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Recording alerts
                                    Contents

Purpose

1.     When to record a suicide risk alert

2.     Assessing suicide risk

3.     Recording a suicide risk alert (SR1)

       3.1 Notifying other involved services of the SR1

4.     When to complete the SR1 form

5.     Risk management plans

       5.1     Immediate risk management
       5.2     Medium to long term risk management
       5.3     Reviewing the suicide risk alert
       5.4     Closing the Suicide Risk event


6.     Information sharing

7.     Use of suicide risk alert information

8.     Suicide risk alerts and critical incident reporting

9.     Process following a completed suicide by a young person

10.    Reviewing youth justice practice

11.    Recording an escape alert

12.    Recording other alerts

       12.1    Physical aggression / potential violence alert
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       12.2    Child Protection Offender Register (CPORA) alert
       12.3    Outstanding YJ warrants alert
       12.4    Outstanding court warrant alert
       12.5    Medical / serious health issues alert
       12.6    Behavioural alert
       12.7    Victim register alert
       12.8    CP offender prohibition order alert
       12.9    Publication order alert
       12.10   Other significant incident alert


Appendix 1: Risk factors and warning signs

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Purpose

To explain:
   who is responsible for recording alerts
   the responsibilities of departmental officers when a young person discloses suicidal
    or self harming behaviour
   the responsibilities of departmental staff when a young person escapes from
    custody or has a serious medical condition

1. When to record a suicide risk alert

A young person who is involved in the youth justice system is regarded as a suicide
risk when they display or disclose a history of one or more of the following:

   a suicide attempt
   a diagnosis of depression
   self injurious behaviour
   expressed or assessed suicidal ideation.

2. Assessing suicide risk

During the process of assessing a young person‟s risk of suicide, where possible
caseworkers must attempt to determine if there is a history of suicide and/or self harm
in the young person‟s family or amongst their peer group. This factor can increase a
young person‟s risk of suicide, however in isolation will not lead to the completion of a
suicide risk alert.

Other factors that caseworkers should explore with the young person and/or their
family include:

   feelings of hopelessness
   a decline in school work / productivity at work and attendance
   death or suicide themes dominating written or creative work
   giving away personal possessions
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   statements showing suicidal ideas or thoughts about death such as “I wish I was
    dead”, “no one cares if I live or die”, “does it hurt to die?”
   feelings of worthlessness, letting parents or others down
   withdrawal from friends.

The recording of a suicide alert is a significant decision and all threats must be taken
seriously. Upon receipt of information that indicates a young person is at risk of
suicide, caseworkers must consult with their team leader or manager to discuss the
information and develop an immediate risk management plan. Refer to Appendix 1 for
more information about risk factors and warning signs for suicide and self-harming
behaviour.

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3. Recording a suicide risk alert (SR1)

Where it is assessed that a young person is at risk of suicide or self-harm/self-injurious
behaviour, the young person‟s caseworker must:

Caseworker responsibilities
   where able, engage the young person in a discussion about their current situation
    and feelings to determine an appropriate immediate management plan (refer to
    section 6.1)
   discuss the concerns and immediate management plan with the team leader
   open a new suicide risk event and complete the SR1 form
   submit the SR1 form to the team leader for approval


Team leader responsibilities
   ensures the immediate management plan is appropriate and checks that the young
    person has adequate interim support
   approves the SR1
   liaises with the manager regarding the SR1 and immediate management plan.

Youth justice service manager responsibilities
   notifies the regional director if the risk of completing suicide is deemed to be
    significant.

3.1 Notifying other involved services of the SR1

Young people involved in the youth justice system may also be involved with other
service providers. It is important that the youth justice service caseworker is aware of
the other service providers involved and liaises with them when an SR1 is recorded by
the youth justice service. Part of this liaison necessitates the youth justice service
providing information documented in the SR1 to relevant service providers. The SR1
form is an internal document and is not to be provided to community agencies for
external use. Refer to section 7, Information sharing.
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If the young person is subject to child protection intervention, verbal advice should be
given to the child safety officer that an SR1 has been completed.

If the young person is involved in the youth justice conferencing process, verbal advice
should be given to the service leader that an SR1 has been completed.

If the young person is in detention but the youth justice service caseworker records the
alert, the youth detention centre caseworker or shift supervisor is immediately notified
either in person or by telephone.

