Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: Systematic Review and Meta-Analysis—A 2019 Update

Giacomo, Ester di; Iozzino, Laura; Ferrari, Clarissa; Strozza, Cosmo; Nielssen, Olav; Girolamo, Giovanni de

doi:10.1007/978-3-030-33188-7_10

Cited by 12 publications

(7 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dass mit 23.4 % Klinikpersonal am häufigsten Opfer von im Klinikkontext begangenen Übergriffen wurden, die Anlass für Konsile waren, deckt sich mit Erfahrungen aus der Praxis und Forschung. In einer Metaanalyse berechneten Di Giacomo et al [22] eine Prävalenz von 18 % auf akutpsychiatrischen Stationen.…”

Section: Gesamtunclassified

Forensisch-psychiatrisches Konsilangebot für die Allgemeinpsychiatrie

Schmidt,

Anna Seeger,

Brackmann

et al. 2023

Fortschr Neurol Psychiatr

View full text Add to dashboard Cite

ZusammenfassungBei einigen psychiatrischen Patienten besteht ein erhöhtes Risiko für interpersonelle Gewaltanwendung, was zu Unterbringungen im Maßregelvollzug führen kann. Ein Großteil der dort behandelten Patienten kam bereits Jahre bevor sie aufgrund eines Deliktes forensisch-psychiatrisch untergebracht wurden, mit dem allgemeinpsychiatrischen Versorgungssystem in Kontakt. Nicht zuletzt aus diesem Grund ist es bedauerlich, dass Maßnahmen zu Gewaltprävention in der Allgemeinpsychiatrie bisher nur vereinzelt etabliert sind. Im Kanton Zürich ermöglicht ein forensisch-psychiatrischer Konsiliardienst dem allgemeinpsychiatrischen Versorgungssystem Zugang zu forensisch-psychiatrischer Expertise. In der vorliegenden Arbeit wird das Leistungsangebot beschrieben und die im Rahmen des Konsiliardienstes untersuchte Patientenpopulation charakterisiert. Zudem wurden die drei häufigsten Diagnosegruppen (Erkrankungen aus dem schizophrenen Formenkreis, affektive Störungen, Persönlichkeitsstörungen) nach Konsilanlass und ihrer Vorgeschichte bezüglich Gewalttaten und Substanzmissbrauch miteinander verglichen und die ausgesprochenen Empfehlungen analysiert. Von 2013 bis 2021 wurden 188 Patienten Zürcher allgemeinpsychiatrischer Kliniken nach Erteilung ihres Einverständnisses untersucht. Diese Patienten wiesen zumeist eine Vorgeschichte an Gewalttaten (72.7%) und Substanzkonsum (66.1%) auf. Fast die Hälfte (48.4%) litt an einer Erkrankung aus dem schizophrenen Formenkreis.

show abstract

Section: Gesamtunclassified

Forensisch-psychiatrisches Konsilangebot für die Allgemeinpsychiatrie

Schmidt,

Anna Seeger,

Brackmann

et al. 2023

Fortschr Neurol Psychiatr

View full text Add to dashboard Cite

show abstract

“…Nonetheless, it is clear most people admitted to acute psychiatric units do not behave violently. A meta-analysis of the rates of violence on acute psychiatric units in high-income countries found 17% (95% CI 14–20%) of service users threatened or committed a violent act (physical violence towards others) during their admission while 83% of those admitted were not violent [ 11 ]. Reported rates vary widely, with studies with higher rate of people with alcohol use disorders, male gender, schizophrenia, and compulsory treatment reporting higher rates of inpatient violence by service users.…”

Section: Introductionmentioning

confidence: 99%

“…Overall, experiences of violence in inpatient units appear common across jurisdictions, with these experiences taking the form of service user-to-staff violence, service user-to-service user violence, and staff-to-service user violence [ 11 , 18 , 19 ]. There is some evidence to suggest that violence is more prevalent in the psychiatric setting compared to other specialities [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Places of safety? Fear and violence in acute mental health facilities: A large qualitative study of staff and service user perspectives

