A survey of threats and violent acts by patients against training physicians

Coverdale, John; Gale, Christopher; Weeks, Sara; Turbott, Sarah H.

doi:10.1046/j.1365-2923.2001.00767.x

Cited by 66 publications

(55 citation statements)

References 20 publications

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“…The literature on threats in the workplace, specifically those witnessed by health professionals, is rich in detail about the context and nature of the threat, but rarely provides data on the subsequent behaviour of the threatener (Flannery et al 1995 ;Brown et al 1996 ;Coverdale et al 2001 ;Davies, 2001 ;McKenna et al 2003). This contrasts with threats of self-harm, where an extensive literature is available to guide the clinician in an evaluation of risk ; much of it deriving from studies of suicide in the general population rather than just patient groups.…”

Section: Introductionmentioning

confidence: 99%

Threats to kill: a follow-up study

Warren¹,

Mullen

Thomas

et al. 2007

Psychol. Med.

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Background Mental health clinicians are frequently asked to assess the risks presented by patients making threats to kill, but there are almost no data to guide such an evaluation. Method This data linkage study examined serious violence following making threats to kill and the potential role of mental disorder. A total of 613 individuals convicted of threats to kill had their prior contact with public mental health services established at the time of the index offence. The group's subsequent criminal convictions were established 10 years later using the police database. Death from suicidal or homicidal violence was also established. Results Within 10 years, 44% of threateners were convicted of further violent offending, including 19 (3%) homicides. Those with histories of psychiatric contact (40%) had a higher rate (58%) of subsequent violence. The highest risks were in substance misusers, mentally disordered, young, and those without prior criminal convictions. Homicidal violence was most frequent among threateners with a schizophrenic illness. Sixteen threateners (2.6%) killed themselves, and three were murdered. Conclusions In contrast to the claims in the literature that threats are not predictive of subsequent violence, this study revealed high rates of assault and even homicide following threats to kill. The mentally disordered were over-represented among threat offenders and among those at high risk of subsequent violence. The mentally disordered threateners at highest risk of violence were young, substance abusing, but not necessarily with prior convictions. Those who threaten others were also found to be at greater risk of killing themselves or being killed.

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Section: Introductionmentioning

confidence: 99%

Threats to kill: a follow-up study

Warren¹,

Mullen

Thomas

et al. 2007

Psychol. Med.

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“…1 The risk of experiencing aggression at work is even greater in psychiatry and psychiatric trainees are most at risk. 2 The definition of violent behaviour in the literature varies widely, reflecting the many ways in which violence may affect health workers. In this article we have classified violence into either physical or verbal aggression.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric training – a dangerous pursuit

Molyneux¹,

Wright

Rush³

et al. 2009

Psychiatr. bull.

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SummaryWe performed a review of the international literature, Royal College of Psychiatrists guidelines and Irish legislation concerning psychiatric trainees and their experience of violence. Physical violence in the workplace was reported by 16% of trainees in Ireland and 67% of specialist registrars in the UK; 72% of trainees in Belgium reported verbal violence. Personal characteristics of trainees which increase the risk of experiencing violence are under-researched, although it is observed that the duration of clinical experience seems to be somewhat protective. the advent of community psychiatry brings new risks to trainees. the Royal College of Psychiatrists issued guidelines and reports that are useful in developing facilities and promoting trainee safety. Although legislation provides some protection to trainees, it also places responsibility on them as employees.

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“…In Britain, most physicians who responded to a survey reported experiencing violence within the past 12 months, and further reported being exposed consistently to a variety of abusive situations [10]. Another study broke down the types of abuse that physicians experienced [11]. The results found that 67% of the respondents reported having been verbally threatened, 54% reported being physically intimidated, 41% stated that they had witnessed property being damaged, and 39% reported being physically assaulted.…”

Section: Introductionmentioning

confidence: 99%

Chronic nonmalignant pain and violent behavior

Bruns¹,

Disorbio²,

Hanks³

2003

Current Science Inc

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Research suggests that violence has entered the medical setting to a remarkable degree, causing medical professionals to be at the highest risk for becoming the victims of assaults and violent acts. This article reviews general theories of aggression and research on these theories, and uses them to assess risk factors in patients with chronic pain. There are data to suggest that pain may increase the risk of aggressiveness in some patients. However, it may decrease the risk in others paradoxically. The research available underscores the need for evaluating patients with pain for the risk of violent or aggressive behavior; specific recommendations are made in this regard.

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A survey of threats and violent acts by patients against training physicians

Abstract: These findings underscore a priority for developing programmes which effectively reduce threats and violence against trainees and which lessen the psychological sequelae of these incidents.

Cited by 66 publications

References 20 publications

Threats to kill: a follow-up study

Threats to kill: a follow-up study

Psychiatric training – a dangerous pursuit

Chronic nonmalignant pain and violent behavior

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