Publish date: 13 February 2025
Five West London staff members conducted a research study on head-banging as a form of self-harm in their forensic service, after noticing an increase in the incidents among patients.
Aubane Etter, Research Assistant, Yoke Wong, Practice Development Nurse, Arthur Chiwandire, Service Director, Siham Yusuf, Assistant Psychologist, and Dr Nicholas Stokes, Research Lead and Consultant Psychologist, were concerned about a significant rise in cases of head-banging at the Orchard Women’s Secure Services from 2020, compared to previous years.
Nationally there is a lack of research and guidelines relating to head-banging particularly within forensic services.
They decided to conduct a service evaluation to explore the trends in occurrence, nature and interventions around the incidents between 2019 and 2021, and further developed the evaluation into a mixed-method study, titled Exploring the correlates of head-banging behaviour in a female forensic mental health unit.
The study has been published in the Journal of Forensic Psychiatry & Psychology.
Yoke, one of the authors said: “The authors are extremely proud of this study. It is a testament to all the staff working in The Orchard Women’s Services as it reflects their depth of commitment and their dedication to working with women who manage their emotional distress through self-harming behaviours. In particular, the study highlights the positive impact of nursing interventions as an immediate response to incidents of self-harm. It can sometimes be difficult to see beyond what is happening in the moment, but I hope our staff in the Orchard know that what they do, really does make a difference,” she said.
Research shows that head-banging is one of the most common forms of self-harm behaviour within inpatient psychiatric settings. But despite its high prevalence in forensic settings, very little research has been conducted on its correlation with demographic and clinical factors.
The paper provides insights into the underlying psychological factors driving head-banging behaviour, which often emerged as a response to interpersonal factors or psychotic symptoms. The paper hypothesised that head-banging may vary in function across diagnoses, with interpersonal factors being a common trigger in service users with a personality disorder. Head-banging behaviour was also found to be significantly more likely in patients of White ethnicity and of a younger age.
The authors say that whilst this study was conducted in a female secure service, its findings will provide useful insights for clinical staff working in other settings.
The study can be read on the journal website.