Quality statement 6: Risk management plans

Quality statement

People receiving continuing support for self‑harm have a collaboratively developed risk management plan.

Rationale

A risk management plan can help people who self‑harm reduce their risk of self‑harming again. It should be based on a risk assessment and developed with the person who has self‑harmed, who should have joint ownership of the plan. They should fully understand the content of the plan, including what can be done if they are at risk of self‑harming again and who to contact in a crisis.

Quality measure

Structure: Evidence of local arrangements to ensure that people receiving continuing support for self‑harm have a collaboratively developed risk management plan.

Process: Proportion of people receiving continuing support for self‑harm who have a collaboratively developed risk management plan.

Numerator – the number of people in the denominator who have a collaboratively developed risk management plan.

Denominator – the number of people receiving continuing support for self‑harm.

What the quality statement means for each audience

Service providers ensure that collaboratively developed risk management plans are in place for people receiving continuing support for self‑harm.

Healthcare professionals ensure that people receiving continuing support for self‑harm have a collaboratively developed risk management plan.

Commissioners ensure that they commission services that have collaboratively developed risk management plans in place for people receiving continuing support for self‑harm.

People who are having long‑term support after self‑harming have a risk management plan developed with their healthcare professional that helps them reduce their risk of harming themselves again.

Source guidance

NICE clinical guideline 133 recommendations 1.4.3 (key priority for implementation) and 1.4.4 (key priority for implementation).

Data source

Structure: Local data collection.

Process: Local data collection.

Definitions

People receiving continuing support for self‑harm

Children or young people (aged 8 years and older) and adults who have carried out an act of self‑poisoning or self‑injury, irrespective of motivation, and are receiving longer‑term psychological treatment and management. It includes people with both single and recurrent episodes of self‑harm. It does not include people having immediate physical treatment or management for self‑harm in emergency departments.

Risk management plan

NICE clinical guideline 133 recommendation 1.4.4 states that a risk management plan should:

  • address each of the long‑term and more immediate risks identified in the risk assessment

  • address the specific factors (psychological, pharmacological, social and relational) identified in the assessment as associated with increased risk, with the agreed aim of reducing the risk of repetition of self‑harm and/or the risk of suicide

  • include a crisis plan outlining self‑management strategies and how to access services during a crisis when self‑management strategies fail

  • ensure that the risk management plan is consistent with the long‑term treatment strategy.

Equality and diversity considerations

NICE clinical guideline 133 recommendation 1.3.3 highlights the higher risks of suicide following self‑harm in people aged over 65 years. These risks should be reflected in risk management plans.