Assaults on Staff in a Locked Ward: Prediction and Consequences

Abstract

Violent incidents that resulted in injury to staff were recorded in a locked acute psychiatric admission ward of 17 beds. In 6 months 41 incidents occurred against 23 staff. Six incidents caused serious injuries and 21 caused significant injuries. Over half the incidents were thought to have been avoidable by the victims. A scale for rating arousal level was devised from the behavioural signs that occurred prior to the assault. High scores on this scale related to an increased chance of serious assault. There were changes in speech and movement prior to the assault in 80 per cent of incidents. However, changes in patients' postures and movements prior to the assault were significantly associated with serious injuries. The practical implications of these results are discussed from the point of view of those dealing directly with acutely disturbed patients.