Inpatient violence in a Dutch forensic psychiatric hospital
| DOI | https://doi.org/10.1108/JFP-04-2016-0020 |
| Pages | 102-114 |
| Published date | 08 May 2017 |
| Date | 08 May 2017 |
| Author | Nienke Verstegen,Vivienne de Vogel,Michiel de Vries Robbé,Martijn Helmerhorst |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
Invited paper
Inpatient violence in a Dutch forensic
psychiatric hospital
Nienke Verstegen, Vivienne de Vogel, Michiel de Vries Robbé and Martijn Helmerhorst
Abstract
Purpose –Inpatient violence can have a major impact in terms of traumatic experiences for victims and
witnesses, an unsafe treatment climate, and high-financial costs. Therefore, the purpose of this paper is to
gain more insight into patterns of violent behavior, so that adequate preventive measures can be taken.
Design/methodology/approach –Data on inpatient violence in a Dutch forensic psychiatric hospital
between 2008 and 2014 were extracted from hospital files on 503 patients.
Findings –More than half of all the patients (n ¼276, 54.9 percent) displayed verbal aggression on at least
one occasion, whereas 27.2 percent of all patients (n ¼137) exhibited one or more incidents of physical
violence. Female patients were responsible for more physically violent episodes than male patients. Patients
admitted with a civil court order exhibited more violent behavior than patients with a criminal court order.
Violent patients with a civil commitment had a significantly longer length of stay than non-violentpatients with
a civil commitment. More violence was found to take place on the earlier days of the week.
Originality/value –This study points at important differences between groups of forensic inpatients in
frequency and type of inpatient violent behavior and in temporal factors. Interventions aimed at reducing the
number of violent incidents should take these differences into account. Further research is necessary to gain
more insight into the background of inpatient violence.
Keywords Gender,Violence, Civil commitment, Criminal commitment, Forensic psychiatry, Inpatient violence
Paper type Research paper
Introduction
Patients in forensic psychiatric hospitals usually have a history of severe (sexually) violent or
disruptive behavior. They receive mandatory treatment to ensure they can safely return to
society. However, violent incidents occur also during this treatment. These incidents may have a
great impact on staff and patients. Based on a literature review of 42 studies, Bowers et al. (2011)
concluded that 79 percent of all nurses from different ward types experienced violence during
their career; 62 percent of all nurses experienced violence during the last year (Bowers et al.,
2011). Another literature review of 55 studies that used the staff observation aggression scale
(SOAS; Palmstierna and Wistedt, 1987) stated that approximately 10 to 20 percent of all
recorded violent incidents had physical consequences for the victims, such as pain, bruises and
welts (Nijman et al., 2005). Furthermore, the financial consequences of these incidents can be
substantial, for example, in terms of higher absence rates of staff as a result of sick leave, working
on restricted duty and vocational rehabilitation (Hunter and Carmel, 1992). A survey among
1,534 professionals in Dutch inpatient psychiatric facilities showed that 8.9 percent of all
respondents had been absent for more than a month in the past five years due to inpatient
violence (Van Leeuwen and Harte, 2015). Inpatient violence is evidently a serious problem and
in-depth knowledge about it is necessary to adequately undertake preventive measures.
Received 7 April 2016
Revised 26 April 2016
28 April 2016
Accepted 29 April 2016
Nienke Verstegen,
Vivienne de Vogel and
Michiel de Vries Robbé are all
based at the Research
Department, De Forensische
Zorgspecialisten, Utrecht,
The Netherlands.
Martijn Helmerhorst is based at
the Van der Hoeven Kliniek,
Utrecht, The Netherlands.
PAGE102
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JOURNAL OF FORENSIC PRACTICE
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VOL. 19 NO. 2 2017, pp. 102-114, © Emerald Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-04-2016-0020
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