Self-harm in people with learning disabilities

Section A

A systematic literature review on the experiences of people with learning disabilities who self-harm. Quality assessment of 12 qualitative papers was guided by the CASP. Through thematic synthesis of these paper three central themes were developed: (1) Negative experiences, (2) The act of self-harm, and (3) A different response. Self-harm took place in a negative context which affected an individual’s self-view and created overwhelming emotions. Responses to self-harm could be experienced as punitive or uncaring which furthered the individual’s negative experiences. Responses which reduced self-harming behaviour were identified. The implications for clinical practice and research were discussed.

Section B

Presented here, is a study exploring how professionals in the care sector work with people with learning disabilities who self-harm. Interviews were conducted with 11 participants and data analysis, informed by critical realist grounded theory methodology, produced four main concepts: a caring vocation, a distressing experience, navigating distress, and powerlessness. A preliminary model of how professionals navigate distress when working with people with learning disabilities who self-harmed was developed. It considered both personal and systemic contexts which influence and are influenced by this process. Implications for clinical practice and research were discussed.