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  3. 10. General
  4. 10.9 Responding to suicide risk behaviour
  5. Key steps
  6. 2. Respond to the child with a suicide risk alert

2. Respond to the child with a suicide risk alert

2.1 Consult with the team leader to decide whether a suicide risk is required

When determining whether to record a suicide risk alert, consult with the team leader to:

  • assess the nature and significance of the information prompting the suicide risk alert
  • decide whether a suicide risk alert is required
  • discuss the rationale for recording the suicide risk alert
  • identify the immediate and, where applicable, ongoing actions, interventions and supports to be implemented which are aimed at ensuring the child’s safety.

Where doubt exists about whether a child is at risk of suicide

Where doubt exists about whether a child is at risk of suicide:

  • liaise with the team leader or senior practitioner for advice and direction about assessing the risk of suicide
  • consult other relevant professionals (for example, a general practitioner, psychologist, other health provider, police, staff or representatives from government and community agencies) who have knowledge about the child or suicidal behaviour, to obtain further information and advice.

After recording the suicide risk alert, develop and where applicable, monitor the immediate and medium to long-term suicide risk management plans. For further information about suicide risk management plans, refer to 2.3 Develop a suicide risk management plan, 2.4 Immediate suicide risk management plan, 2.5 Medium to long-term suicide risk management plan and 3. Review the suicide risk management plan.

2.2 Record the suicide risk alert in ICMS within 24 hours

When a child discloses or displays suicide risk behaviour or when it is assessed that the child meets the criteria for a suicide risk alert, it is the responsibility of staff at the RIS, CSSC or CSAHSC to create a suicide risk event and record a suicide risk alert (SR1) form in ICMS within 24 hours of the incident, disclosure or assessment.

The suicide risk alert is not activated in ICMS until after the team leader approves the suicide risk alert (SR1) form in the suicide risk event.

If the child is subject to ongoing intervention, the suicide risk event is to be allocated immediately to the CSO with case responsibility and all relevant information forwarded to that CSSC.

2.3 Develop a suicide risk management plan

Develop a suicide risk management plan with the child, their parents, carers and other significant people, where possible. The complexity, number and extent of actions in the suicide risk management plan vary and depend on:

  • the point at which the plan is instigated -either:
    • at intake, the notifier may be the only person responsible for implementing the immediate suicide risk management plan actions (for example, removing available means of suicide and not leaving the child alone and seeking help from a general practitioner)
    • during an investigation and assessment, the parent may be the only person responsible for implementing the immediate suicide risk management plan actions
    • during ongoing intervention, a range of people may be undertaking actions with the child in the immediate and medium to long-term suicide risk management plans (for example child protection and youth justice staff, recognised entity staff, carers, health workers)
  • the nature and significance of the information prompting the suicide risk alert - if a child is physically injured or hospitalised as a result of their suicide risk behaviour, the immediate suicide risk management plan actions may be undertaken by a range of people relevant to the child's current situation and context (for example, general practitioner or other health provider, parent, youth worker or other identified support person). The ongoing actions and persons responsible for implementing the actions identified in the medium to long-term suicide risk management plan may differ from the immediate suicide risk management plan, particularly when the child's circumstances change.
  • the child's circumstances -the number, extent and persons responsible for implementing the suicide risk management plan will depend on:
    • the child's characteristics and individual circumstances (for example, the child's ethnicity, behaviour, health or special needs, child's relationships with others) and
    • the characteristics of the persons able and willing to undertake actions to protect and support the child (for example, an Aboriginal child subject to youth justice and child protection interventions may have child protection, youth justice and recognised entity staff responsible for certain actions within the suicide risk management plans).

2.4 Develop an immediate suicide risk management plan

Develop an immediate suicide risk management plan as part of the suicide risk alert (SR1) form in ICMS. The maximum lifespan of an immediate suicide risk management plan is two weeks.

The purpose of the immediate suicide risk management plan is to:

  • document the immediate actions and interventions to be undertaken in response to the child's suicide risk alert
  • guide short-term casework activities aimed at safeguarding the child's immediate safety needs and ensuring the timely provision of health or therapeutic assessment and support services until, for ongoing intervention cases, the medium to long-term suicide risk management plan is developed.

The immediate suicide risk management plan must contain:

  • information about the strategies and/or referrals to assess the child's medical and/or mental health needs, as appropriate (for example, general practitioner, Queensland Health's Child and Youth Mental Health Service, Evolve Services)
  • the activities relevant people will undertake aimed at ensuring and monitoring the child's immediate safety (for example, document the roles and activities of those closest to the child in daily life (for example, parent, carer, youth worker) and those with other areas of expertise (for example, mental health counsellors, drug and alcohol service representatives).

