There was a major rise within the variety of self-injury incidents reported within the UK’s psychological well being providers over the past decade (Woodnutt et al., 2024). The best way somebody injures themselves can depend 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 likely to be. 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 sturdy medicines and poisonous chemical substances, or in hospital environments akin to safe wards, eradicating private objects that may 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 objects are restricted, folks might flip to different strategies akin to headbanging — repeatedly hitting their head in opposition to a tough floor like a wall or flooring. Headbanging is without doubt one of the most typical methods folks hurt themselves (Chester & Alexander, 2018), however there’s nonetheless little analysis about why it occurs, how typically it happens, or what conditions result in it.
This examine undertook a overview of headbanging and self-injury incidents throughout the final 5 years inside a personal sector safe psychological well being supplier.
There was an increase in self-harm incidents involving headbanging – significantly in safe wards the place harmful objects are confiscated.
Strategies
Doyle et al. (2025) carried out a examine taking a look at how typically headbanging and different self-injury incidents have been reported in one of many UK’s largest impartial psychological well being suppliers, which operates safe and specialist providers for adults, adolescents and other people with neurodevelopmental circumstances. They included all knowledge recorded over a five-year interval. Their examine included data from 421 sufferers whose incidents had been recorded based on hospital coverage.
The researchers checked out just a few key particulars concerning the folks concerned — their analysis, age, gender, and the sort of ward or service they have been in. This included locations akin to Baby and Adolescent Psychological Well being wards, low safe wards, and different specialist environments.
Moderately than counting the full variety of headbanging incidents (as a result of one individual may need many, which may make the information onerous to match), the staff centered on which sufferers had at the least one headbanging incident through the examine interval. They then in contrast the traits of these sufferers to the traits of sufferers who had engaged in some other type of self-injurious behaviour to search for patterns; for instance, whether or not sure age teams or diagnoses have been linked to headbanging extra typically.
The examine used the hospital’s inside incident reporting system, the place employees document each the kind and severity of every incident. Workers responding to an incident rated how critical it was utilizing classes akin to no hurt, low hurt, reasonable hurt, or critical incident. The extra critical instances typically required the individual to be transferred to a bodily (normal) hospital for remedy.
Outcomes
Headbanging incident frequency
The outcomes confirmed that almost all 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 an excellent smaller minority of sufferers had between 100 and 499 incidents of headbanging.
A lot of the incidents of headbanging throughout the pattern have 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. Critical 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 general self-injury for the pattern (which incorporates the headbanging knowledge) and this confirmed related developments 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 previous sufferers reported headbanging.
A lot 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 akin to Publish-Traumatic Stress Dysfunction, Autism, Schizophrenia or a variety of different psychological well being or neurodevelopmental problems.
Lastly, the authors checked out the kind of service that the incidents got here from. Most of those have 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 have been reported to be from a neighborhood setting.
People who engaged in headbanging as a type of self-injury tended to take action lower than 10 instances, and most incidents have been rated as low hurt by hospital employees.
Conclusions
This examine presents a descriptive overview of headbanging and self-injury amongst a small, specialist group of sufferers in a personal psychological well being service. The authors discovered that youthful folks, significantly girls with a analysis of Emotionally Unstable Persona Dysfunction (EUPD), have been most certainly to have interaction on this type of self-harm. The very best charges have 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 developments in self-injury. Nationwide surveys present that youthful adults are extra probably than older adults to report self-harm and to have circumstances akin to PTSD or ADHD (Grownup Psychiatric Morbidity Survey, 2023/4), which may produce behaviours that overlap with or are typically interpreted as EUPD (Sarr et al., 2025). This implies that the sufferers on this examine replicate patterns already seen extra broadly.
General, the examine provides a small, native view to an already well-established image, that self-injury amongst youthful girls with EUPD stays a major problem throughout providers.
This examine of hospital data discovered that headbanging as a type of self-injury was extra more likely to happen in younger females with a analysis of emotionally unstable character dysfunction.
Strengths and limitations
One power of this examine is that it used routinely collected hospital knowledge relatively than counting on separate analysis interviews or questionnaires. Though these sorts of knowledge might be affected by variations in how employees report incidents, they do replicate how incidents are recorded in actual time and consistent with hospital coverage. The examine additionally checked out data overlaying 5 years, which supplied a pretty big pattern of incidents and allowed for some comparability over time.
Nonetheless, there are a number of necessary limitations. This examine solely appears to be like at fundamental 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 examine principally simply describes who had incidents — their age, gender, and analysis — with out making an attempt to elucidate why headbanging occurred or whether or not these elements 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 frequent in youthful, feminine sufferers with Emotionally Unstable Persona Dysfunction (EUPD) — aren’t new. Different analysis already exhibits related patterns, so the examine doesn’t actually add new information.
Lastly, the examine doesn’t give a lot context about how the ward setting or care practices would possibly have an effect on headbanging. For instance, guidelines about what objects sufferers can use, employees responses, or developmental elements may all affect behaviour, however the examine doesn’t discover these. With out this context, it’s onerous to interpret the outcomes.
It is a small descriptive examine about headbanging and self-harm – the examine doesn’t try to discover why headbanging occurred specifically populations.
Implications for follow
Future analysis and scientific follow would profit from a extra nuanced method to understanding behaviours akin to headbanging. Differentiating between self-harm, sensory regulation, and communicative behaviours may assist keep away from over-pathologising all cases of headbanging as self-injury. Recognising these distinctions is necessary for tailoring help methods and for guaranteeing that interventions are applicable to every particular person’s wants and intent.
It will even be beneficial 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 elements collectively may present a extra full understanding of why sure behaviours happen, and the way care environments is likely to be tailored to scale back misery and promote safer coping methods.
Future analysis ought to goal to distinguish between headbanging as self-harm, sensory regulation and communication with the intention to keep away from over-pathologising all cases of headbanging as self-injury.
Assertion of pursuits
haven’t 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 affect 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 problems, advanced put up‐traumatic stress dysfunction and emotionally unstable character dysfunction: A Delphi examine. 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 knowledge 2015–2022‘, Journal of Psychiatric and Psychological Well being Nursing, 31(5), pp. 716-728.
