Trauma on the Front Lines: Violence Exposure Across Disciplines in an Inpatient Psychiatric Hospital

Inpatient psychiatric health care workers are at high risk for exposure to workplace violence, with nurses and psychiatric technicians particularly vulnerable because of frequent direct patient contact. Despite growing awareness of this issue, limited research has examined how violence exposure differs across professional disciplines and how such exposure affects staff members' well-being. This study aimed to compare rates of violence exposure across staff disciplines in an inpatient psychiatric hospital and examine associations between trauma exposure and staff psychological well-being.

A cross-sectional survey was conducted at a 274-bed inpatient psychiatric hospital in Texas. Using a modified version of the Staff Workplace Experiences Questionnaire, 142 staff members reported their experiences of workplace violence and related emotional impacts. Participants were grouped by level of patient contact (high, moderate, or low direct care), and multiple regression analyses were used to assess relationships between discipline and trauma exposure and well-being indicators (e.g., helplessness or perceived support).

Staff in high direct care roles (nurses and psychiatric technicians) reported significantly higher rates of trauma exposure (total, witnessed, and experienced) than those in moderate or low direct care roles. High direct care staff also reported increased feelings of fear, helplessness, and being very upset and decreased perceptions of safety and support. Across disciplines, higher trauma exposure was associated with increased psychological distress and lower perceived support.

These findings highlight the disproportionate burden of trauma on direct care psychiatric staff and underscore the need for trauma-responsive organizational strategies and specific interventions to reduce violence exposure and support staff well-being.