Introduction to Section 3

Summary

Because violence can manifest anywhere, we all need to be prepared for its impact. The following four chapters describe the main settings outside standard psychiatric inpatient wards where violence is manifest in different ways and how the different environmental circumstances influence management.

In the community, potential victims are much less protected and, as far as is possible, de-escalation (defusion) of violence becomes the primary intervention.

The problem of violence in medical settings has sadly come to the fore in recent years because of an increase in episodes, and its management and prevention need to be developed further. Emergency departments are in the front line here, and paramedics and other ambulance staff are also vulnerable to assault. It is to be expected that when common policies of management are adopted, hospital settings will gain greatly.

The new chapter on forensic psychiatry and adult inpatient secure settings () offers readers an insight into the historical context behind the existence and development of forensic psychiatric services in England and Wales. Key pieces of legislation are outlined, as is a description of how forensic services are currently configured.