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Related Experiment Video

Updated: Jun 27, 2026

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
09:12

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress

Published on: July 4, 2013

Defensive practice in mental health.

Richard Mullen1, Anita Admiraal, Judy Trevena

  • 1Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin 9054, New Zealand. richard.mullen@stonebow.otago.ac.nz

The New Zealand Medical Journal
|December 23, 2008
PubMed
Summary
This summary is machine-generated.

Defensive clinical practice is common among mental health professionals in New Zealand. This behavior, including patient safety checks and hospital admissions, occurs despite a no-fault compensation scheme, suggesting other pressures influence these decisions.

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Last Updated: Jun 27, 2026

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
09:12

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress

Published on: July 4, 2013

Area of Science:

  • Psychiatry
  • Mental Health Nursing
  • Clinical Psychology

Background:

  • Defensive clinical practice is a concern in healthcare settings.
  • Understanding the prevalence and drivers of defensive medicine is crucial for patient care.
  • New Zealand operates a no-fault compensation scheme for medical injuries.

Purpose of the Study:

  • To evaluate the extent of defensive clinical practices among psychiatrists and psychiatric nurses.
  • To identify specific defensive practices perceived by mental health professionals.
  • To explore potential reasons for defensive practice in psychiatric settings in New Zealand.

Main Methods:

  • Anonymous questionnaire survey distributed to all psychiatrists and psychiatric nurses.
  • Survey focused on perceptions of various defensive practices.
  • Target population included professionals in acute clinical settings within a New Zealand Mental Health Service.

Main Results:

  • Defensive practice is perceived as widespread in psychiatric settings.
  • Practices like safety questioning, admissions, and delayed discharges were frequently identified as defensive.
  • Psychiatric nurses reported higher perceptions of defensive practices compared to psychiatrists.

Conclusions:

  • Defensive practice is prevalent in mental health services, even with a no-fault compensation system.
  • Concerns beyond financial liability likely contribute to defensive behaviors.
  • Specific pressures within mental health may encourage defensive clinical practice.