bottom up scenario is created. There is a limit with repect to how quickly the school can put a relevant strategy in place. Andralogical inclinations will be required when taking notes from this free service  = Aspergermins.

'' How can we help the student ?''

How many dimensions has your question got ?

When a school contracts a CP & instructs they might they specific specialised data, a school will not know they actually shall. Regardless of clear agreement, specialist recommendation may be missing from the report. They may agree to look at your carefully elucidated X, but hand in a box ticked Y, which any SU receives anytime. I'm speaking from DOC dimensions made in ideal worlds on a board since i can that is true. The fact remains - the ability to gather personally phenomenological & existential data specific to service user is DOC. There is nothing about 'being unspecific' in the legislation = DOC. Thus this isn't a missive, this merely illustrates the challenges in sourcing professionals with the relevant skills on behalf of SU's as promised in any special school statement. I can quote a recent remark ( by phone ) be a former federated principle, who is now a regional director for the same special school trust :

''We cannot find a chartered psychologist who can do what we want them to do''

Therefore for schools encounter unhelpful obstacles in front of them, in the process of doing the right thing. Ironically the difficult quest to engage a relevant chartered person is another of the service users woes in itself. In fact shall we all bang our heads against the wall in a show of solidarity might be the question. I ad hoc trained a chartered psyche the same school mentioned. The principle had contracted a professional could understand how to interpret a WISC 4. In that sense the matters around your service users et al face angst of many separate dimensions. You'd also need to be sceptical if interviewing and probing CP on specific areas. They may indicate experience in the natural science with theory of mind, = have tackled its more challenging concepts, and yet just tick boxes as per the streamlined purposes they had been trained in. Far be it, but it sounds like your service user, and others in complex predicaments listed, can have certain forms of need which shall not confluence with expertise lite, & many that could.

Should you not had time to search the web. I can link to this study as it is free source in the domain. I'd imagine that at least the odd passage could be helpful for building up the beginning of a robust architecture : 

https://pubmed.ncbi.nlm.nih.gov/34313741/

On noticing a sense of urgency. SU needs a short / long tern parallel. Will continue with a post containing further hypothesis that could suit your service user ( or not ) shortly.

Regards from M of the research base Aspergermins.