Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Owen, C. Articles by Tennant, C. Search for Related Content PubMed Citation Articles by Owen, C. Articles by Tennant, C. Staff Issues, Staffing Violence in Treatment Settings

Violence and Aggression in Psychiatric Units

OBJECTIVE: To help predict aggressive and violent behaviors, the frequency and types of these behaviors in acute psychiatric inpatient settings were examined, and potential interactions between staffing and patient mix and rates of the behaviors were explored. METHODS: Data on violent incidents were gathered prospectively in three adult acute psychiatric units in a general hospital and two units in a primary psychiatric hospital in Sydney, Australia. Staff recorded violent and aggressive incidents, which were ranked on an 8-level scale. They also completed weekly reports of staffing levels and patient mix. Poisson regression analysis was used to calculate relative rates, 95 percent confidence intervals, and p values. RESULTS: A total of 1,289 violent incidents were recorded over a seven-month period. Based on the scale, 58 percent of the incidents were serious. Seventy-eight percent were directed toward nursing staff. Complex relationships between staffing, patient mix, and violence were found. Relative risk increased with more nursing staff (of either sex), more nonnursing staff on planned leave, more patients known to instigate violence, a greater number of disoriented patients, more patients detained compulsorily, and more use of seclusion. The relative risk decreased with more young staff (under 30 years old), more nursing staff with unplanned absenteeism, more admissions, and more patients with substance abuse or physical illness. In total these factors accounted for 62 percent of the variance in violence. CONCLUSIONS: Violent incidents in psychiatric settings are a frequent and serious problem. Incidents appear to be underreported, and the seriousness of an incident does not guarantee it will be reported.

This article has been cited by other articles:

				J. Ho, D. C. Ralston, L. B. McCullough, and J. H. Coverdale When Should Psychiatrists Seek Criminal Prosecution of Assaultive Psychiatric Inpatients? Psychiatr Serv, August 1, 2009; 60(8): 1113 - 1117. [Abstract] [Full Text] [PDF]

				E. P. Ryan, J. Aaron, M. L. Burnette, J. Warren, R. Burket, and T. Aaron Emotional Responses of Staff to Assault in a Pediatric State Hospital J Am Acad Psychiatry Law, September 1, 2008; 36(3): 360 - 368. [Abstract] [Full Text] [PDF]

				N. N. Singh, G. E. Lancioni, A. S. W. Winton, A. D. Adkins, R. G. Wahler, M. Sabaawi, and J. Singh Individuals with Mental Illness Can Control their Aggressive Behavior Through Mindfulness Training Behav Modif, May 1, 2007; 31(3): 313 - 328. [Abstract] [PDF]

				G. M. Smith, R. H. Davis, E. O. Bixler, H.-M. Lin, A. Altenor, R. J. Altenor, B. D. Hardentstine, and G. A. Kopchick Special Section on Seclusion and Restraint: Pennsylvania State Hospital System's Seclusion and Restraint Reduction Program Psychiatr Serv, September 1, 2005; 56(9): 1115 - 1122. [Abstract] [Full Text] [PDF]

				A. N. Khadivi, R. C. Patel, A. R. Atkinson, and J. M. Levine Association Between Seclusion and Restraint and Patient-Related Violence Psychiatr Serv, November 1, 2004; 55(11): 1311 - 1312. [Abstract] [Full Text] [PDF]

				E. P. Ryan, V. S. Hart, D. L. Messick, J. Aaron, and M. Burnette A Prospective Study of Assault Against Staff by Youths in a State Psychiatric Hospital Psychiatr Serv, June 1, 2004; 55(6): 665 - 670. [Abstract] [Full Text] [PDF]

				M. E. Johnson Violence on Inpatient Psychiatric Units: State of the Science Journal of the American Psychiatric Nurses Association, June 1, 2004; 10(3): 113 - 121. [Abstract] [PDF]

				J. I. Rossberg and S. Friis Staff Members' Emotional Reactions to Aggressive and Suicidal Behavior of Inpatients Psychiatr Serv, October 1, 2003; 54(10): 1388 - 1394. [Abstract] [Full Text] [PDF]

				A. Sipos, R. Balmer, and T. Tattan Better safe than sorry: a survey of safety awareness and safety provisions in the workplace among specialist registrars in the South West Psychiatr. Bull., September 1, 2003; 27(9): 354 - 357. [Abstract] [Full Text] [PDF]

				B. Z. Erdos and D. H. Hughes Emergency Psychiatry: A Review of Assaults by Patients Against Staff at Psychiatric Emergency Centers Psychiatr Serv, September 1, 2001; 52(9): 1175 - 1177. [Full Text] [PDF]

				B. Ng, S. Kumar, M. Ranclaud, and E. Robinson Ward Crowding and Incidents of Violence on an Acute Psychiatric Inpatient Unit Psychiatr Serv, April 1, 2001; 52(4): 521 - 525. [Abstract] [Full Text] [PDF]

				A. E.-D. Soliman and H. Reza Risk Factors and Correlates of Violence Among Acutely Ill Adult Psychiatric Inpatients Psychiatr Serv, January 1, 2001; 52(1): 75 - 80. [Abstract] [Full Text] [PDF]

				C. Owen, C. Tarantello, M. Jones, and C. Tennant Repetitively Violent Patients in Psychiatric Units Psychiatr Serv, November 1, 1998; 49(11): 1458 - 1461. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1998 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us