Mortality and avoidable death in people with severe self-injurious behaviour: results of a Dutch study.

Martin et al. (1997) followed adults with severe self-injury and intellectual disability. They counted who died, what killed them, and which deaths could have been prevented.

The team used Dutch medical records. They compared the death rate to the general population.

More adults died than expected. Lung and airway diseases were the top killer.

Self-injury played a role in 12 out of every 100 deaths. Two deaths were labeled avoidable.

Amaral et al. (2017) later tracked every adult with ID in England. They found the same lung-driven risk but added hard numbers: life cut short by almost 20 years. This larger, newer study supersedes the Dutch signal.

Tyrer et al. (2009) also saw lung disease leading deaths in UK adults with ID. Their data extend the Dutch warning by showing doctors often leave ID off death certificates, hiding the true toll.

Boudreau et al. (2015) reviewed drug help for severe SIB. Half of adults improved on opioid blockers. Linking these findings, cutting SIB could lower the 12% of deaths tied to the behavior.

If you serve adults with ID and SIB, treat every cough or wheeze as urgent. Push for chest X-rays, flu shots, and aspiration checks. Add SIB reduction to the care plan; it is not just a behavior issue—it is a life-span issue. Track medical follow-through and flag any delay: two deaths in the study were judged avoidable.