A preliminary investigation into patterns of aggression in an Australian forensic psychiatric hospital

• Published in: The journal of forensic psychiatry & psychology 2003-04, Vol.14 (1), p.67-84
• Main Authors: Daffern, Michael, Mayer, Maggie M., Martin, Trish
• Format: Article
• Language: English
• Subjects: Aggression; Australia; forensic; Forensic science; inpatient; Mental health; Mental hospitals; Mental illness; Patients; Psychiatry; Psychology; Retrospective studies; seclusion; Special hospitals
• ISSN: 1478-9949; 1478-9957
• DOI: 10.1080/1478994031000074306

The aggressive behaviour of psychiatric inpatients has profound consequences for patients, staff, ward atmosphere and psychiatric hospitals in general. Considerable international research exists, primarily conducted in general psychiatric hospitals, on the prevalence and determinants of aggression. Conclusions drawn from this research contribute valuable information about the clinical and demographic characteristics of aggressive patients. There is little Australian research available, however, that contributes directly to aggression management and minimization strategies for local facilities. Furthermore, no published research on aggression in an Australian forensic psychiatric hospital exists. Australian research is required because of the clear influence of situational and cultural contributors to aggression. The aim of this project was to review retrospectively documented incidents of aggression that occurred during the first year of operation of the Thomas Embling Hospital, a forensic psychiatric hospital in Victoria, Australia. Results showed that aggression was prevalent although most likely there was an underestimate of verbal and physical aggression. Acute wards recorded almost 90% of incidents. Proportionately, males and females were similar in both the frequency and type of aggression. Males tended to be aggressive towards males and females were aggressive towards females. Variations in the patterns of physical aggression across wards were found. These variations may have been a consequence of differences in aggression management strategies, particularly the tendency to use restraint and seclusion. The use of seclusion to contain actual or potentially aggressive patients may contribute to more frequent aggression and injury to staff since the staff were more frequently the victims of physical aggression during restraint than by direct assault.