Where detention centre staff complete the SR1, the detention centre caseworker or
case management officer is responsible for informing the relevant youth justice service
and if the young person is subject to a child protection order, the young person‟s child

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safety officer. If the SR1 is completed after hours, the shift supervisor will complete
these tasks.

4. When to complete the SR1 form

A new suicide risk event must be opened and an SR1 form completed whenever a
young person engages in a new episode of suicide risk behaviour(s). The SR1 must
be completed within 24 hours of a risk being identified.

Where Child Safety Services has completed a suicide risk alert for a young person
subject to youth justice intervention, departmental officers do not need to create
another SR1 form for that incident.


5. Risk management plans

All SR1 forms must have a clear immediate risk management plan documented at the
time the SR1 is created. Within two weeks of the creation of the alert, a medium to
long term risk management plan must also be developed.

5.1 Immediate risk management

To ensure the immediate safety of a young person assessed as a suicide risk, the
young person‟s caseworker must identify an immediate risk management plan in
consultation with the team leader. The plan must be clearly documented in the SR1
form and submitted to the team leader for final approval.

Caseworker responsibilities
When developing an immediate risk management plan, caseworkers must give
consideration to the following:

   exploring with the young person their issue or problem
   assisting the young person to identify their options
   informing the young person that a suicide risk alert must be recorded
   involving the young person in the development of the plan
   informing the young person‟s parent/s or carer of the assessed risk to ensure an
    adequate level of monitoring and support is provided to the young person
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   informing Child Safety Services of the risk, if the young person is subject to dual
    intervention
   assisting the young person to identify an appropriate support network
   referring the young person to counselling
   if assessed as appropriate, arranging an immediate mental health assessment
   contracting with the young person not to self-harm or attempt suicide
   if appropriate, completing a referral for additional youth worker support or
    increasing caseworker contact – in person or via the telephone.

5.2 Medium to long term risk management

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The medium to long term risk management plan must be completed within two weeks
of the SR1 form being completed. If the young person is in detention but is likely to be
released within the two week period, the detention centre caseworker will complete the
medium to long term risk management plan in addition to following the SRAT process.
During development of the medium to long term risk management plan, the detention
centre caseworker will liaise with the youth justice service caseworker to ensure the
plan can be adequately implemented when or if the young person is released into the
community. Where a detained young person will not be released from detention the
SR5 – Suicide Prevention Plan is sufficient (detention centre process only).

For young people subject to a youth justice order, the medium to long term suicide risk
management plan must be incorporated within the case plan and detail the following:

   interventions that have occurred since the SR1 was recorded
   any further follow-up to be undertaken.
The medium to long term risk management plan must be submitted to the team leader
for final approval.

For young people subject to child safety intervention, the department‟s response to the
suicide risk alert must be coordinated with Child Safety Services. This includes
consulting with the child safety officer about any immediate and medium to long term
risk management plan that is developed by the youth justice service. Similarly the
child safety officer must be invited to any meeting held to review a suicide risk alert
that has been created by the youth justice service. The views of the child safety officer
must be considered, including any action or interventions employed by Child Safety
Services in response to the suicide risk.


Case worker responsibilities

   opens current suicide risk event
   completes the medium to long term suicide risk management plan
   submits the management plan to the team leader for approval.

Team leader responsibilities

   opens the medium to long term suicide risk management plan
   determines if the management plan is appropriate
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   approves the medium to long term suicide risk management plan


5,3 Reviewing the suicide risk alert

A medium to long term risk management plan must include regular case reviews with
the young person and their parent/s or carer. Frequency of the reviews will be
determined by the level of risk posed by the young person and the medium to long
term risk management plan.




Recording alerts                                                                       5
Case worker responsibilities
   schedules a review meeting with the team leader
   sends a letter to the young person and their parent/s or carer inviting them to the
    review meeting
   pre-completes sections of the case review form in the case plan section of ICMS
   prints the case review form for the review meeting
   records the minutes of the review meeting on the case review form
   ensures all meeting participants sign the case review form as a record of the
    meeting
   provides a copy of the case review form to the meeting participants
   places the signed case review form on the young person‟s case file
   inputs the information recorded on the paper copy of the case review form on the
    ICMS form
   submits the case review form to the team leader for approval
   following approval enters future interventions and activities agreed during the
    review meeting into the new version of the case plan.

Team leader responsibilities
At the review meeting the team leader:

   discusses the current risk management plan with the young person and their
    parent or carer
   determines if the management plan is still appropriate.


