There was a big rise within the variety of self-injury incidents reported within the UK’s psychological well being providers during the last decade (Woodnutt et al., 2024). The best way somebody injures themselves can rely upon the place they’re on the time. It is because entry to issues that may trigger hurt — like blades, glass, or different sharp or harmful objects — impacts how critical the harm is perhaps. This concept known as entry to means.
Limiting entry to means has lengthy been a part of how governments attempt to stop hurt, for instance by controlling who can have firearms, limiting entry to robust medicines and poisonous chemical compounds, or in hospital environments equivalent to safe wards, eradicating private gadgets that might trigger hurt (Sarchiapone et al., 2011).
With the general rise in self-injury throughout the inhabitants, psychological well being employees are seeing extra sufferers who hurt themselves, particularly in safe wards. When dangerous gadgets are restricted, folks might flip to different strategies equivalent to headbanging — repeatedly hitting their head towards a tough floor like a wall or ground. Headbanging is likely one of the commonest methods folks hurt themselves (Chester & Alexander, 2018), however there’s nonetheless little analysis about why it occurs, how usually it happens, or what conditions result in it.
This research undertook a evaluate of headbanging and self-injury incidents throughout the final 5 years inside a non-public sector safe psychological well being supplier.
There was an increase in self-harm incidents involving headbanging – notably in safe wards the place harmful gadgets are confiscated.
Strategies
Doyle et al. (2025) carried out a research how usually headbanging and different self-injury incidents had been reported in one of many UK’s largest impartial psychological well being suppliers, which operates safe and specialist providers for adults, adolescents and folks with neurodevelopmental situations. They included all information recorded over a five-year interval. Their research included data from 421 sufferers whose incidents had been recorded in accordance with hospital coverage.
The researchers checked out a number of key particulars concerning the folks concerned — their analysis, age, gender, and the sort of ward or service they had been in. This included locations equivalent to Baby and Adolescent Psychological Well being wards, low safe wards, and different specialist environments.
Slightly than counting the overall variety of headbanging incidents (as a result of one particular person might need many, which might make the information onerous to match), the group centered on which sufferers had a minimum of one headbanging incident throughout the research interval. They then in contrast the traits of these sufferers to the traits of sufferers who had engaged in every other type of self-injurious behaviour to search for patterns; for instance, whether or not sure age teams or diagnoses had been linked to headbanging extra usually.
The research used the hospital’s inner incident reporting system, the place employees file each the sort and severity of every incident. Workers responding to an incident rated how critical it was utilizing classes equivalent to no hurt, low hurt, reasonable hurt, or critical incident. The extra critical circumstances typically required the particular person to be transferred to a bodily (basic) hospital for therapy.
Outcomes
Headbanging incident frequency
The outcomes confirmed that the majority sufferers had fewer than 49 headbanging incidents over the five-year interval, with the bulk reporting between 0 and 9 incidents every. A small variety of sufferers had between 50 and 99 incidents of headbanging, and a fair smaller minority of sufferers had between 100 and 499 incidents of headbanging.
Many of the incidents of headbanging throughout the pattern had been rated as both ‘no hurt’ or ‘low hurt’. Solely a small variety of sufferers skilled reasonable hurt 10–49 instances, whereas most had between 0 and 9 episodes of hurt. Severe incidents solely appeared to have an effect on a really small variety of sufferers. The authors don’t report the precise figures, solely the general patterns within the type of a graph.
The authors additionally reported total self-injury for the pattern (which incorporates the headbanging information) and this confirmed comparable traits throughout age, analysis and gender.
Traits of the sufferers within the pattern
The authors reported that 64% of the headbanging incidents concerned feminine sufferers (70% for self-injury) and that youthful sufferers had extra incidents of self-injury, whereas the variety of incidents decreased with age. Solely a really small proportion of 10-14 yr outdated sufferers reported headbanging.
Many of the headbanging and self-injury incidents occurred in sufferers who had a analysis of Emotionally Unstable Persona Dysfunction, with a lot smaller quantities in different diagnoses equivalent to Submit-Traumatic Stress Dysfunction, Autism, Schizophrenia or a spread of different psychological well being or neurodevelopmental issues.
Lastly, the authors checked out the kind of service that the incidents got here from. Most of those had been from the Low Safe and Specialist Rehab wards, adopted by Baby and Adolescent Psychological Well being wards, Autism and Studying Incapacity Wards, Medium Safe Psychological Well being Wards and Neuropsychiatry wards. A really small minority of sufferers had been reported to be from a group setting.
Those who engaged in headbanging as a type of self-injury tended to take action lower than 10 instances, and most incidents had been rated as low hurt by hospital employees.
Conclusions
This research presents a descriptive overview of headbanging and self-injury amongst a small, specialist group of sufferers in a non-public psychological well being service. The authors discovered that youthful folks, notably ladies with a analysis of Emotionally Unstable Persona Dysfunction (EUPD), had been almost definitely to interact on this type of self-harm. The very best charges had been reported in Baby and Adolescent Psychological Well being Providers (CAMHS) and low safe wards.
