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Repetitively violent patients in psychiatric units
C Owen1, C Tarantello, M Jones
1Department of Psychological Medicine, University of Sydney and Canberra Hospital, Woden, New South Wales, Australia. cowen@mail.usyd.edu.au
Psychiatric Services (Washington, D.C.)
|November 24, 1998
Summary
Repeated violence by psychiatric patients is a serious issue. Staff often fail to respond appropriately to violent acts by these recidivist patients, despite clear warning signs.
Area of Science:
- Psychiatry
- Clinical Psychology
- Occupational Health
Background:
- Violent incidents in inpatient psychiatric settings pose significant risks to patients and staff.
- Understanding the patterns and characteristics of repeated violence is crucial for effective intervention.
Purpose of the Study:
- To examine violent incidents among repeatedly violent psychiatric patients.
- To understand the clinical and occupational health significance of repeated violence in these settings.
Main Methods:
- Prospective data collection on violent incidents over seven months in five Sydney psychiatric units.
- Comparison of recidivist (≥20 incidents) and nonrecidivist violent patients regarding incident nature, warning signs, and staff responses.
Main Results:
- Twenty percent of patients were recidivists, accounting for 69% of all violent incidents.
- Recidivists were older; male recidivists often had organic brain syndrome, and female recidivists had personality disorders.
- Staff response to recidivists was less likely to involve institutional mechanisms (e.g., occupational health, injury forms, police notification), despite more warning signs.
Conclusions:
- Recidivism of violence and aggression is a significant problem in psychiatric settings.
- Staff's under-responsiveness to violent acts by recidivist patients is a critical concern requiring attention.