Warning signs, triggers and changes that matter

Self-harm and suicide risk frequently show small changes before a serious incident. Staff might notice a child covering their arms or legs, wearing long sleeves inappropriately, collecting sharp items, talking about being done with life, giving away possessions, searching for methods online, refusing food, not sleeping, withdrawing after contact, or becoming suddenly flat after days of agitation.

No single sign proves intent. Compare any change with the child’s usual baseline, watch for a cluster of signs, and share concerns early so care and plans can be adjusted.

Changes that should not be ignored

• Physical signs: unexplained cuts, burns, bruises, ligature marks or hidden dressings.
• Language signs: expressions of hopelessness, saying people would be better off without them, or talking as if the future is closed.
• Behaviour signs: withdrawal, heightened agitation, giving up activities, hoarding medication or withdrawing to be alone unexpectedly.
• Online signs: searching for methods, sharing images, following harmful accounts or receiving worrying messages.
• Routine changes: not sleeping, not eating, not attending school or refusing normal contact with trusted staff.
• Means interest: asking about blades, cords, tablets or places where they could not be interrupted.

It is usually the pattern, not a single dramatic clue, that shows risk is rising.