Emergency Psychiatry: A Review of Assaults by Patients Against Staff at Psychiatric Emergency Centers

Erdos, Brandon Z.; Hughes, Douglas H.

doi:10.1176/appi.ps.52.9.1175

Cited by 41 publications

(35 citation statements)

References 10 publications

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“…The observation that nursing staff were more likely to be assaulted is consistent with findings from previous studies. 5,[10][11][12] In a study by Erdos & Hughes, 78% of assaults were committed against nursing staff, whereas only 4% were against a psychiatrist.…”

Section: Original Papersmentioning

confidence: 99%

Violence against mental health staff: a survey in a Nigerian psychiatric hospital

et al. 2011

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Aims and methodA survey was conducted to investigate physical assaults against mental health staff of a Nigerian psychiatric hospital in a 12-month period and also during their working career in the hospital retrospectively using a questionnaire method.ResultsIn total, 101 out of 120 questionnaires were completed (response rate 84.2%). Within the period of their employment in the hospital 49.5% of staff had been physically assaulted at least once, and over the previous 12 months 33.7% had been physically assaulted. Nursing staff (82.3%) were more frequently assaulted than doctors, most often during routine assessment of patients (44.3%). In total, 88% of staff sustained injuries requiring medical attention. Vulnerability to assaults was not associated with attending a course on prevention and management of psychiatric patient violence.Clinical implicationsAssaults by patients against mental health staff, especially nurses, are quite widespread in Nigeria. There is a need to formulate policies on prevention and management of violence in people with mental disorders in Nigerian psychiatric hospitals.

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Section: Original Papersmentioning

confidence: 99%

Violence against mental health staff: a survey in a Nigerian psychiatric hospital

et al. 2011

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“…5 Aggressive behaviour continues to be a leading source of stress and personal injury for staff (and patients) in inpatient facilities. [6][7][8] At the organisation level, aggressive behaviour can lead to lost productivity and increases in workers compensation costs, insurance costs, and refurbishment costs when repairs to the environment become necessary. 9 The prevention of such violence involves a complex interaction between the client, their social structure and their environment.…”

Section: What Are the Implications For Practice?mentioning

confidence: 99%

Reducing aggressive behaviour and staff injuries: a multi-strategy approach

Meehan¹,

Fjeldsoe²,

Stedman³

et al. 2006

Aust. Health Review

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Objective: To evaluate the impact of a multistrategy approach on the management of patient aggression and staff injury rates at a stand-alone mental health facility. Methods:A multi-strategy aggression management program was developed and introduced over a 2-year period. The program had four components; staff education/training, a staff support program, risk assessment tools, and a computerised incident monitoring system. Aggressive incidents by patients, staff injuries due to patient aggression and compensation payments to staff for the 2-year period before implementation of the aggression management program were compared with the 3-year period following implementation of the program.Results: There was a significant decrease in the number of staff injuries reported in the 3-year period following the implementation of the aggression management program. Although the number of aggressive incidents reported did decrease over the study period, the decrease was not statistically significant. Conclusions:Despite the increasing acuity of the clients at the study facility, there was a significant decrease in staff injuries due to aggressive behaviour. The strategies implemented seem to offset the potential for violence. It is likely that the combined impact of the strategies is greater than the impact of individual strategies implemented

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“…For instance, physicians working in emergency departments, psychiatric emergency departments, and after-hours clinics, as well as those on house calls, have an increased likelihood of experiencing abusive encounters. 7,[12][13][14][15] Emergency departments appear to be especially problematic. An American study reported that 1 in 3 emergency department physicians was physically assaulted during the previous year.…”

Section: Introductionmentioning

confidence: 99%

How the Medical Culture Contributes to Coworker-Perpetrated Harassment and Abuse of Family Physicians

Miedema

MacIntyre²,

Tatemichi³

et al. 2012

The Annals of Family Medicine

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PURPOSE Harassment and abuse in the workplace of family physicians has been associated with higher levels of stress, increased consumption of alcohol, and higher risk for developing mental health problems. Few studies have examined issues contributing to abusive encounters in the workplace of family physicians. METHODSFor the overall study we used a mixed methods design, which included a cross-sectional survey of a randomly selected sample of active family physicians from the database of the College of Family Physicians of Canada and telephone interviews with those who reported experiencing work related harassment and abuse in the last year. The data presented here arise from the qualitative interviews of the study, which were analyzed thematically. RESULTSThe interview arm of the study included 23 female and 14 male participants. The major themes that emerged from the study were (1) modeling of abusive behaviors, (2) status hierarchy among various medical disciplines, (3) shortage of physicians, and (4) lack of transparent policies and follow-up procedures after abusive encounters. The results are discussed using the broken window theory.CONCLUSION Many family physicians experience harassing and abusive encounters during their training or in the workplace. The current medical culture appears to contribute to harassment and abuse in the workplace of family physicians in Canada. We described the components that intentionally or unintentionally facilitate abusive behavior in the medical culture. Ann Fam Med 2012;10:111-117. doi:10.1370/afm.1341. INTRODUCTIONH ealth care workers are at greater risk of workplace abuse than most other workers, with the exception of law enforcement officers and taxi drivers.1 Among health care professionals, nurses and family physicians are at greatest risk for being abused. [2][3][4][5][6] Research conducted in Canada, Japan, Australia, New Zealand, and the United States has found that in their work, physicians experience many forms of harassment and abuse, 1 including verbal abuse, intimidation, sexual harassment, stalking, and assault from both patients and colleagues.7-10 An Australian study reported that 64% of general practitioners reported abuse in the previous year, with low-level mistreatment, such as verbal abuse, being the most common. More than 10% reported experiences of sexual harassment and physical abuse. 7 Similar trends have been found in such other countries as New Zealand and Canada. 8,11 Research conducted in Canada, carried out by our research team, reported that 98% of family physicians reported having experienced at least 1 minor abusive event (eg, humiliation), 75% reported having experienced a major event (eg, sexual harassment), and 39% had experienced a severe event (eg, assault) during their career as a physician.9 Twenty-nine percent of the polled physicians reported having been abused in the previous month by either a patient or family member of a patient. A small group reported having been abused by colleagues (9%) and coworkers (6%) in the prev...

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Emergency Psychiatry: A Review of Assaults by Patients Against Staff at Psychiatric Emergency Centers

Cited by 41 publications

References 10 publications

Violence against mental health staff: a survey in a Nigerian psychiatric hospital

Violence against mental health staff: a survey in a Nigerian psychiatric hospital

Reducing aggressive behaviour and staff injuries: a multi-strategy approach

How the Medical Culture Contributes to Coworker-Perpetrated Harassment and Abuse of Family Physicians

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