[Aggressive incidents while on crisis duty]

Being on duty in a crisis team of the Mental Health Service can be a highly emotional and stressful experience. Pressed for time and providing a 24-hour service, team-members often have to make major decisions without consulting and agreement of all the parties concerned. The East Brabant Mental Health Service (GGZ OostBrabant) felt they needed to find out more about the threatening behaviour encountered by the crisis team and to identify the risk factors. For this purpose a weekly record was kept of all the incidents that occurred and these were discussed and analysed with the help of the Staff Observation Aggression Scale-Revised. In 2002 14% of the crisis contacts involved aggression. A striking feature of these incidents was that they occurred relatively often at certain times: at the end of the morning or very late at night/in the early hours of morning. The weekly meeting at which the incidents can be fully discussed is an opportunity to pass on to all staff members the knowledge and skills needed to deal with aggression.