5.4 Closing the Suicide Risk event
Youth Justice Services is responsible for reviewing and, if appropriate, closing suicide
risk alert events created by the youth justice service. If a suicide risk alert has been
created by Child Safety Services, Youth Justice Services must not close the event.

The review meeting is the forum at which the medium to long term risk management
plan can be discussed and the current suicide risk alert can be evaluated to determine
whether the event can be closed. When deciding to close a suicide risk event, the
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team leader must ensure the alert was created by Youth Justice Services and consider
whether the young person still meets any of the criteria for which an SR1 would
normally be completed. If it is assessed that the young person still meets any of the
criteria, then the suicide risk event cannot be closed. Team leaders and caseworkers
should not determine a young person‟s current risk of suicide or self harm in isolation
but in consultation with others actively engaged with the young person, including the
young person‟s parents or carer and Child Safety Services for all young people subject
to dual intervention.

In addition to assessing whether the young person still meets the criteria for a suicide
risk alert, if any of the activities, interventions or responses outlined in the medium to
long term risk management plan have not been addressed and finalised (or a rationale
provided for why they do not have to be addressed) then the suicide risk event must
not be closed until the plan is completed.

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The function of closing the suicide risk event, thereby moving the alert to „historical‟
enables anyone viewing the young person‟s profile to quickly ascertain the current
status in respect to the young person‟s emotional and psychological wellbeing (i.e.
depression, self harm, suicidal ideation). The number of closed suicide risk events is
reflected in brackets next to the suicide risk alert. Only a current suicide risk alert will
display as a count outside of the bracket.

Closing a suicide risk alert event is a significant case decision. The team leader must
ensure adequate assessment has occurred in respect of the young person, their
current situation, and the effectiveness of any interventions employed. The team
leader must ensure the information is clearly documented in the case review, before
taking action to close the event.


Team leader responsibilities
Following a review of the suicide risk and management plan, the team leader will
determine if the risk is still current. Where it is assessed that the risk has been
resolved and the suicide risk management plan is complete, the team leader will:
   complete an event closure form.

While a suicide risk event may be closed, the department‟s ongoing response to the
original risk does not cease. That is, any immediate and medium to long term risk
management plan developed should be incorporated in the case plan to ensure the
issue continues to be considered and addressed by the case worker.

6. Information sharing

In addition to informing the young person about the alert and the immediate risk
management plan, consideration must also be given to sharing information with other
people connected to the young person including the young person‟s parent/s or carer
(unless this is not appropriate). Information about a young person may be passed to
someone else:

   with the young person‟s consent, or
   to ensure the young person‟s safety.

Where a young person is involved with other agencies, the young person must be
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informed that disclosure is likely to further support the immediate risk management
plan and that disclosure can occur without their consent. If information is disclosed to
other agencies, disclosure should be limited to information that is necessary to elicit
assistance and support for the young person.


7. Use of suicide risk alert information

Suicide risk alert information on the ICMS system must be checked by departmental
officers when undertaking the following:

   advising regional directors in relation to young people detained in watchhouses
   advising of a young person‟s admission to a detention centre

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   starting a new file for a young person placed on conditional bail, bail support or
    youth justice order
   preparing for a young person‟s appearance in court
   upon receipt of a referral to a youth justice conference
   transferring case work or case management responsibility
   completing a new suicide risk alert
   completing an assessment and single case plan
   preparing a presentence report.

8. Suicide risk alerts and critical incident reporting

Attempted suicide by a client (including self-harming episodes assessed as attempted
suicide) is a Level 1 critical incident. Self-harming episodes where medical treatment
or hospitalisation is required are Level 2 critical incidents. Therefore in addition to
completing an SR1 form, a critical incident report form must also be completed where
these incidences arise. Refer to the Critical Incident Reporting procedures.


9. Process following a completed suicide or death of a young person

If a young person subject to departmental intervention dies, the youth justice service
manager:

Youth justice service manager responsibilities
   provides immediate verbal notification of the death to the regional director
   ensures a critical incident report form is completed
   verifies that counselling and/or debriefing services are being provided to the young
    person‟s family, other young people and staff involved with the young person,
    where required/requested
   ensures a notification is made to Child Safety Services if they are involved with the
    young person and/or information is received that indicates sibling/s of the
    deceased young person may be at risk of harm
   ensures the details of the death are inputted to the young person‟s ICMS profile
   advises the regional director of the process undertaken by the youth justice
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    service.


