Intellectual Disability

    Exclude, if the patient’s behavior is related to a profound intellectual disability.

    For example,

    • The person has no conscious awareness that he/she is self-harming.

    This would apply only to patients with severe intellectual disability. Patients with milder intellectual disabilities can and do consciously self-harm.

    If the disability is clearly severe and the person is not aware of the self-harm behavior, then it is not a case of intentional self-harm.

    Action  =  Exclude

    Vignette Example – Intellectual Disability

    Admission Notes: 28-year-old man with head injury. Profoundly autistic, accompanied by carer who explains he has a pattern of head-banging.

    Behaviour: Non-communicative. No eye contact. Rocking back and forth and reluctant to allow head examination.