Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards

Abstract

BackgroundWorkplace violence (WPV) against healthcare workers (HCWs) employed in psychiatric inpatient wards is a serious occupational issue that involves both staff and patients; the consequences of WPV may include increased service costs and lower standards of care. The purpose of this review was to evaluate which topics have been focused on in the literature and which are new in approaching the concern of patient violence against HCWs employed in psychiatric inpatient wards, in the past 20 years.MethodsWe searched for publications in PubMed and Web of Science using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management, occurrence rates, and physical/nonphysical consequences.ResultsOur search resulted in a total of 64 publications that matched our inclusion criteria. The topics discussed, in order of frequency (from highest to lowest), were as follows: “risk assessment,” “risk management,” “occurrence rates,” and “physical/nonphysical consequences.” Schizophrenia, young age, alcohol use, drug misuse, a history of violence, and hostile-dominant interpersonal styles were found to be the predictors of patients’ violence.ConclusionRisk assessment of violence by patients appeared the way to effectively minimize the occurrence of WPV and, consequently, to better protect mental HCWs. We found paucity of data regarding psychologic sequelae of WPV. According to these findings, we suggest the need to better investigate the psychologic consequences of WPV, with the aim of checking the effective interventions to assist HCW victims of violence and to prevent psychologic illness.

Emergency psychiatric services in Roozbeh Hospital: A qualitative study of the staff's experiences

“…It has been reported that the majority of assaults against nurses occur in psychiatric departments . d'Ettorre and Pellicani reported that between 7.5% and 33% of victims of violence later developed psychological symptoms, such as anxiety, depression, and avoidance behavior. Other psychological outcomes may include anger, fear, posttraumatic stress disorder (PTSD) symptoms, guilt, and self‐blame .…”

“…Psychiatric emergency service is an important element in the continuum of mental health care, providing a wide range of professional psychiatric services, from evaluation, assessment, and treatment to referral and aftercare planning . While this service is used very frequently and increasingly so as of late, the number of relevant studies on this topic is scant compared to other areas within the mental health field.…”

Emotional intelligence and personality characteristics of psychiatric nurses and their situations of exposure to violence

“…These reasons may be related to nurses’ busy schedules, inadequate safety precautions, inexperience in crisis management, presence of patients’ distressed family members, inadequate use of care services, the belief that personal priorities or cases are more urgent, and doubts that patients’ or patient relatives’ needs are not thoroughly met . The rate and type of violent exposures nurses experience vary, but it should be remembered that nurses who work in psychiatry clinics manage everyday risks related to patient factors (eg, nature of patient mental health problems, demographics, motive for aggression, extent mental health problems are impairing communication); staff factors (eg, characteristics of individual staff, knowledge, poor communication skills, high anxiety level, moral commitments, capacity for emotional self‐regulation, and teamwork skills); and environmental factors (eg, quality and safety of physical environments, available facilitates and staffing, available space, temperature, noise, rules and policy). Data suggest that between 24% and 80% of psychiatric care staff have been assaulted by a patient at least once in their career .…”

“…The rate and type of violent exposures nurses experience vary, but it should be remembered that nurses who work in psychiatry clinics manage everyday risks related to patient factors (eg, nature of patient mental health problems, demographics, motive for aggression, extent mental health problems are impairing communication); staff factors (eg, characteristics of individual staff, knowledge, poor communication skills, high anxiety level, moral commitments, capacity for emotional self‐regulation, and teamwork skills); and environmental factors (eg, quality and safety of physical environments, available facilitates and staffing, available space, temperature, noise, rules and policy). Data suggest that between 24% and 80% of psychiatric care staff have been assaulted by a patient at least once in their career . Mental health nurses identified top three factors related to negative violent events; nurses’ role of enforcing compliance with treatment; nurses’ inability to de‐escalate patients’ negative feelings; and indifferent, impatient, or rude behaviors of nurses .…”

“…The relationship between nurses and patients in the psychiatry service, high concern levels of personnel and miscommunication are the significant determinants of violence. The type of communication established while working with the people that display forcible behaviors (and an assessment or feedback provided by the personnel) is an important factor that should be considered to manage aggression …”