The Support Systems for Self-harm and Suicide (4S) Study is a research study investigating how secondary schools, colleges and governing bodies of youth organisations in England deliver self-harm and suicide prevention, intervention and postvention. 

Intervention is actions that try to reduce the risk of harm by finding out about a problem in its early stages and addressing it as soon as possible.

Example: A coach notices that a player has seemed “down” recently. The coach takes them aside after practice and checks in about how they’re feeling and what’s going on.

Postvention is actions taken after a serious situation or problem has happened, to manage it carefully so that it is less harmful. 

Example: A support worker helps a family to find out information, access a local support group, and be referred to long-term resources when someone has died by suicide.


Phase 1 Study (2022 – 2024)

We are investigating how secondary schools, colleges and youth organisations currently support young people with self-harm and suicide. We are doing this in four different ways:

We are recruiting Patient and Public Involvement and Engagement (PPIE) stakeholder groups to work with us and inform what we do

We are conducting a scoping review of current guidance available to those supporting young people with self-harm and suicide

We are using secondary data analysis to investigate 1) who young people talk to about self-harm and suicide, and 2) how prevention, intervention and postvention programmes communicate about self-harm and suicide

We are surveying schools, colleges and youth organisation governing bodies (YOGBs) to understand current policy and approaches to prevention, intervention and postvention of self-harm and suicide for young people

Phase 2 Study (2024 – 2026)

Based on our learning from Phase 1, we are co-producing principles of practice to support organisations working with young people around self-harm and suicide prevention and postvention. There are two parts to this project:

We are conducting in-depth interviews with groups of:
– Young people aged 14 to 21 who have experience of self-harm or suicide
– Adults who work with young people

We will then do a Delphi study to co-produce ‘gold-standard’ principles of practice. Expert panels of academics and clinicians, professionals, school, college, and youth setting staff will vote to obtain a consensus on the principles

If you would like to receive updates about the project and our findings, please email a.e.russell@exeter.ac.uk to be added to our distribution list.


4S Funding

The 4S Study is funded by National Institute of Health Research (NIHR) School for Public Health Research (SPHR). The views expressed are those of the author(s) and not necessarily those of the NIHR SPHR.

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