1. Errolie Sermaine, Learning in Mind Jessica Russell, Ways to Wellbeing
Embedding Recovery Principles in the Safeguarding Process Community Learning Mental Health Research Project
Errolie Sermaine, Learning in Mind
Jessica Russell, Ways to Wellbeing

2. Trigger Warning
Although carefully selected, the subject and content in this presentation may be difficult for some
For anyone affected by the issues raised there are links available at the end of the presentation and on the MHFE noticeboard padlet for immediate access

3. Survey Questions

4. Survey Results
Q1 – Safeguarding incidents - ranged from 2 – 1000 Q2 – Increase during Phase 1? - unknown 50%, no increase 25%, yes 25% Q3 – PHQ Q9 - comfortable 40%, uncomfortable 50%, skipped question 10% Q4 – CPD undertaken - Yes 25%, no 75% Q5 – Confidence not very 80%, confident 20%

5. Recovery Principles
‘Recovery is about building a meaningful and satisfying life, whether or not there are recurring or ongoing symptoms or mental health problems. The key themes of recovery are:
Agency - gaining a sense of control over one's life and one's illness. Finding personal meaning - an identity which incorporates illness, but retains a positive sense of self.
Opportunity - building a life beyond illness. Using non-mental health agencies, informal supports and natural social networks to achieve integration and social inclusion.
Hope - believing that one can still pursue one's own hopes and dreams, even with the continuing presence of illness. Not settling for less, i.e. the reduced expectations of others.’
Centre for Mental Health

6. Embedding Recovery Principles in Safeguarding Conversations
Empowerment - People being supported and encouraged to make their own decisions and informed consent.
Prevention - It is better to take action before harm occurs – don’t be afraid of the conversation
Proportionality - The least intrusive response appropriate to the risk presented – this means practitioners having some sense of assessing risk
Protection - Support and representation for those in greatest need – this is embedded in the new learner participant consent form
Partnership - Local solutions through services working with communities – signposting and further formal safeguarding practices
Accountability - Accountability and transparency in safeguarding practice – letting the learner know and having the discussion
Social Care Institute for Excellence

7. Strategies: Self Harm
It is important to take self-harming seriously. Most people who self-harm describe their behaviour as a way of coping with overwhelming feelings associated with difficult or painful experiences
It can be a way of feeling better and re-establishing control over their emotions. Most people who self-harm try to keep it a secret and feel very ashamed.
"Look at the individual, not the harm. Look at the person beyond
the scars. Scars are not important. The person that did them is important."

8. Strategies: Self Harm
Here are some simple things that you can do to help:
Establish a rapport
Ask how they are feeling but allow them to talk at their own pace
Don’t be judgmental
Let them know that you want to listen to them and hear how they are feeling
Be compassionate and respect what they are telling you, even though you may not understand or find it difficult to accept what they are doing.
Be aware that someone will only stop self-harming when they feel ready and able to do so.

9. Management Strategies: Self Harm
Knowledge is power - encourage them to gather as much information as possible about their own behaviour. They could keep a diary of what’s going on when they feel the need to self-harm: over a period of time they can identify specific triggers.
Help them try to find ways to make life less stressful – occasional treats, eat healthily, get plenty of sleep, exercise – all of these are known to boost self-esteem and lift low moods.
Give them contact details of local and national help-lines : place these contact details where they can find them easily, in case they need to talk to somebody when in a crisis.
For further help and advice:

10. Management Strategies: Self Harm
Encourage them to try to talk about their feelings with someone supportive - they may feel alone, but there are others who will understand their pain.
Help them work on building up their self-esteem - reassure them that they’re not to blame for how they feel; self-harm is an expression of powerful feelings and it's not their fault. They could list their feelings, then write positive statements about themselves. They could ask friends to write things they like about them and keep these lists visible.
Encourage them to think about their anger and what they do with it - if they weren't busy being angry with themselves, who would they really be angry with? Help them to write a list of people who have caused them to feel like this.
Cushion punching technique - a good way to express anger in a safe way.
For further help and advice:

11. Management Strategies: Self Harm
Creativity is a powerful tool against despair - if they feel like it, they could try drawing or painting how they feel. Some people draw on themselves, using bright body colours.
If they feel the need to self-harm, help them to focus on staying within safe limits. A supportive GP will give them good advice on minimizing and caring for their injuries and help them to find further help.
For further help and advice:

12. Management Strategies: Self Harm
Thinking / Questions so far?

13. Structuring a supportive discussion with learner who has disclosed recent suicidal thoughts
Try to:
Establish rapport
Use a calm, patient, non-judgemental, and empathic approach
Begin with supportive statements and open-ended inquiries
Start with general and then move towards more specific questions in a sensitive and non-judgemental way that creates an opportunity for dialogue; do ask specific questions about self-harm, suicidal thoughts, plans, attitudes towards suicide, history of suicidal behaviour, thoughts of death, and feelings of hopelessness.

14. Structuring a supportive discussion with learner who has disclosed recent suicidal thoughts
Try not to:
Allow your personal feelings influence your reaction
Rush the person or ask leading questions
Interrogate the patient or force the patient to defend his or her actions
Minimise the patient's distress
Undermine the seriousness of the suicidal thought or action.
Allowing people to talk about their suicidal feelings is really important. Don’t be afraid that talking about suicidal thoughts and feelings will be encourage someone to act on them

15. Learner Voice
Learner bereaved by suicide and safeguarded for suicidal thoughts shares experience of being listened to in a safeguarding conversation.
“At the end of that first class I remember showing my son’s photo and explained what I had gone through and the staff member just listened.”
“There was no trying to put themselves in my position, or relating somebody else’s experience... I would have probably just shut down.”
“ I tend to look at the other persons face and see what reaction they show. I don't know if they were reacting to the story or the effect it was having on me but if they were giving out a feeling of discomfort it always put me on a state of unease at the next meeting.”

16. Questions & Discussion
What could you do differently?
What could your setting do differently?

17. Signposting & Further Information
Getting support for self and others:
- online support community
- access to talking therapies
- for survivors of bereavement by suicide
- advice and information