Suicide risk, emergency action and urgent escalation

Some situations need urgent escalation because the risk of suicide may be immediate or rising quickly. This includes clear intent to die, a plan with access to means, a recent attempt, saying goodbye, intoxication, severe agitation, command hallucinations, or behaviour suggesting the child cannot be kept safe with routine support.

Homes must follow local emergency and mental health pathways. In any country, if there is immediate danger to life or a serious medical emergency, staff should call emergency services and seek urgent medical help without delay.

Red flags for urgent action

• Expressed intent: the child says they want to die or will kill themselves.
• Plan and means: method, timing and access are becoming clear.
• Recent serious act: ligature, overdose, near-hanging or other potentially lethal behaviour.
• Rapid deterioration: panic, agitation, dissociation, intoxication or refusal of all support.
• Goodbye behaviour: giving things away, making final statements or shutting down future planning.
• Unable to maintain safety: the child cannot be left to ordinary staffing and routine.

Manager focus: crisis pathways

When a child has intent, means and timing, treat the risk as real and act fast.