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.