Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T06:24:51.143Z Has data issue: false hasContentIssue false
  • English
  • Français

Assaults on psychiatrists – a three year retrospective study

Published online by Cambridge University Press:  13 June 2014

Martin O'Sullivan  and
David Meagher
David Meagher
Affiliation:
St Vincent's Hospital, Dublin 4, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This study investigates the problem of assaults on psychiatrists by their patients.

Method: A postal questionnaire was circulated to 178 psychiatrists and trainees working in the Dublin area enquiring about assaults experienced in the previous three years.

Results: Of those 147 (82%) who responded 57 (39%) had been assaulted. There were few discriminating factors between those assaulted and those not but those in child psychiatry were less likely and those in general adult psychiatry were more likely to have been the victim of an assault. Only 10% of respondents had received any formal training in violence management. Assailants tended to be male (63%) and known to the doctor involved (71%). Personality disorder (37%), schizophrenia (29%) and substance abuse (26%) were common assailant diagnoses. Management responses to the assaults were generally internal with administrative staff involvement in only four cases.

Conclusions: Factors which potentially protect or expose clinicians to a greater risk of assault are not well defined and need to be further explored. Simple clinician or patient variables are not especially predictive of violence risk. Clinicians need to acquaint themselves better with the basic practices of violence prevention and management. External measures (such as involving administration) could be used more frequently to combat this common problem.

Keywords

AssaultViolence
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 15 , Issue 2 , June 1998 , pp. 54 - 57
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Thackrey, M. Therapeutics for aggression: Psychological/physical crisis intervention. Human Sciences Press Inc: New York, 1987.Google Scholar
2.Madden, DJ, Lion, JR, Penna, MW. Assaults on psychiatrists by patients. Am J Psych 1976; 133(4): 422–5.Google ScholarPubMed
3.New York state senate select committee on mental and physical handicap: Violence revisited – A report on traditional indifference in state mental institutions towards assaultive activity, (1975-1976). Albany, New York state senate.Google Scholar
4.Tardiff, K, Koenigsberg, HW. Assaultive behaviour among psychiatric outpatientss. Am J Psychiatry 1985; 142(8): 960–3.Google Scholar
5.Haller, RM, Deluty, RH. Assaults on staff by psychiatric inpatients: a critical review. Br J Psychiatry 1988; 152: 174–9.CrossRefGoogle ScholarPubMed
6.James, DG, Fineberg, NA, Shah, AKet al.An increase in violence in an acute psychiatric ward, a studv of associated factors. Br J Psychiatry 1990; 156: 846–52.CrossRefGoogle Scholar
7.Miller, RD, Maier, GJ. Factors affecting the decision to prosecute mental patients for criminal behaviour. Hosp Community Psychiatry 1987; 38(1): 50–5.Google Scholar
8.Reid, WH, Bollinger, MF, Edwards, G. Assaults in hospitals. Bull Am Acad Psychiatry Law 1985; 13(1): 1–4.Google ScholarPubMed
9.Fottrell, E. A study of violent behaviour among patients in psychiatric hospitals. Br J Psychiatry 1980; 136: 216–21.Google Scholar
10.O'Shea, B. The Violent Breed: a review of human violence with particular attention to that perpetrated by patients against their doctors. Ir J Psych Med 1988; 5(1): 6–10.Google Scholar
11.Pearson, M, Wilmot, E, Padi, M. A study of violent behaviour among inpatients in a psychiatric hospital. Br J Psychiatry 1986; 149: 232–5.Google Scholar
12.O'Shea, B, Mee, D, McGennis, A, Storey, A. Patient's violence towards psychiatric nurses. Psychiatric Nursing 1983; 2(3): 15–20.Google Scholar
13.Lanza, ML. The reactions of nursing staff to physical assault by a patient. Hosp Community Psychiatry 1983; 34: 44–7.Google Scholar
14.Lion, JR, Snyder, W, Merrill, GL. Underreporting of assaults on staff in a state hospital. Hosp Community Psychiatry 1981; 32: 497–8.Google Scholar
15.Hodgkinson, PE, McIvor, L, Phillips, M. Patients assaults on staff in a psychiatric hospital: a two year retrospective study. Med Sci Law 1985; 25: 288–94.Google Scholar
16.Ruben, I, Wolkon, G, Yamamoto, J. Physical attacks on psychiatric residents by patients. J Nerv Ment Dis 1980; 168: 243–5.Google Scholar
17.Katz, P, Kirkland, FR. Violence and social structure on mental hospital wards. Psychiatry 1990; 53: 262–77.Google Scholar
18.Dietz, PE, Rada, RT. Battery incidents and batterers in a maximum security hospital. Arch Gen Psychiatry 1982; 39: 31–4.CrossRefGoogle Scholar
19.American Psychiatric Association. Clinician safety. Report of the American Psychiatric Association task force on clinician safety. Washington: APA, 1992.Google Scholar
20.Aiken, GJM. Assaults on staff in a locked ward: prediction and consequences. Med Sci Law 1984; 24(3): 199–207.CrossRefGoogle Scholar
21.Reid, WR, Bollinger, MF, Edwards, JG. Serious assaults by inpatients. Psychosomatics 1989; 30(1): 54–6.CrossRefGoogle ScholarPubMed
22.Atakan, Z. Violence on psychiatric inpatient units; what can be done?. Psychiatric Bull 1995; 19(10): 593–7.CrossRefGoogle Scholar
23.Mortimer, A. Reducing violence on a secure ward. Psychiatric Bull 1995; 19(10): 605–9.Google Scholar
24.Carmel, H, Hunter, M. Staff injuries from patient attack: Five years data. Presented at the 143rd annual meeting of the American Psychiatric Association, New York, 1990.Google Scholar
25.Tardiff, K. A survey of psychiatrists in Boston and their work with violent patients. Am J Psychiatry 1974; 131: 1008–11.Google Scholar
26.Tardiff, K. Characteristics of assaultive patients in private hospitals. Am J Psychiatry 1984; 141: 1232–5.Google Scholar
27.Sheehan, JD, Hardie, T, Watson, JP. Social deprivation, ethnicity and violent incidents on acute psychiatric wards. Psychiatric Bull 1995; 19(10): 597–600.Google Scholar
28.Agarwal, M, Roberts, M. Management of violence among psychiatric inpatients. Psychiatric Bull 1995; 19(10): 609–12.Google Scholar
29.Tardiff, K, Sweillam, A. Assaultive behaviour among chronic psychiatric inpatients. Am J Psychiatry 1979; 139: 212–5.Google Scholar
30.Norko, MA, Zonana, HV, Philips, RTM. Prosecuting assaultive psychiatric inpatients. Hosp Community Psychiatry 1991; 42: 193–4.Google ScholarPubMed