et al. 2022

View full text Add to dashboard Cite

Aim To understand violence on acute mental health units according to staff and service user perspectives and experiences. Background The collateral damage of violence in acute inpatient mental health settings is wide-ranging, impacting on the health and wellbeing of staff and service users, and detrimental to public perceptions of people who are mentally unwell. Despite international research on the topic, few studies have examined psychiatric unit violence from both staff and service user perspectives. Methods We conducted in-depth interviews with 85 people (42 staff, 43 service users) in four adult acute mental health inpatient units in New Zealand. We undertook a thematic analysis of perspectives on the contributing factors and consequences of violence on the unit. Results Both staff and service users indicated violence was a frequent problem in acute inpatient units. Four themes regarding the causes of violence emerged: individual service user factors, the built environment, organisational factors, and the overall social milieu of the unit. Staff often highlighted complexities of the system as causal factors. These included the difficulties of managing diverse service user illnesses within an inadequate and unsafe built environment whilst having to contend with staffing issues and idiosyncrasies relating to rule enforcement. In contrast, service users talked of their needs for care and autonomy not being met in an atmosphere of paternalism, boredom due to restrictions and lack of meaningful activities, enforced medication, and physical confinement as precipitants to violence. Two broader themes also emerged, both relating to empathy. Both staff and service users exhibited ‘othering’ (characterised by a profound lack of empathy) in relation to acutely unwell individuals. Explanations for violent behaviour on the unit differed between groups, with service users being more likely to attribute unwanted behaviour to contextual factors and staff more likely to ‘blame’ mental illness. The consequences of violence included stress, physical injury, and a culture of fear and stigma. Conclusion Violence in acute inpatient mental health units in New Zealand is a significant, complex, and unresolved problem negatively impacting the therapeutic mission of these settings. Further in-depth qualitative investigations are urgently required into what is experienced as violence by service users, their view of how violence occurs, the role of fear and power relations, and the contributions of the built and organisational environment to all forms of violence to all unit users. A core function of the acute mental health unit is to offer a therapeutic environment for individuals at their most vulnerable. For this to happen, the unit must be a rewarding place to work, and a safe place to be.

show abstract

“…The episodes may occur both in the workplace and outside the workplace but are related to one’s work or function. The reason for client-on-worker violence are often complex and can be influences by a multitude of individual, situational, and organizational causes (Arnetz et al, 2015; di Giacomo et al, 2020; Nowrouzi-Kia et al, 2019; Papadopoulos et al, 2012; Pompeii et al, 2013; J. T. Wassell, 2009). In psychiatry and prisons, employees interact with inmates and patients in challenging life situations.…”

Section: Introductionmentioning

confidence: 99%

Workplace’s Development of Activities and Action Plans to Prevent Violence From Clients in High-Risk Sectors

Karlsen

Andersen

Jaspers

et al. 2022

J Interpers Violence

View full text Add to dashboard Cite

Introduction Interventions trying to prevent violence from clients towards employees tend to show limited effect on the risk or the frequencies of violent episodes, possibly due to a too-narrow focus on only one or a few preventive strategies. This study aimed to show what employees and line managers identify as key intervention areas for preventing violence and threats. Methods The study is based on data collected during a participatory intervention study aiming to improve violence prevention in Danish psychiatric units and prison and detention centers. In the intervention study, employees and line managers from 13 work units developed 293 suggestions and 92 action plans to prevent workplace violence. Through qualitative thematic analysis of the suggestions and action plans, we identified the main categories that work units viewed as important and realistic to work with to improve violence prevention. Results We identified 12 topics of violence prevention that work units considered relevant. Action plan topics used by more than half of the work units included: specific approaches to violence prevention (e.g., de-escalating techniques), communication between employees to transfer knowledge between shifts, and introduction to new employees and temporary workers. Topics used by three to five work units were: interdisciplinary corporation, communication and relational work, uniform approaches, organization of work, and staffing. Topics used rarely were: definition of violence and threats, policy and guidelines, support from colleagues and management, and engagement in violence prevention. For nine of the 12 topics, action plans were developed in both high-risk sectors. Conclusions The violence prevention action plans developed by work units from two high-risk sectors indicate that workplaces estimate the prevention of client-induced workplace violence to require activities on many levels and cannot be solved by a single focused approach. This variety of preventive activities needs to be considered when designing violence prevention interventions.

show abstract

Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: Systematic Review and Meta-Analysis—A 2019 Update

Cited by 12 publications

References 57 publications

Forensisch-psychiatrisches Konsilangebot für die Allgemeinpsychiatrie

Forensisch-psychiatrisches Konsilangebot für die Allgemeinpsychiatrie

Places of safety? Fear and violence in acute mental health facilities: A large qualitative study of staff and service user perspectives

Workplace’s Development of Activities and Action Plans to Prevent Violence From Clients in High-Risk Sectors

Contact Info

Product

Resources

About