Safety for psychiatrists

The global issue of the National Health Service (NHS) staff safety was prioritised in 2005 by Department of Health's documentation Promoting Safer and Therapeutic Services which placed an expectation upon the Security Management Service to provide safety training for all frontline staff by March 2008.

I conducted a survey, similar to the one by Dibben et al (Psychiatric Bulletin, March 2008, 32, 85–87), within the Birmingham and Solihull Mental Health Trust, examining personal safety awareness among staff and associate specialists and consultant grades (n=64). This revealed that 85% of staff and associate specialists, and 78% of consultants had received breakaway training within the past year; 36% of consultants were aware of local trust protocols and 100% of those surveyed believed medics of all grades should routinely receive safety training. This differs from the published study which found many senior medics regard such training as potentially worthless.

It should be remembered that it is senior colleagues who conduct Mental Health Act assessments on acutely disturbed patients within the community. Indeed, my study revealed that a quarter of consultants had been directly involved in incidents of patient aggression within the previous year.

Inadequate environmental safety provision for psychiatric staff is commonplace. It is unfortunate therefore, that Dibben et al's study discovered many medics avoid wearing personal alarms even when available, instead relying upon defensive skills of colleagues in an emergency. The Royal College of Psychiatrists and NHS trusts should jointly seek to improve safety provisions. However, I believe ‘personal safety’ is just that – the responsibility of individual healthcare workers, regardless of discipline or seniority and one should not expect to defer this entirely to colleagues or their employers.