NCJ Number
125640
Date Published
1989
Length
21 pages
Annotation
Available data suggest that violence is common in psychiatric hospitals, although most incidents do not result in serious injuries.
Abstract
Environmental factors in violence are time of day, day of week, architectural blind spots, overcrowding, and staffing levels. These factors relate to the central question of whether psychiatric hospitals foster violence. The context of violence on psychiatric wards is one where there is a very low level of planned patient activities and where a low level and poor quality of staff-patient interaction occurs. Other aspects of psychiatric ward management that increase violence include staff-management problems and violent incident management practices. Some researchers have identified serious problems with the use of traditional techniques such as physical restraint, sedation, and seclusion. Evidence suggests that these techniques may escalate violent incidents and function as reinforcers. Further, violent behavior is intermittently reinforced by the inconsistent use of management techniques, including the ultimate use of prosecution. To prevent violence in psychiatric hospitals, proper staff training in violence prevention is especially important. In addition to training and education, it is essential to have clear operational policies on how violent incidents should be managed, monitored, and reported. A framework in which to plan a violence assessment and intervention program for psychiatric wards is presented. 67 references.