Staff beliefs about why people with learning disabilities self‐harm: a Q‐methodology study

Accessible summary•  Staff beliefs about why people with learning disabilities self‐harm are important because they can affect the way that staff respond to the behaviour. •  Staff who work with people with learning disabilities said why they think people with learning disabilities self‐harm. •  Staff had many different views on why people with learning disabilities self‐harm. Staff thought that people with learning disabilities self‐harm because they are distressed. Some staff said it is difficult to understand why people with learning disabilities self‐harm. Some staff said people self‐harm because of their learning disabilities. •  It would be useful for staff to receive more training about self‐harm. This could improve care for people with learning disabilities who self‐harm .Summary Staff beliefs about self‐harm can influence staff responses to the behaviour. Existing research into staff beliefs about self‐harm by people with learning disabilities is limited, with qualitative research restricted to forensic services. The aim of this study was to use Q‐methodology to explore staff beliefs about why people with learning disabilities self‐harm. Five distinct viewpoints were identified: self‐harm is individual, complex and emotionally meaningful; self‐harm is a means to communicate distress, whether or not you have learning disabilities; self‐harm is difficult to understand but seems to be a way to modify emotional states; self‐harm is a result of having learning disabilities and being different; and self‐harm is meaningful within relationships. These viewpoints represent the variety of theories and discussions in the literature. It is proposed that some of these viewpoints may result in more helpful responses to self‐harm than others. Therefore, further staff training that promotes skills in developing a comprehensive and individual understanding of self‐harm is recommended.