This case study describes how residential accommodation and day service staff worked together to provide good quality, positive behaviour support to eliminate the use of mechanical restraint for a 38-year-old man, James – his name has been changed to protect his identity. James has cerebral palsy, epilepsy, and other disabilities, and has self-harmed from the age of two, hitting the left side of his head and face. To stop the self-harm, mechanical restraints, in the form of splints and a helmet, were used. When James began to self-harm using the mechanical restraints his carers decided to investigate the possible causes of the self-harm. They found he had several underlying medical problems that caused pain and distress, therefore James’s self-harm could be interpreted as cries for help. His carers’ ability to monitor and interpret these cries for help enabled them to support him to have his needs met. This meant they no longer needed to mechanically restrain him and restraints have not been used since October 2014.