Regional director responsibilities
   provides immediate verbal notification of the death to the Deputy Director-General
   receives a copy of the critical incident report form
   discusses the case with the youth justice service manager to determine the role of
    the youth justice service in relation to the incident.


10. Reviewing youth justice practice


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Following the completed suicide of a young person, the regional director may request a
practice review be conducted by an out-of-area youth justice service manager.
Reviews are conducted for the following purpose:
   to ensure accountability and transparency in departmental decision making,
    practice and procedures
   to identify improvements in departmental systems, policies and practice
   to facilitate ongoing learning and development particularly in the area of suicide
    risk management
   to acknowledge quality service provided by departmental officers involved in the
    case.

Regional director responsibilities
If the regional director determines that a practice review would be beneficial to their
region:
   identifies an appropriate region to assist in the completion of the practice review
   contacts the relevant regional director to request their region‟s assistance to
    complete the review
   informs the youth justice service manager of any arrangements made.

Youth justice service manager responsibilities
Where a practice review has been arranged the youth justice service manager will:
   gather all file material and ensure electronic word documents are copied (either
    electronically or in hard copy format)
   forward the file material by courier to the region conducting the practice review.


Youth justice service manager (conducting practice review) responsibilities

Upon receipt of all relevant documentation, the manager responsible for conducting
the practice review will:

   review all documentation related to the case management of the young person
   record details of the youth justice service‟s response to and management of the
    suicide risk incident both prior to and following the completed suicide
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   consider the information in accordance with the department‟s policy and
    procedures, in particular the Management and recording of suicide risk concerns
    (YJ-017-02) and Critical Incident Reporting policies
   produce a report documenting their findings
   forward the report via their regional director, to the regional director of the
    requesting region.


11. Recording an escape alert

A young person who is in the lawful custody of either the Queensland Police Service or
the department is held in a secure facility. While they are being transported to or from

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such a facility by police, they are also in custody. Departmental officers have a
responsibility to record all incidences involving the escape of young people from lawful
custody.

An escape has occurred when a young person absconds from:
   a police watchhouse
   a youth detention centre (YDC)
   whilst being escorted by the police
   whilst on other leave of absence from a youth detention centre.

If an escape occurs from a youth detention centre or whilst a young person is under
police escort to or from the centre, whilst actually admitted to the centre (for example
to attend court) then the escape alert is recorded by the youth detention centre.

If the young person is not yet admitted to a youth detention centre and escapes from
police custody, then the alert is completed by the youth justice service caseworker.

Caseworker responsibilities

Where a youth justice service is responsible for completing an escape alert the
caseworker will:

   immediately inform the manager
   create a new escape alert event
   complete the escape alert form
   submit the escape alert form to the team leader for approval
   complete an after hours referral form. Refer to Chapter 8, Working with Child
    Safety Services.

Team leader responsibilities

   review the escape alert form
   approve the escape alert form
   complete a critical incident report form.
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Youth justice service manager responsibilities

   upon notification of the escape, advises the regional director
   advise the Direction, Youth Detention Operations
   inform the relevant Youth Detention Centre of the escape
   ensure the critical incident report is completed.

Once a young person is apprehended and returned to custody, the caseworker will:
   open the escape alert event
   complete the event closure form.
Recording alerts                                                                     10
12. Recording other alerts

To ensure appropriate recording of case related information, there are other
circumstances when alerts should be recorded on ICMS. Recording other alerts can
ensure the safety and well-being of the young person and departmental officers.

12.1   Physical aggression / potential violence alert

Where it is identified that a young person, a young person‟s family member or other
client has:

   verbally or physically threatened departmental or community agency staff; and/or
   has a history of personal violence offences against others; and/or
   is assessed as having the potential to be violent
The youth justice service caseworker should discuss with their team leader the
decision to record a physical aggression / potential violence alert. When completing
the alert, the youth justice service caseworker must provide factual and complete
information about the assessed risk. The alert information should then be used to
inform appropriate planning for the safety of the young person, other young people and
departmental staff.


