Incidents of violence in psychiatric inpatient care

During a period of 18 months a systematic inventory of aggressive incidents was made on two psychosis wards at the psychiatric department of Danderyd Hospital, Stockholm, Sweden. The Staff Observation Aggression Scale (SOAS) for recording and assessing aggressive incidents was used. Staff subjected to violence or threat of violence was interviewed using a semi-structured questionnaire. In one part of the study, a somewhat reduced variant of the same questionnaire was used but this time staff answered anonymously. Aggressive incidents were distributed over the 24 h, but had two distinct peaks - morning and evening. Aggressive incidents most often occur with patients with some kind of a psychotic diagnosis, most often schizophrenic psychoses. The female staff was more exposed to violence than male. Female patients are also more violent to female staff than to male staff. There is a significant difference in the emotional reactions of female and male staff after aggressions. In the staff, men are more often frightened while women tend to get surprised. Still, staff members of both genders feel insulted and angry. The "research" interviews were experienced as therapeutic discussions by the staff.