Prosecuting psychiatric patients who assault staff: a New Zealand perspective

The prosecution of psychiatric inpatients for violent acts remains controversial but is increasingly considered as a management option for a minority of patients. Most of the literature so far has been based in North America. This study in a rural New Zealand psychiatric unit was undertaken to explore the rates, reasons and outcomes of referring psychiatric inpatients to the police for possible prosecution of violent acts committed while in hospital.

Data were extracted retrospectively from the log of ward incident forms of the inpatient unit for the 24 months between July 2002 and June 2004 inclusive. Any incident fitting an operationalized definition of physical or verbal aggression was included in this study. The type, time, location and persons involved in each incident were recorded. Case files of all patients were used to extract information on diagnosis, treatment and further details of the incident. The details and outcome of each incident was individually verified with the local police department.

Data were available for 31 incidents. There were three cases of assault by three patients that resulted in police involvement, and one patient was convicted. Brief histories and descriptions of the incidents are provided.

Despite an increasing awareness that prosecution of patients for violent acts is an option for psychiatric staff, such referrals to the police and subsequent convictions remain rare. In the absence of clear national policies, individual hospitals must be proactive in formulating flexible policies to address such incidents on a case by case basis.