Case worker responsibilities
To place the alert on ICMS, the caseworker will discuss the information with the team
leader and at the team leader‟s direction:
   identify the information that should be placed on ICMS
   open the alerts tab on ICMS to add a new alert
   enter the details of the alert and save the information

Team leader responsibilities

   considers the information
   provides verbal approval to the caseworker to enter the information in an alert on
    ICMS.
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12.2   Child Protection Offender Register (CPORA) alert
       Legislation:    Child Protection (Offender Reporting) Act 2004
                       Child Protection (Offender Prohibition) Order Act 2008

If a young person has a conviction recorded against them in relation to a class 1 or
class 2 offence, an alert must be recorded on ICMS. Refer to Chapter 25, Child
Protection Offender Reporting Act – Reportable Offenders.
In addition, if a young person has a prohibition order made against them, a CPORA
alert will also apply as the making of a prohibition order automatically results in the
young person‟s details being placed on the Child Protection Offender Register.


Recording alerts                                                                    11
Completion of a CPORA alert is necessary to ensure program planning for the young
person takes into account their status as a reportable offender. The alert will also
ensure decision making in relation to the young person‟s court orders takes into
account reporting obligations of the young person and the department.
The alert should be entered post-sentence by the court coordinator or the young
person‟s allocated case worker.
Court coordinator / caseworker responsibilities
   confirm the young person‟s status as a reportable offender
   open the alerts tab on ICMS to add a new alert
   enter the details of the alert including the date the young person will cease their
    reporting obligations
   save the information

Team leader responsibilities

   considers the information
   provides verbal approval to the caseworker to enter the information in an alert on
    ICMS.


12.3 Outstanding YJ warrants alert

Once a warrant is issued by the department, an alert must be created on ICMS.

Case worker responsibilities

   confirm the warrant has been issued
   open the alerts tab on ICMS to add a new Outstanding YJ warrant alert
   enter the details of the alert including:
    -   the name of the departmental officer that applied for the warrant
    -   the date the warrant was granted
   save the alert.


When advice is received that the warrant has been executed or recalled, the
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caseworker will:
   update the alert with the date the warrant was executed or recalled.


12.4    Outstanding court warrants alert

Once a warrant is issued by the court, an alert must be created on ICMS.

Case worker responsibilities
   confirm the warrant has been issued
   open the alerts tab on ICMS to add a new Outstanding court warrant alert
   enter the details of the alert including:
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    -   the name of the court
    -   the date the warrant was issued
   save the alert.


When advice is received that the warrant has been executed or cancelled, the
caseworker will:
   update the alert with the date the warrant was executed or cancelled.


12.5    Medical / Serious health issues alerts

If the youth justice service becomes aware that a young person suffers from a serious
medical condition, the completion of a medical / serious health issues alert will enable
appropriate measures to be put in place to ensure the young person‟s well-being.

Examples of medical information that may need to be recorded as an alert include
conditions such as:
   life-threatening allergies (e.g. nut allergies)
   a medical condition requiring medication such as epilepsy, diabetes or asthma
   a diagnosed medical condition that may impact on the young person‟s ability to
    participate in programs
   the young person is suffering a psychotic episode and/or has significant mental
    health issues
   phobias.


All medical information recorded is highly confidential and must only be used with the
knowledge and agreement of the young person or an authorised medical officer. The
information required to be documented for medical alerts is:
   the nature of the medical condition
   name of the person who supplied the information about the medical condition.

Caseworker responsibilities
To place a medical alert on ICMS, the caseworker will discuss the information with the
team leader and at the team leader‟s direction:
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   identify the medical information that should be placed on ICMS
   open the alerts tab on ICMS to add a new alert
   enter the details of the alert and save the information.

Team leader responsibilities

   considers the medical information
   provides verbal approval to the caseworker to enter the information into ICMS.

12.6    Behaviour alerts

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Behaviour alerts may be completed when young people exhibit concerning behaviours.
Behaviours eligible for an alert include:
   significant drug and/or alcohol use
   volatile substance misuse
   fire lighting
   the young person is a sexual offender who is assessed to be at high risk of
    reoffending
   the young person displays sexualized behaviour

Caseworker responsibilities
To place a behaviour alert on ICMS, the caseworker will discuss the information with
the team leader and at the team leader‟s direction:
   identify the information that should be placed on ICMS
   open the alerts tab on ICMS to add a new alert
   enter the details of the alert and save the information


Team leader responsibilities

   considers the information
   provides verbal approval to the caseworker to enter the information into ICMS.


12.7    Victim information alert
If a young person is subject to the victim information register alert should be created in
ICMS.


