We did a postal survey of psychiatric trainees (n=70) based at six different psychiatric hospitals in the West Midland deanery, using a 32-item questionnaire covering issues related to trainees’ safety as outlined in the College guidelines (Royal College of Psychiatrists, 1999). Forty-two trainees (60%) responded, of which 9 (21%) reported physical violence and 22 (53%) reported verbal threats. The major concern was that 13 (31%) trainees did not have access to safety alarms and 15 (35%) never wore a safety alarm. Even though the College guideline states that trainees must undergo breakaway training every 6 months, as many as 24 (57%) trainees did not have such training. Furthermore, 27 (64%) trainees did not find the seating arrangements at the out-patient clinics very safe, as compared with 35 (84%) for the accident and emergency psychiatry assessment rooms and 17 (41%) for the ward review rooms. Alarmingly, 20 (48%) trainees were not aware of the presence of safety alarm buttons on the ward, as compared with 32 (76%) on accident and emergency department and 27 (36%) for out-patient clinic rooms.

Our experience suggests that all deaneries and psychiatry hospitals have a lot of work to do to improve psychiatry trainee's safety.