Violent incidents in a forensic adolescent unit: A functional analysis

Abstract

This paper reports on a survey which identified categorised and measured the relative frequency of specific antecedents before, and the consequences following, violent incidents in an adolescent forensic unit during a two-year period. Retrospective analysis of 219 violent incidents involved the examination of incident forms, nursing-process records and accident reports. Antecedents and precipitating factors were also recorded. The results demonstrated that the vast majority of incidents were precipitated by several observable antecedents or precipitating factors (186, 85%). Only a small proportion of the violent incidents were preceded by a single risk indicator (21, 9.5%) and a minority were reported to have occurred in the absence of observable antecedents (12, 5.5%). The severity of violent incidents was rated on a four-point scale but no significant correlation was found between category or frequency of antecedent and the violent act itself. The consequences for the young person following acts of violence were also documented, and the results show that the large majority of incidents were followed by increased staff observation (197, 90.5%). Coercive interventions such as physical restraint (177, 80.8%) or idiosyncratic sanctions (88,40.2%) were commonly recorded. A significant proportion of violent incidents did not appear to be followed by staff intervention, sanction or punishment (80, 36.5%). Finally, results are considered against research and best practice evidence, and suggestions for further studies are presented. Organisational interventions, strategies for the management of aggression and violence, and a staff training needs analysis are also indicated.