Caseworker responsibilities
To place a victim information alert on ICMS, the caseworker will discuss the
information with the team leader:
   identify the information that should be placed on ICMS
   open the alerts tab on ICMS to add a new alert
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   enter the details of the offence for which the alert relates
   save the information


Team leader responsibilities

   considers the information to be included on the alert
   provides verbal approval to the caseworker to enter the information into ICMS.
12.8    CP Offender Prohibition order alert
If a young person has a prohibition order made against them, in addition to a CPORA
alert, a CP Offender Prohibition Order alert will also apply.


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Completion of a CP Offender Prohibition Order alert is necessary to ensure program
planning for the young person takes into account the restrictions placed on the young
person as a result of their prohibition order. The alert will also ensure decision making
in relation to the young person‟s court orders takes into account reporting obligations
of the young person and the department.
The alert should be entered by the court coordinator or caseworker once the
application for a prohibition order is decided by the court.
Court coordinator / caseworker responsibilities
   confirm the young person is subject to a prohibition order
   open the alerts tab on ICMS to add a new alert
   enter the details of the prohibition order including the date the prohibition order will
    expire
   save the information

Team leader responsibilities

   considers the information
   provides verbal approval to the caseworker to enter the information in an alert on
    ICMS.


12.9   Publication order alert
Where a publication order is made in relation to a young person, a publication alert
must be made on ICMS following the making of the publication order.
Court coordinator / caseworker responsibilities
   confirm the young person is subject to a publication order
   open the alerts tab on ICMS to add a new alert
   enter the details of the publication order including the date the publication order
    was made and the offences to which it relates
   save the information

Team leader responsibilities
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   considers the information
   provides verbal approval to the caseworker to enter the information in an alert on
    ICMS.


12.10 Other significant incident alert
Where information is received by a youth justice service regarding a significant incident
affecting a member of the young person‟s family or support network, consideration
should be given to completing a other significant incident alert.
Incidences that may be considered relevant to completing the alert include:
   death of a family member


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   serious injury/hospitalisation of a family member
   incarceration of a family member.


Caseworker responsibilities
To place an other significant incident alert on ICMS, the caseworker will discuss the
information with the team leader and at the team leader‟s direction:
   identify the information that should be placed on ICMS
   open the alerts tab on ICMS to add a new alert
   enter the details of the incident including dates
   save the information


Team leader responsibilities

   considers the information to be included on the alert
   provides verbal approval to the caseworker to enter the information into ICMS.




                                                                                          Youth Justice Services Practice Manual, March 2010




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Appendix 1: Risk factors and warning signs



Suicide is a complex human behaviour that cannot be easily predicted. Consequently
all staff must remain vigilant and alert to the fact that a number of risk factors and or
warning signs can indicate that a young person is contemplating suicide or self harm or
is at risk of suicide or self harm.

It is easy to become accustomed to frequent statements by young people threatening
self-harm, however this behaviour may indicate suicide risk or become an indicator of
suicide risk.

Risk factors and warning signs may occur in clusters, or one single risk factor or
warning sign may provide the only clue that a young person is "in trouble".

The saying that "people who talk about suicide will not do it" is false.

Both longer term risk factors and immediate events may contribute to an attempted
suicide.

Stress and crises are very important precursors to suicide.

Outlined below are some examples of risk factors. The list is not exhaustive, but
evidence has shown that a range of primary risk factors may contribute to youth
suicide and suicidal behaviour. These include:

   A previous suicide attempt, the most significant risk factor for a completed suicide
   Deliberate self harm
   A history of mental illness including clinical depression
   Being bereaved by the suicide of a family member, friend or significant other
   Drug and alcohol abuse
   Major loss
   Disruptive and unsupportive family background/ family breakdown/ conflict
   Exposure to suicide
   Social isolation/ alienation/ not belonging within family or community

                                                                                            Youth Justice Services Practice Manual, March 2010




    Having poor coping and problem-solving skills and low self-esteem
   Issues relating to sexuality and sexual identity
   Problems with the law or being detained in a watchhouse or detention centre
   Being on remand and uncertain about the future.

Outlined below are some examples of warning signs of possible suicide risk. The list is
not exhaustive. The presence of warning signs or symptoms will not always indicate
suicidal intent. However the more that symptoms point towards an overall and
pervasive theme of hopelessness and helplessness, the greater is the likelihood that
they are indicators of suicide risk.

