I will paraphrase rather than word for word.
'ds presented in A&E due to deterioration in self-harm. He had cut himself with scissors the previous day.
He reported that he deliberately self-harmed because of worries related to school and his brothers. He has two brother (16 and 19) he said that 19 year old sometimes hit him when he lived at home (i would add ds did not volunteer the brother info, i had to prompt ds to tell CAMHS what he had told SW and i told CAMHS that his brother hadnt lived at home for over a year)
He told us that he was bullied at school and this make him worried and not want to go to school. When asked about going back to school, he said he hated it and it would make him very sad and worried. He also said he worries about his eye problems and autism.
He has been self harming by scratching himself for approx 2 years. He described he sometimes has itches and he has to scratch himself. I wonder if there is hypersensivity to feeling on his skin, which evokes a need to scratch.
He decided to scratch himself with scissors because he was feeling sad, he wanst sure why he felt sad. He reported also punching himself and hitting himself with a hairbrush. He reported scratching does nothing to help his feelings. He said he is happy 1% of the time and unhappy 99% of the time.
I assessed his thoughts about wanting to die, these thoughts are connected to wanting to get away from his worries and his scratching rather than intent to die.
RISK He has a significant history of self harm which is triggered by his worries and sad feelings. Risk to others low. Risk to self low.
Safety plan was agreed with mum
Says about keeping all sharp objects and medication etc away from him and
I advised that mum will need to consider whether DS going to school would cause an increase in self harm and wanting to die. Ongoing liaison between CAMHS and school would be helpful to develop a joint understanding and way of managing his self harm
Yours thoughts please?