NCJ Number
94879
Date Published
1982
Length
20 pages
Annotation
The effectiveness of management strategies on adult psychiatric wards will greatly affect the level of violence experienced. Intervention to decrease violence should be at the ward level.
Abstract
Few studies on the extent of violence in psychiatric hospitals have been conducted, and these have often been methodologically flawed. A study by Depp(1976) found that aggressors had more physical handicaps than victims, men tended to assault men and women assaulted women, and blacks were more aggressive towards whites than whites towards blacks. Other studies support different findings. Research on the effectiveness of seclusion in preventing violence has been plagued by methodological and theoretical problems, and there are ethical and moral issues to be considered. Seclusion appears to present only a partial solution. More research is needed on the effectiveness of physical restraint in preventing violence. Few papers have been published on the management of violent incidents in psychiatric hospitals. Researchers have suggested that staff confront the aggressor with 'overwhelming force,' establish a clear ward policy, and document all incidents. Management documents produced by the health services and labor unions are unclear, leaving the individual nurses to decide how and when to react. Few studies have been conducted on how staff-patient interaction affects the extent of violence in the institution. Many researchers have found that staff talk far more to each other than to patients. Others have found that staff behavior patterns were unaffected by changes in ward policy, although patients' behavior was very responsive to changes in staff-patient interaction. Staff may be reinforcing violent behavior by only paying attention to the troublemakers and ignoring those who behave. Future research must identify the most crucial aspects of ward management to ensure the plannning of effective interventions. About 80 references are included.