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Understanding inpatient violence in a New Zealand child and adolescent psychiatric setting
Author(s) -
van Kessel Kirsten,
Milne Duncan,
Hunt Kessiah,
Reed Peter W.
Publication year - 2012
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/j.1447-0349.2011.00789.x
Subject(s) - seclusion , psychiatry , audit , medicine , suicide prevention , injury prevention , ethnic group , poison control , occupational safety and health , hostility , human factors and ergonomics , psychology , clinical psychology , medical emergency , management , pathology , sociology , anthropology , economics
This paper describes the rate of violent episodes at a youth psychiatric unit, identifies significant clinical and demographic differences between service users who had admissions with violent episodes and those who did not, and describes characteristics of violent incidents, including antecedents, consequences, victim type, and severity of violence. A retrospective file audit over a 2‐year period reviewed 303 admissions. Characteristics of violent incidents (n = 242) and service users (violent/non‐violent) were recorded. Of 263 service users, 21.7% exhibited violent behaviour. Significant differences between admissions with and without violent episodes were found in terms of ethnicity, legal status, length of admission, and diagnosis. Staff were the most frequent victims and less severe incidents were most common. The most frequent antecedents to violence were positive symptoms of psychosis, hostility, and agitation, while the most common consequences were seclusion, physical restraint and ‘as‐required’ medication. This study has identified that v iolent incidents are a common and significant issue. The findings might help staff in reviewing current management approaches. Future areas of study have been identified.