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Violence, alcohol and drugs: The views of nurses and patients on psychiatric intensive care units, acute adult wards and forensic wards

Published online by Cambridge University Press:  01 June 2009

Ignatius Loubser ,
Robert Chaplin  and
Alan Quirk
Ignatius Loubser
Affiliation:
The College Research and Training Unit (CRTU), Standon House, London Honorary Research Worker/Specialist Registrar
Robert Chaplin*
Affiliation:
Research Fellow/Consultant Psychiatrist
Alan Quirk
Affiliation:
Research Fellow/Research Sociologist
*
Correspondence to: Dr. Robert Chaplin, The College Research and Training Unit (CRTU), 4th Floor, Standon House, 21 Mansell Street, London, E1 8AA. E-mail: [email protected]
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Abstract

Aims and method: To measure the numbers of staff and patients experiencing physical assault, and identify the perception of staff and patients regarding alcohol and drug related violence on Psychiatric Intensive Care wards (PICUs), acute adult wards and forensic wards. Postal questionnaires were received from 2761 individuals. They yielded quantitative and qualitative data. Further information arose from discussion groups of staff at feedback events.

Results: Nurses on PICUs (61%) were more likely to report assault than those on acute wards (45%) or forensic wards (33%). Patients on PICUs (25%) were significantly more likely to report assault than those on acute wards (14%) but not forensic wards (23%). Nurses were more likely than patients to report that drugs and alcohol had caused violence on their ward. Nurses on PICUs and forensic wards thought drug use was more likely to cause violence than alcohol. Compared with PICUs, more nurses considered that violence was due to alcohol and drugs on acute wards but not on forensic wards. Many nurses on PICUs carried out personal searches but few had received training in this.

Conclusion: Nurses on PICUs appear to be at particularly high risk of violence. Reducing the availability of illegal drugs on PICUs and improvement of staff training could be important means of reducing violence.

Keywords

Violencesubstance misusedrugspsychiatric intensive care units (PICU)acute adult wardsforensic wards
Type
Original Article
Information
Journal of Psychiatric Intensive Care , Volume 5 , Issue 1 , June 2009 , pp. 33 - 39
Copyright
Copyright © NAPICU 2009

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References

Arsenault, L., Moffitt, T.E., Caspi, A., Taylor, J.T. and Silva, P.A. (2000) Mental disorders and violence in a total birth cohort. Results from the Dunedin study. Archives of General Psychiatry. 157 (10): 556–572.Google Scholar
Beer, D.M. (2007) Cannabis and mental health. Journal of Psychiatric Intensive Care. 3 (1): 45–47.CrossRefGoogle Scholar
Chaplin, R., McGeorge, M. and Lelliot, P. (2006) The National Audit of Violence: Inpatient care for adults of working age. Psychiatric Bulletin. 30 (12): 444–446.CrossRefGoogle Scholar
Dawson, P., Kingsley, M. and Pereira, S. (2005) Violent patients within psychiatric intensive care units: Treatment approaches, resistance and the impact upon staff. Journal of Psychiatric Intensive Care. 1 (1): 45–53.CrossRefGoogle Scholar
Dolan, M. and Kirwan, H. (2001) Survey of staff perceptions of illegal drug use among patients in a medium secure unit. Psychiatric Bulletin. 25: 14–17.CrossRefGoogle Scholar
Estroff, S.E., Jeffrey, W., Swanson, W.S.et al. (1998) Risk reconsidered: Targets of violence in the social networks of people with serious psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology. 33(suppl. 1): 95–101.Google Scholar
Goffman, E. (1961) Asylums. London: Penguin.Google Scholar
Healthcare Commission (2005) The National Audit of Violence (2003–2005) Final Report. http://www.healthcarecommission.org.uk/_db/_documents/04017451.pdfGoogle Scholar
Hodgins, S. (1992) Mental Disorder, intellectual deficiency and crime: Evidence from a birth cohort. Archives of General Psychiatry. 49(6): 476–483.CrossRefGoogle ScholarPubMed
Hodgins, S., Mednick, S., Brennan, P.A.Schulsinger, S. and Engberg, M. (1996) Mental disorder and crime: Evidence from a Danish birth cohort. Archives of General Psychiatry. 53(6): 489–496.CrossRefGoogle ScholarPubMed
Hodgins, S. and Müller-Isberner, R. (2004) Preventing crime by people with schizophrenic disorders: the role of psychiatric services. British Journal of Psychiatry. 185(3): 245–250.CrossRefGoogle ScholarPubMed
Ley, A., Jeffery, D., Ruiz, J., McLaren, S. and Gillespie, C. (2002) Underdetection of comorbid drug use at acute psychiatric admission. Psychiatric Bulletin. 26: 248–251.CrossRefGoogle Scholar
McGeorge, M., Shinkwin, L. and Hinchcliffe, G. (2008) The Healthcare Commission National Audit of Violence 2006–2007 Final Report: Working age adult services. Royal College of Psychiatrist Research and Training Unit: College Centre for Quality Improvement. London.Google Scholar
Mellesdal, L. (2003) Aggression on a psychiatric acute ward: A three-year prospective study. Psychological Report. 92: 1229–1248.CrossRefGoogle Scholar
National Institute for Clinical Excellence (2005) Violence: The short term management of disturbed/violent behaviour in inpatient psychiatric settings and emergency Departments. Clinical Guideline 25. London: NICE.Google Scholar
Phillips, P. and Johnson, S. (2003) Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units. Psychiatric Bulletin. 27: 217–220.Google Scholar
Priebe, S., Fakhoury, W., Watts, J., Bebbington, P., Burns, T., Johnson, S., Muijen, M., Ryrie, I., White, I., and Wright, C. (2003) Assertive outreach teams in London: Patient characteristics and outcomes. Pan-London Assertive Outreach Study, Part 3. British Journal of Psychiatry. 183(2): 148–154.CrossRefGoogle ScholarPubMed
Quirk, A., Lelliot, P. and Seale, C. (2004) Service users’ strategies for managing risk in the volatile environment of an acute psychiatric ward. Social Science and Medicine. 59: 2573–2583.CrossRefGoogle ScholarPubMed
Quirk, A., Lelliott, P. and Seale, C. (2006) The permeable institution: An ethnographic study of three acute psychiatric wards in London. Social Science and Medicine. 63(8): 2105–2117.CrossRefGoogle Scholar
Steadman, H.J., Mulvey, E.P., Monahan, J., ClarkRobbins, P., Appelbaum, P.S., Grisso, T., Roth, L.H., and Silver, E. (1998) Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighbourhoods. Archives of General Psychiatry. 55: 393–501.Google Scholar
Swanson, J., Holzer, C., Ganju, V.K., and Jono, R.T. (1990) Violence and psychiatric disorder in the community. Evidence from the Epidemiologic Catchment Area Surveys. Hospital and Community Psychiatry. 41(7): 761–770.Google ScholarPubMed
Swanson, J.W., Swartz, M.S., Van Dorn, R.A., Elbogen, E.B., Wagner, H.R., Rosenheck, R.A., Stroup, T.S., McEvoy, J.P. and Lieberman, J.A. (2006) A national study of violence in persons with schizophrenia. Archives of General Psychiatry. 63(5): 490–499.CrossRefGoogle ScholarPubMed