Whereas these findings present a snapshot of headbanging incidents inside one organisation, they sit inside broader traits in self-injury. Nationwide surveys present that youthful adults are extra possible than older adults to report self-harm and to have situations equivalent to PTSD or ADHD (Grownup Psychiatric Morbidity Survey, 2023/4), which might produce behaviours that overlap with or are typically interpreted as EUPD (Sarr et al., 2025). This implies that the sufferers on this research replicate patterns already seen extra broadly.
General, the research provides a small, native view to an already well-established image, that self-injury amongst youthful ladies with EUPD stays a big problem throughout providers.
This research of hospital information discovered that headbanging as a type of self-injury was extra more likely to happen in younger females with a analysis of emotionally unstable persona dysfunction.
Strengths and limitations
One power of this research is that it used routinely collected hospital information relatively than counting on separate analysis interviews or questionnaires. Though these varieties of knowledge will be affected by variations in how employees report incidents, they do replicate how incidents are recorded in actual time and in keeping with hospital coverage. The research additionally checked out information overlaying 5 years, which offered a pretty big pattern of incidents and allowed for some comparability over time.
Nonetheless, there are a number of vital limitations. This research solely seems at primary statistics from a small group of sufferers, lots of whom had repeated headbanging incidents. Due to this, it’s onerous to know if the patterns they report apply to different sufferers or different hospitals.
The research principally simply describes who had incidents — their age, gender, and analysis — with out attempting to clarify why headbanging occurred or whether or not these components actually made a distinction. It doesn’t use extra superior evaluation that would present connections between affected person traits, the setting, or employees practices.
The primary findings — that headbanging was extra widespread in youthful, feminine sufferers with Emotionally Unstable Persona Dysfunction (EUPD) — aren’t new. Different analysis already reveals comparable patterns, so the research doesn’t actually add new information.
Lastly, the research doesn’t give a lot context about how the ward setting or care practices may have an effect on headbanging. For instance, guidelines about what gadgets sufferers can use, employees responses, or developmental components might all affect behaviour, however the research doesn’t discover these. With out this context, it’s onerous to interpret the outcomes.
This can be a small descriptive research about headbanging and self-harm – the research doesn’t try to discover why headbanging occurred specifically populations.
Implications for apply
Future analysis and medical apply would profit from a extra nuanced strategy to understanding behaviours equivalent to headbanging. Differentiating between self-harm, sensory regulation, and communicative behaviours might assist keep away from over-pathologising all situations of headbanging as self-injury. Recognising these distinctions is vital for tailoring help methods and for guaranteeing that interventions are applicable to every particular person’s wants and intent.
It will even be priceless to discover how environmental restrictions, emotional regulation, and developmental stage work together to form patterns of self-injury inside safe and inpatient settings. Contemplating these components collectively might present a extra full understanding of why sure behaviours happen, and the way care environments is perhaps tailored to cut back misery and promote safer coping methods.
Future analysis ought to goal to distinguish between headbanging as self-harm, sensory regulation and communication to be able to keep away from over-pathologising all situations of headbanging as self-injury.
Assertion of pursuits
don’t have any conflicts of curiosity to declare.
Edited by
Laura Hemming.
Hyperlinks
Major paper
Isobel Doyle, Kristina Brenisin & Kieran C Breen (2025). The incidence of headbanging as a type of self-harm amongst inpatients inside a safe psychological well being setting–the impression of age, gender and analysis. The Journal of Forensic Psychiatry & Psychology, 36(5), 697-710. DOI: https://doi.org/10.1080/14789949.2025.2545206
Different references
Grownup Psychiatric Morbidity Survey: Survey of Psychological Well being and Wellbeing, England, 2023/4 – NHS England Digital
Chester, V., & Alexander, R. T. (2018). Head banging as a type of self-harm amongst inpatients inside forensic psychological well being and mental incapacity providers. Journal of Forensic Psychiatry & Psychology, 29(4), 557–573. https://doi.org/10.1080/ 14789949.2018.1425472
Sarchiapone, M. et al. (2011) ‘Controlling entry to suicide means‘, Worldwide journal of environmental analysis and public well being, 8(12), pp. 4550-4562.
Sarr, R., Spain, D., Quinton, A.M., Happé, F., Brewin, C.R., Radcliffe, J., Jowett, S., Miles, S., González, R.A., Albert, I. and Scholwin, A., (2025). Differential analysis of autism, attachment issues, complicated put up‐traumatic stress dysfunction and emotionally unstable persona dysfunction: A Delphi research. British Journal of Psychology, 116(1), pp.1-33.
Woodnutt, S. et al. (2024) ‘Evaluation of England’s incident and psychological well being nursing workforce information 2015–2022‘, Journal of Psychiatric and Psychological Well being Nursing, 31(5), pp. 716-728.
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