Verbal and physical aggression from the psychiatric patients : a survey of mental health professionals in a community mental health team

Abstract

CONTEXT: Aggressive behaviors and violence from psychiatric patients have been consistently reported. AIMS: It was intended to explore the experience of mental health professionals about the aggression from the psychiatric patients. SETTINGS AND DESIGN: This study was a cross‑sectional survey in the community. MATERIALS AND METHODS: A semi‑structured questionnaire was used for the survey covering the experience of threat, verbal or physical aggression, ever and during the previous year. Awareness about procedures following incidences and suggestions for possible solutions were also enquired. STATISTICAL ANALYSIS USED: Results were presented in percentages, and qualitative analysis was done for the themes of suggestions. RESULTS: A considerable proportions of mental health professionals reported experiencing aggression from the patients. Based on the type, frequencies ever or in the previous year were threatened (39.5%, 15.9%), verbal aggression (63.6%, 28.6%), and physical aggression (29.3%, 13.5%), respectively. Less than half (45.9%) of the professionals formally reported the incidence, although majority knew the process. Most (97.6%) were aware of the zero‑tolerance policy, but only 19.5% felt it was being followed adequately. Review room safety (86.8%), review in the presence of two members of staff (100.0%), and support from forensic team (57.6%) were suggested as measures. Other elements highlighted were training to staff, robust risk assessment and communication, safer work environment, postincidence actions, and challenges to adhere zero tolerance in mental health. CONCLUSIONS: A considerable proportion of mental health professionals experience aggression and violence from psychiatric patients. While the risk from mentally ill patients cannot be completely ameliorated, structured approach and attention to safety might decrease the occurrence.