Immediate suicide risk management plans for children at intake or during an investigation and assessment

When a suicide risk alert is generated at intake (for example, when an intake enquiry or child concern report is recorded) or during an investigation and assessment and the child is not subject to ongoing intervention, record the actions the notifier or parent agrees to undertake in the immediate suicide risk management plan. Where the notifier or parent (if the notifier) does not agree to undertake actions:

  • consider whether the parents lack of commitment to the actions in the plan, would require a more intrusive response, for example, recording a notification
  • record the notifier or parents response and the rationale for the decision made.

As the department does not have an ongoing role in providing intervention to children unless they are subject to an ongoing intervention case, it is critical that the intake or investigation and assessment response clearly explores (with relevant people and agencies, including where applicable, the notifier) all available options for securing the child’s immediate physical safety.

For further information about resolving doubt about whether a child is at risk of suicide risk, refer to 2.1 Consult with team leader to decide whether a suicide risk alert is required.

Consider referrals to services

Children who display suicide risk behaviour or who are at risk of suicide, may already have involvement with other services that have expertise to offer in addressing or reducing such behaviours. 

If a child is not involved with professional service providers, consider making referrals to relevant services or consulting with them for information, resources and assistance.

2.5 Develop a medium to long-term suicide risk management plan

Medium to long-term suicide risk management plans are only developed for children who are subject to an ongoing intervention case. The medium to long-term suicide risk management plan is to be developed in ICMS within two weeks of recording the suicide risk alert and developing the immediate suicide risk management plan. 

The medium to long-term suicide risk management plan will be developed following a review of the immediate suicide risk management plan and submitted to the team leader for approval. Wherever possible, develop the medium to long-term plan with the child, their parents, carers and other significant people. The maximum lifespan of a medium to long-term suicide risk management plan is three months.

The medium to long-term suicide risk management plan will include the following:

  • details of interventions that have occurred since recording the suicide risk alert, including outcomes of the interventions already undertaken as part of the immediate suicide risk management plan
  • strategies for how and when the medium to long-term suicide risk management plan will be monitored and reviewed, including persons responsible
  • any further follow-up to be undertaken, including persons responsible
  • an assessment about the current level of risk (high, medium, low).

Consult with the team leader about the current level of risk

Consult with the team leader about whether the current level of risk identified in the child's medium to long-term suicide risk management plan is high, medium or low.

The high, medium and low classifications allow anyone viewing the medium to long-term suicide risk management plan to rapidly ascertain the level of risk associated with the child, based on:

  • the CSOs knowledge and professional judgement about the risk factors and warning signs, including cultural considerations, specific to the particular child
  • progress and outcomes associated with any interventions that have occurred since recording the suicide risk alert
  • information and assessment about the child's current situation, behaviour, presentation and context.

For children subject to statutory and youth justice intervention, the decision about the current level of risk to be identified in the medium to long-term suicide risk management plan will be informed by joint discussions with both program or intervention areas.

2.6 Inform relevant people

After recording a suicide risk alert and completing the immediate or medium to long-term suicide risk management plan, inform relevant people about the alert and associated risk plan, as follows:

  • at intake - inform the notifier
  • during an investigation and assessment - inform the child, parents, and other relevant people (for example carers, medical staff, education staff, recognised entity staff).
  • for a child is subject to ongoing intervention - inform the child, parents, carers and other relevant people about the suicide risk alert and the particulars of the suicide risk management plan (for example, medical staff, education staff, recognised entity staff).

Critical incident reporting

Where a child attempts suicide or a child's self-harming episodes are assessed as attempted suicide, complete a critical incident report in accordance with the Critical incident reporting policy.

2.7 Respond to a child with multiple suicide risk alerts

A subsequent suicide risk alert must be completed whenever the child demonstrates or engages in a new episode of suicide risk behaviour.

Where a child subject to a suicide risk alert repeatedly engages in suicide risk behaviours, consult with the team leader to consider whether the recurring suicide risk behaviour:

  • signifies an escalation or intensification in the pattern or severity of the child's suicide risk behaviour or risk of suicide
  • is being adequately addressed by actions in the current suicide risk management plan.

When deciding whether to record a subsequent suicide risk alert, consider whether actions in the immediate or medium to long-term suicide risk management plan (whichever is relevant) are effective in addressing the repeated suicide risk behaviour.

When a subsequent suicide risk alert is recorded, consider whether the previous suicide risk management plan contains actions, interventions and supports that are relevant to the child's pattern of self-harming behaviour, the risk, their situation and what progress has been made. The suicide risk management plan may repeat the strategies of the previous plan if the new episode is to be responded to and managed in the same way.