Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States

Abstract

Introduction Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. Purpose To explore MHS perspectives of assault by psychiatric patients. Methods A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants’ age ranged from 22 to 63 years (mean age = 32.4). Moustakas’ theoretical underpinnings guided the study. Results Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes—increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes—unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. Discussion Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient’s behavior. Conclusion The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

“…Inpatient mental health patients report (re)traumatising experiences including abuse, coercion, aggression and violence on wards [4,5,6,7,8]. Staff also report abuse and violence on the wards [9,10], as well as having to risk-assess for and respond to incidents of self-harm and suicide attempts, which are prevalent in these settings [11]. In this context, some mental health service providers in the UK are increasing their use of surveillance-based technologies in inpatient settings [12].…”

On importance of new group therapy for decrease of agitation during the critical period of nursing shift changes on an acute psychiatric inpatient floor

“…[7] Nurses also experience psychosocial impacts consisting of environmental safety, stigmatization of staff victim, unsupportive superiors. [8] The prevalence of direct and indirect traumatic experience amongst patients in psychiatry setting is as high as 84.5%. [9] Many recent studies have focused on non-pharmacological interventions.…”