Staff beliefs on self harm in people with learning disabilities affect responses


There is a limited literature about self harm in people with learning disabilities. There are some qualitative studies, but mostly relating to forensic services. The researchers in this study were interested in the extent to which the beliefs that staff hold about self-harm influence their response to the behaviour.

The researchers used Q-methodology a research method used to study people’s subjectivity or viewpoint involving rank-ordering a set of statements from agree to disagree. They identified five distinct viewpoints held by staff about why people self harm. That self -harm is:

  • individual, complex and emotionally meaningful;
  • a means to communicate distress, whether or not you have learning disabilities;
  • difficult to understand but seems to be a way to modify emotional states;
  • a result of having learning disabilities and being different;
  • meaningful within relationships.

The authors suggest that the viewpoints represent a variety of theories and discussions found in the literature and that some viewpoints are more likely to result in helpful responses to self-harm than others.

They conclude that there is a need for staff training promoting  a comprehensive and individual understanding of self-harm in people with learning disabilities.

Staff beliefs about why people with learning disabilities self-harm: a Q-methodology study, Dick K et al in British Journal of Learning Disabilities, 39: 233–242

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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