Violence reduction in mental health and criminal justice: recent and current developments
| DOI | https://doi.org/10.1108/17556228200700005 |
| Date | 01 June 2007 |
| Published date | 01 June 2007 |
| Pages | 28-41 |
| Author | Gail Miller,Brodie Paterson,Richard Benson,Paul Rogers |
| Subject Matter | Health & social care |
28
Violence reduction in mental health
and criminal justice: recent and
current developments
Abstract
Traditional methods of addressing workplace
violence have relied almost solely on reactive
measures. Methods of de-escalation, strategies to
calm the already distressed person down by means
of positive communication, or responding to an
actual or potential act of violence by means of
physical control have formed the focus of training
initiatives provided for staff. This approach has
suggested an acceptance of the premise that
violence in certain services is an inevitable problem
that must be managed. This paper proposes that
many incidents can be prevented and outlines the
emerging evidence to support a structured, holistic
approach. Additionally,it provides an overview of the
recent policy agenda, the evidence base and
examples of some recent and ongoing development
work that attempts to change practice.
Key words
violence; violence reduction; prevention; training
Introduction
Violence reduction and violence management have
become key policy and practice workforce priorities for
mental health and across criminal justice across the UK
over the last 10 years (Scottish Health Service Management
Executive, 1996; Royal College of Psychiatrists (RCP),
1998; Nursing & Midwifery Council (NMC), 2001; NHS
Security Management Service (NHS SMS), 2003; National
Audit Office (NAO), 2003; World Health Organisation
(WHO), 2003; Welsh Assembly Government (WAG), 2004;
WHO, 2004; National Institute for Clinical Excellence
(NICE), 2005; National Institute for Mental Health
England (NIMHE), 2004; Wales Audit Office (WAO, 2005);
Metropolitan Police Authority (MPA), 2005; Association of
Chief Police Officers (ACPO), 2006).
Although, historically, it has been well documented that
violence is a major occupational hazard for mental health
and criminal justice staff, it is only recently that violence
management through violence reduction has received the
attention needed. However,recent interest in the approach
continues to be hampered by a lack of high-quality research
in order to inform policy and practice decision-making.
Definition and scope
Interest in the issue of violence towards health care workers
has grown dramatically over the past 20 years. In particular,
attention has focused on violence and services for people
with mental health problems or learning disabilities. Many
definitions of violence occur,which makes public health
initiatives relying on counting violent incidents and
research fraught with difficulties. A number of reports
outline the incidence of aggression and violence in services
using different outcome measures. Consequently, in
October 2005, NHS SMS published the first figures based on
consistent definitions, and this indicated that staff working
in mental health and learning disability services faced a
higher risk. The Department of Health directions (DoH,
2003) introduced a new national reporting system based on
legal definitions of physical and non-physical assault. These
clarified reporting procedures to ensure a consistent
approach. The definition for physical assault, which replaces
all previous definitions used in the NHS in England was:
‘The intentional application of force to the person of
another,without lawful justification, resulting in
physical injury or personal discomfort’ (Eisener v.
Maxwell 1951, Kaye v. Robinson 1991) (NHS
SMS, 2003).
Gail Miller, Associate Director for Violence Reduction, West London Mental Health Trust
Brodie Paterson, Lecturer, Department of Nursing, University of Stirling
Richard Benson, Senior Lecturer in Forensic Health, HESAS, University of Glamorgan
Paul Rogers, Professor of Forensic Nursing, University of Glamorgan, Broadmoor Hospital, West London Mental
Health Trust and Caswell Clinic, Bro Morgannwg NHS Trust
The Journal of Mental Health Workforce Development Volume 2 Issue 1 June 2007 © Pavilion Journals (Brighton) Ltd
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