Psychiatric Quarterly

, Volume 78, Issue 2, pp 83–90

Psychiatric Patient Assault and Staff Victim Gender: Fifteen-year Analysis of the Assaulted Staff Action Program (ASAP)

  • Raymond B. FlanneryJr
  • Louise Marks
  • Lisa Laudani
  • Andrew P. Walker
Original Paper

Abstract

Extensive, largely cross-sectional research has documented the continued occurrence of patient assaults on male and female staff. Different studies report either male or female staff to be at highest risk. Studies of same/different gender assaults which might more fully answer this question have been few. In these latter studies both male and female staff were at high risk for same gender assaults. In community settings males were at risk from same gender assaults but females were at risk from assaults by both patient genders. The present 15-year longitudinal retrospective study examined same/different gender assaults over time. Since the health care system under study experienced several major policy changes during these years, data were also examined at 5-year intervals to assess the stability of findings across time. Male and female staff were at increased risk from same gender assaults over time in both inpatient and community settings. The findings and their implications are discussed. In addition, a cost-effective, comprehensive risk management strategy for containing assaults is outlined.

Keywords

Assaults Gender Psychiatric Patient Risk Management Staff Victim 

References

  1. 1.
    Dobrin A, Wiersema P, Loften C, et al.: Statistical handbook of Violence in America.: Ornyx Press, Phoenix, AZ, 1996.Google Scholar
  2. 2.
    Blair DT: Assaultive behavior: Does provocation begin in the front office?. Journal of Psychosocial Nursing 29:21–26, 1991.Google Scholar
  3. 3.
    Busch AB, Shore MF: Seclusion, restraint: A review of the literature. Harvard Review of Psychiatry 8:261–270, 2000.PubMedCrossRefGoogle Scholar
  4. 4.
    Davis S: Violence in psychiatric patients: A review. Hospital, Community Psychiatry 42:585–590, 1991.Google Scholar
  5. 5.
    Flannery RB Jr: Characteristics of assaultive psychiatric inpatients: Updated review of findings, 1995-2000. American Journal of Alzheimer's Disease and Other Dementias 16:153–156, 2001.PubMedGoogle Scholar
  6. 6.
    Dinwiddie SH, Briska W: Prosecution of violent psychiatric inpatients: Theoretical, practical issues. International Journal of Law and Psychiatry 27:17–29, 2004.PubMedCrossRefGoogle Scholar
  7. 7.
    Occupational Safety and Health Administration: Guidelines for Preventing Workplace Violence in Health Care and Social Service Workers. Publication #3148. Washington, DC, United States Department of Health and Human Services, 1996.Google Scholar
  8. 8.
    Flannery RB Jr: Psychiatric patient assault and staff victim gender: Review of findings. Journal of Healthcare Safety, Compliance, and Infection Control 5:69–72, 2001.Google Scholar
  9. 9.
    Linhorst DM, Scott LP: Assaultive behavior in state psychiatric hospitals: Differences between forensic and nonforensic patients. Journal of Interpersonal Violence 19:857–874, 2004.PubMedCrossRefGoogle Scholar
  10. 10.
    Mellesdal L: Aggression on a psychiatric acute ward: A three-year prospective study. Psychological Reports 92:1229–1248, 2003.PubMedCrossRefGoogle Scholar
  11. 11.
    Flannery RB Jr: Repetitively assaultive psychiatric patients: Review of published findings, 1978–2001. Psychiatric Quarterly 73:229–237, 2002.PubMedCrossRefGoogle Scholar
  12. 12.
    Flannery RB Jr, Hanson MA, Penk WE, et al: Violence against women: Psychiatric patient assaults on female staff. Professional Psychology: Research and Practice 25:182–184, 1994.CrossRefGoogle Scholar
  13. 13.
    Flannery RB Jr, Lizotti D, Laudoni L, Staffieri A, et al.: Violence against women and the Assaulted Staff Action Program. Administration and Policy in Mental Health 28:491–498, 2001.PubMedCrossRefGoogle Scholar
  14. 14.
    Harris CT, Rice ME: Staff injuries sustained during altercations with psychiatric patients. Journal of Interpersonal Violence 1:193–211, 1986.CrossRefGoogle Scholar
  15. 15.
    Kalogerakis MG: The assaultive psychiatric patient. Psychiatric Quarterly 43:372–381, 1971.Google Scholar
  16. 16.
    Flannery RB Jr: The Assaulted Staff Action Program: Coping with the Psychological Aftermath of Violence. Chevron Publishing Corporation, Ellicott City, MD, 1998.Google Scholar
  17. 17.
    Flannery RB Jr, Farley EM, Rego S, et al.: Characteristics of staff victims of psychiatric patient assaults: Fifteen-year analysis of the Assaulted Staff Action Program (ASAP). Psychiatric Quarterly, in press.Google Scholar
  18. 18.
    Lion JR, Snyder W, Merrill GC: Underreporting of assaults on staff in a state hospital. Hospital and Community Psychiatry 32:497–498, 1981.PubMedGoogle Scholar
  19. 19.
    James TB: Domestic violence: The 12 Things You Aren't Supposed to Know. Aventine Press, Chula Vista, CA, 2003.Google Scholar
  20. 20.
    Archer J (Ed): Male Violence. Routledge, New York, 1994.Google Scholar
  21. 21.
    Campbell A, Muncer S, Bibel D: Female-female criminal assault: An evolutionary perspective. Journal of Research in Crime and Delinquency 35:413–429, 1998.CrossRefGoogle Scholar
  22. 22.
    Medical Directors Council, National Association of State Mental Health Program Directors: Reducing the use of seclusion and restraint: Findings, strategies, and recommendations. Emergency Psychiatry 6:7–13, 2000.Google Scholar
  23. 23.
    Rachlin S: The prosecution of violent psychiatric inpatients: One respectable intervention. Bulletin of the American Academy of Psychiatry and the Law 22:239–247, 1994.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Raymond B. FlanneryJr
    • 1
    • 2
    • 3
  • Louise Marks
    • 1
  • Lisa Laudani
    • 2
    • 4
  • Andrew P. Walker
    • 1
  1. 1.Massachusetts Department of Mental HealthBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of Psychology/6BWorcester State HospitalWorcesterUSA
  4. 4.Vinfen CorporationBostonUSA

Personalised recommendations