Children at Risk of Self Harm Home Care :: Nationwide Children's Hospital

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Children at Risk for Self-Harm or Harm to Others: Home Safety Guidelines for Families

Your child has been in the hospital because he or she is at risk of self-harm or harming others. When your child leaves the hospital, there are some things you need to do for safety at home.

Closely Monitor your Child

Monitor your child at all times until at least the first follow-up appointment with a mental health professional. The clinician can assess your child’s safety and talk to you about the continuing need for close supervision.

Close supervision means:

  • Keep your child’s bedroom door open at all times.
  • Do not allow your child to be alone in any room of the house, including the bathroom, without leaving the doors open. Check on him often.
  • Do not let your child visit friends, relatives or others unless there is constant adult supervision.
  • Talk to the counselor or administrator at your child’s school. Make arrangements for the child’s safety needs to be met.
Let your child know you are available and willing to listen when he is ready to talk to you about what happened. Do not try to make him talk about the reasons for his actions. Many children are not comfortable discussing issues soon after discharge. Pressure to do so may make him feel worse. A more in-depth discussion will take place during your child’s visit with a mental health counselor. Continue to use the support systems and coping strategies you and your child learned while he was in the hospital.
Encourage your child to follow his or her personal safety plan. It is helpful to make a few copies of the safety plan so you can post one in the child’s room and on the refrigerator. Your child and his guardian or caretaker should each have a copy of the safety plan to carry with them all the time.
If your child seems to be in a better mood, do not assume this means that he is not at risk to hurt himself. Many times children hurt themselves when they feel less depressed and have more energy to carry out such actions.

Safety-Proof the House

This may include things you have not considered before.

General guidelines are:

  • It is very important that all knives, guns and ammunition be removed from the home. If that is not possible lock these items away to deny your child access. Store ammunition in a separate place from the firearm. Research shows that having a gun in the home increases the risk of suicide.
  • Search your house and your child’s room. Look for any items that could be used to selfharm. These items include weapons, sharp objects, over-the-counter and prescription medicines (these might be hidden), belts, ropes, and cords.
  • Lock up or remove all prescription and over-the-counter (OTC) medicines. We recommend a safety lock box for all medicines kept in your home. This includes such items as:
    • aspirin
    • Tylenol®
    • vitamins
    • supplements
    • all other OTC and prescription medicines
  • Your child should not have access to alcohol, cleaning supplies and power tools. “Out of reach” is not enough. These items must not be accessible to your child at all. It is possible that all of these different items may have to be removed from your home for a long period of time.
  • Be aware of items in the home that your child could use to cut off his air flow. These items include: plastic bags, balloons, belts and cord of any kind (electric cords, cords from window blinds and vacuum cleaner cords).
  • Take away your child’s keys. Do not allow him or her to have access to a car until the first follow-up appointment with a mental health professional.

Act Right Away on Your Child’s Comments

If your child mentions wanting to hurt himself or others again, always take it seriously. This includes comments about death, dying, serious self-harm, seriously harming another person or an attempt to end his life or end another person’s life.

Take ALL comments and attempts seriously and keep trying these resources until you reach someone:

  • Call your child’s provider at: _________________________.
  • Call 911 for immediate medical or safety concerns.
  • Call your local 24-hour crisis line.
    • In Franklin County call Nationwide Children’s Hospital’s Psychiatric Emergency Evaluation Center at 614-722-1800.
    • Outside Franklin County- 1-800-273-TALK(8225)
  • Take your child (or use emergency transportation) to the emergency room.


It is extremely important that your child have a follow-up appointment scheduled before he is discharged. If an appointment has not been set when you are ready to take him home, request that his physician or another clinician who is working with him arrange the appointment.

Follow-up care is very important. Even if it seems everything is fine, you need to continue to follow up as discussed at the time of discharge.

Please contact Nationwide Children's Hospital Behavioral Health at 614-355-8080 if you need to set up an appointment. You may also contact your health care provider for a list of counseling services covered by your health care plan.

Children at Risk for Self-Harm or Harm to Others: Home Safety Guidelines for Families (PDF)

HH-IV-124 5/11, Revised 7/15 Copyright 2011, Nationwide Children's Hospital

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000