Direct observational coding of staff who are the victims of assault.

Abstract

Staff members in psychiatric hospitals are frequently assaulted by patients. When asked what events triggered specific assaults on staff, staff and patients disagree. Staff members usually say that symptoms of psychosis led to the assault, whereas patients usually say aversive interactions with staff triggered the incident. For years, experts have called for direct observational research to address this issue and possibly resolve the discrepancy found in the verbal-report data. Over 26,000 hr of direct observational coding of staff activities, including staff-patient interactions, was collected across 10 years by independent, noninteractive raters on Social Learning Program units. Eight of nine kinds of aversive staff-patient interactions occurred more frequently among staff members who had been assaulted. One possible interpretation of these data is that aversive interactions lead to assaults on staff, but other possibilities must be considered. Practical recommendations for reducing likelihood of assault are detailed.

Promoting Personal Growth and Balancing Risk of Violence in Community-Based Mental Health Care: A Professional Perspective

“…Other researchers, such as Dorn, Volavka, and Johnson (2012), point out that the research on the potentially preventive effects of follow-up by a municipality-based mental health-care team to reduce the risk of violent behavior is incomplete. A study by Newbill et al (2010) pointed in the same direction-health professionals seemed to ascribe episodes of violent behavior to clients' psychotic symptoms. This is in contrast to the clients themselves, who emphasized that it was the health personnel's interventions that led to acts of violence.…”

“…Descriptions of increased emotional stress and contexts of vulnerability resulting in outward aggression and less serious violence should, according to the informants, be described in clients' journals, where there is no structured violence risk assessment of the individual. Newbill et al (2010) show that, when meeting people with severe mental health disorders, an approach characterized by cooperative discussions, which promote alternative ways of safeguarding human needs, can be significant. On the contrary, setting up boundaries that give the client a sense of being a victim of a system without proper care appears to increase client aggression levels (Newbill et al, 2010).…”

Evaluating the impact of an electronic application of the Dynamic Appraisal of Situational Aggression with an embedded Aggression Prevention Protocol on aggression and restrictive interventions on a forensic mental health unit

“…limit-setting and de-escalation), even though they are commonly used in mental health units (Roberton et al 2012). This is pertinent because interventions such as limit setting can precipitate aggressive reactions from patients (Newbill et al 2010;Nolan et al 2009), and patient reactions can be influenced by the manner in which limits are set (Lancee et al 1995;Maguire et al 2014).…”

“…This is pertinent because interventions such as limit setting can precipitate aggressive reactions from patients (Newbill et al . ; Nolan et al . ), and patient reactions can be influenced by the manner in which limits are set (Lancee et al .…”

Patient and visitor assault on nurses and midwives: An exploratory study of employer ‘protective’ factors

“…Furthermore, violence might occur when nurses want patients to do something they do not want to do, or they stop patients from doing something that they want to do, or when they deny patients' requests (Newbill et al . ). Finally, clinical settings and environmental factors have also been considered contributing factors to PVA.…”