Characteristics of Staff Victims of Pschiatric Patient Assaults: 15-Year Analysis of the Assaulted Staff Action Program (ASAP)

Abstract

Psychiatric patient assaults on staff victims are a worldwide occupational hazard. This paper reports on a 15-year study of the characteristics of staff victims of patient assaults and a crisis intervention procedure to ameliorate the aftermath of theses incidents. The debate on the efficacy of early interventions is outlined and the present 15-year findings are presented, findings demonstrating remarkable consistency in victim characteristics over time. The crisis intervention procedures were associated with sharp declines in disrupted victim functioning. The validity of the study's findings are noted and the implications for enhanced risk management training and staff victim crisis intervention procedures are discussed.

Characteristics of Assaultive Psychiatric Patients: 20-Year Analysis of the Assaultive Staff Action Program (ASAP)

“…Physical assaults were the most prevalent. These findings in concert with earlier published findings [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] continue to document that patient assaults on staff are a worldwide, occupational health hazard [3]. These characteristics have remained stable over time, even as the present health care system (DMH), like others worldwide, has adjusted to facility closures; downsizings; privatizing of inpatient and community services; several reductions in force; the addition of child and forensic patients; various advances in medications and rehabilitation services; the development of flexible community response systems for more complicated, multidiagnostic individuals; a major restraint-free policy initiative, and a wide array of advocacy groups.…”

“…The findings from the present 20-year study, which appears to be the longest, continuous study of patient assault characteristics in the published literature, are consistent with previous cross-sectional and longitudinal studies in public and private settings during a forty-year period [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and are also essentially similar to the 10-, and 15-year studies from this same public sector health care system [1,16]. Older male patients with diagnoses of schizophrenic illness and/or other neurological abnormality and histories of violence toward others and substance use disorder and younger, male/female patients with diagnoses of personality disorders and histories of violence toward others, personal victimization, and substance use disorder were more likely to be assaultive.…”

“…As has been noted, ASAP is a voluntary, system-wide, peer-help, crisis intervention program to assist staff victims to cope with the psychological sequellae of patient assaults. It is consistent with the current emphasis on ''psychological first aid'' that offers empowerment, support, and response to individual victim needs [18]. When an assault occurs, the ASAP team member on-call goes to the patient care site of the incident and offers ASAP services.…”

“…This study included both state and state-vendored facilities in both inpatient and community settings. Assault data was gathered within the context of the Assaulted staff Action Program (ASAP) [17], a voluntary, system-wide, peer help crisis intervention program to assist staff victims in addressing the psychological sequellae of patient assaults [18]. Patient assault characteristics at 10-, 15-, and 20-year intervals were compared for possible changes in such characteristics over time.…”

Characteristics of Staff Victims of Psychiatric Patient Assaults: 20-Year Analysis of the Assaulted Staff Action Program

“…This issue is international in scope, and refers primarily to patient assaults on staff. These injuries may result in death; disability; medical injury; and various forms of psychological distress, including posttraumatic stress disorder (PTSD) [1][2][3]. These nonfatal injuries are so serious that both the United States and Canadian federal governments have issued guidelines for preventing such injuries and for providing medical and psychiatric services in their aftermath [4,5].…”