A preoccupation with death and or preparations for death such as:

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   Making a will/indicating who should have their possessions
   Saying goodbye to people
   Giving away personal possessions
   Recurring themes of death in music, poetry, art work
   Talking about death
   Talking about a person who has died
   Gathering the means to attempt suicide

Verbal warning signs such as:

   Direct threats like "I'm going to kill myself" or “I want to die”.

Indirect statements such as:

   "You'll be sorry when I'm dead"
   "I might as well be dead"
   "They would be better off without me"
   "Life has no meaning/has lost its meaning"
   "If I killed myself they would be sorry"
   "If I don't see you again, thanks for everything"
   "Here, take this, I won't need it any more"

Situational crisis and or stressors such as:

   Loss/death of relatives or significant others
   Loss of relationship - "Dear John/Jane" letter
   Rejection of family/significant other
   Separation from family/significant others
   Peers leave detention centre
   Family crisis/parent or sibling in jail
   Family or relationship conflict
                                                                                           Youth Justice Services Practice Manual, March 2010




   Trouble with the law
   Point of sentence or legal decision such as admission to detention centre, return to
    detention, additional custodial sentence, bail refused, losing a sentence appeal or
    review
   A change in health status, eg unwanted pregnancy, onset of serious or chronic
    illness
   Anniversary of death or other significant event
   Incident of abuse
   Victimisation by peers
   Disruptive/violent incident in detention

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   Major failure

Changes in behaviour/personality such as:

   Social withdrawal and isolation from others
   Impatience or impulsive behaviours
   Increased use of drugs/alcohol
   Mood swings, angry outbursts, irritability
   Sudden happiness may indicate a decision to die
   Disorientation/disorganisation
   Agitated depression such as aggressive outbursts, frenetic behaviour and
    oppositional behaviour
   Loss of interest in appearance/normal activities
   No future plans/no ability to plan for the future.

Depression and or changes in feelings such as:

   Anxiety
   Apathy
   Chronic fatigue
   Crying easily
   Hopelessness/helplessness
   Self defeating attitude

Physical changes such as:

   Abrupt change in appearance
   Self neglect
   Lack of energy
   Recent weight or appetite change
   Changing in sleeping patterns
                                                                               Youth Justice Services Practice Manual, March 2010




   Increase in unexplained or minor illnesses.

Changes in thinking such as:

   Drop in self-esteem
   Scattered thoughts/tunnel vision
   Difficulty in decision making
   Inability to concentrate or think rationally
   Exaggerated fears of disease.



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Additionally young people in detention can feel particularly isolated and vulnerable at
holiday and celebration times such as Easter and Christmas. This can initiate, increase
and or revive their risk of self harm and suicide. Additionally many staff members with
whom young people have valuable interactions during the year, are often absent at
these times. Young people at risk of self-harm and suicide should be especially
monitored at these times and contingency plans put in place as required.

The impending release of a young person into the community following a period in
detention may also prompt feelings of anxiety and stress in a young person and
increase or revive their risk of suicide or self harm. As such a young person‟s risk
should be assessed and monitored as part of the young person‟s transition plan.

When changes in behaviour, feelings, physical condition or thinking (as above) are
observed in a young person, immediate assessment should be undertaken to ascertain
if thoughts of suicide are involved.

Additional risk factors and warning signs for Aboriginal and Torres Strait
Islander young people

For Aboriginal and Torres Strait Islander young people it has been identified that the
risk of suicide and self-harming behaviour can increase:

   At a time of emotional stress and anger when young people feel unable to
    outwardly express their anger and instead turn the aggression inwards and harm
    themselves as a means of expression.
   In situations where young people feel they have lost control over their personal
    situation, usually soon after being incarcerated and they would rather take their
    own life and regain personal control than feel that others have total control over
    their situation. Staff must not underestimate the importance of cultural and other
    factors affecting Aboriginal and Torres Strait Islander young people in detention, for
    example:

-   When conducting assessments it may be important to take into account the
    diversity of cultural beliefs across Aboriginal and Torres Strait Islander
    communities.
-   Aboriginal and Torres Strait Islander young people can be very traumatised when
    separated from their family and community
-   Spiritual beliefs and isolation at night may have special relevance as it is often not
    customary for Aboriginal and Torres Strait Islander people to be isolated at night or
                                                                                             Youth Justice Services Practice Manual, March 2010




    for long periods of time
-   Aboriginal and Torres Strait Islander young people in detention are more
    geographically isolated from their families and communities than most non-
    Indigenous young people.


(Source: Management and recording of suicide risk concerns)




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