Violence toward mental health staff and safety in the work environment

Abstract

An increasing number of violent episodes toward staff were noted at a university department of psychiatry. A multidisciplinary committee was formed consisting of psychiatrists, biostatisticians, psychologists, nurses, administrators, data managers, social workers, security services, educators on personal safety and an attorney to address the problem. To determine the prevalence of violence toward mental health staff, clinicians and non-clinicians, the trend of violence over time, gather more detail about the violent events, the personal struggle of staff affected and establish suggestions for intervention. A workplace violence survey was designed to query staff experiences of endangerment, threats, assaults, age, sex and discipline, years in the field, treatment setting, sense of safety and proclivity to press charges. Of 742 surveys distributed, respondents returned 380 (response rate 51%). Forty-three percent of respondents reported being threatened and 25% assaulted. Threats and assaults increased significantly (P<0.001) over all the time periods queried based on Poisson regression analysis. Work experience was a protective factor (P<0.001), but not a guarantee against violent events. Threats and assaults on mental health staff have a substantial prevalence and are increasing in our psychiatric population. Practical recommendations derived from our study but in need of further research for confirmation are: (1) multidisciplinary personal safety training to enhance team-building, improve communication and help prevent violent events and (2) establishment of post-event protocols to assist staff-victims and administrators navigate through complex issues occurring after violent events.