Self‐Harm Among People with Intellectual Disabilities Living in Secure Service Provision: A Qualitative Exploration

In: Journal of applied research in intellectual disabilities: JARID, Band 22, Heft 6, S. 503-513

Abstract

Background  Research into self‐harm among people with intellectual disabilities has focused predominantly on high frequency internally maladaptive behaviour among people whose disability is severe or profound. Research into different forms of self‐harm, such as cutting or burning the skin, found in those with mild intellectual disabilities; especially those living in secure accommodation, has largely been neglected, although there has been recognition of its impact on individuals and staff working in this field. This study aimed to address this issue through exploration of the experiences and understanding of self‐harm among people with intellectual disabilities living in secure accommodation. A second aim was to explore experiences of interventions associated with this behaviour.Method and Results  Semi‐structured interviews were carried out with nine people who self harm, have intellectual disabilities and had been placed in secure accommodation. Interpretative Phenomenological Analysis yielded three master themes. The first related to the interpersonal context of self‐harm and included sub themes relating to past experiences of abuse and loss, and current issues of control and protection. The second master theme related to the emotional experience of self‐harm, which varied throughout the process of self‐harm and was characterized by anger, frustration, hopelessness, relief, guilt and regret. The third master theme related to the management of self‐harm. Participants had experience of helpful individual and collaborative strategies, as well as interventions that were experienced as controlling, unhelpful or ridiculing.Conclusion  Emerging themes are considered in relation to the wider‐self‐harm literature and current psychotherapeutic models. A number of limitations to the study are noted and the use of this methodology with people with intellectual disabilities was discussed.