Retrospective review of trends in assaults and seclusion at an acute psychiatric ward over a 5‐year period

Abstract

In developing countries such as South Africa, not much is known about the prevalence of assaults and seclusion occurring in mental health wards over time. Here, we describe a 5-year trend in assaults and seclusions, stratified by gender, at Stikland Hospital, South Africa. A retrospective review of clinical records of patients admitted to the acute psychiatric admission wards at Stikland and involved in assault and secluded was undertaken between 1 January 2005 and 31 December 2010. Data on the number of patient and staff assaults as well as seclusions, gender, age, marital status, level of education, level of income, duration of hospital admission and primary psychiatric diagnosis were collected. Significantly (P < 0.01) more men than women engaged in patient assaults, while significantly (P < 0.01) more men were secluded than women. On a monthly basis, the number of gender-stratified patient assaults and seclusions significantly increased (P < 0.01) throughout the study period. In conclusion, we show here that gender had a significant effect on both patient assault and seclusion numbers, which increased towards the end of the study period. Monitoring of these events is therefore important to continuously improve quality of care.

Violent behavior by women involuntarily committed to a forensic psychiatric hospital in Rio de Janeiro, Brazil

“…The main psychiatric diagnosis was schizophrenia (n=13; 46%). Our findings corroborate the results reported in the literature, which has identified schizophrenia as the main mental disorder associated with aggressive behavior in both developed [17][18][19] and developing countries 20,21 .…”

Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 1

“…2005a; 2005b), increased staff turnover (Luckhoff et al . ), reduced job motivation (Arnetz & Arnetz ; Hahn et al . ; Needham et al .…”

“…), more fear‐based responses to clients who present with A/V issues (Duxbury ), increased avoidance with fewer interactions with clients (Luckhoff et al . ; Michie & West ), it contributes to lower client satisfaction scores (Abderhalden et al . ; Meehan et al .…”

“…The prevalence of A/V continues to rise internationally among healthcare professionals, including nurses (Bourne 2003;Hahn et al 2010;Kynoch et al 2009;UKCC 2001;Wells & Bowers 2002). A/V have been linked with a number of documented outcomes: it places inpatient mental health nurses at an increased risk for injury and/or low morale (Beech & Leather 2008;Nijman et al 2005a;Wykes 1994), and it leads to psychological and physical consequences (Foster et al 2007;Hahn et al 2010), increased absenteeism (Foster et al 2007;Nijman et al 2005a;2005b), increased staff turnover (Luckhoff et al 2013), reduced job motivation (Arnetz & Arnetz 2001;Hahn et al 2010;Needham et al 2005), more fear-based responses to clients who present with A/V issues (Duxbury 2002), increased avoidance with fewer interactions with clients (Luckhoff et al 2013;Michie & West 2004), it contributes to lower client satisfaction scores (Abderhalden et al 2006;Meehan et al 2000), and is very expensive (LeBel & Goldstein 2005).…”

Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 2

“…This is regrettably another issue that is currently under-investigated though a small number of authors have advanced preliminary hypotheses and findings. Whittington and Wykes (1994), for example, developed a cyclic model of exposure to violence; unresolved or unaddressed stress and/or trauma in the clinician that arises from exposure to violence can then result in specific behaviours which then, ironically, can lead to increased risk of further violent incidents (Luckhoff et al 2012). Cutcliffe's (1999) study and, more recently, Ward's (2013) findings lend support to this model.…”