Safety for psychiatrists

Dibben et al (Psychiatric Bulletin, March 2008, 32, 85–87) clearly address the importance of safety for both trainee and consultant psychiatrists within the work environment.

I recently undertook a similar survey, using an anonymous postal questionnaire, among all medical staff (consultants, n=6; trainees, n=10) working in a mental health unit based in a major general hospital in Ireland, likewise adapted from safety guidelines drawn by the Royal College of Psychiatrists (2006).

Our findings contrasted with those of Dibben et al (2008), with consultants giving more consideration to safety issues than trainees: attendance to breakaway training (100% v. 20%), awareness of local safety policies (100% v. 0%), use of personal alarms (100% v. 20%) and perception of vulnerability (80% v. 20%). Direct inspection of all the interview rooms in the psychiatric unit (n=15) found out that none of them met all the predetermined safety criteria.

Inadequacy of safety standards in the mental health setting indeed appears to be a widespread phenomenon (Chaplin et al, 2006). Safety in the clinical environment is thus an issue that needs to be taken with utmost importance by clinicians and adopting a degree of vigilance about sound safety measures lies to a certain extent within one's own responsibility. Nevertheless, health managers must not mismatch their priorities and should ensure the implementation of useful recommendations derived from audits regarding staff safety. Ultimately, this would also avoid the trap of such audits merely ending up as an exercise in systematic inquiry.