Violence and aggression in mental health inpatient units: an evaluation of aggression minimisation programs

Violence and aggression in inpatient units constitute a major workplace hazard for mental health nurses, who must take account of many considerations when dealing with potentially aggressive or violent patients. This paper discusses some of the problems that arise in connection with violence and aggression in mental health facilities, including incidence and prevalence, risk management processes, under-reporting, causes of aggression, the link between aggression and mental illness, difficulties in defining and categorising aggressive incidents, and the effect of such behaviour on the therapeutic relationship. Research into the effectiveness of aggression minimisation programs is in its infancy and it is difficult to draw conclusions about the effectiveness of relevant training systems. After a review of various national and international training courses, a description is given of methods of aggression minimisation conducted in The Hunter New England Health Service, NSW, Australia. The aims of this paper are to explore aspects of violence and aggression in mental health inpatient units and to evaluate programs designed to prevent and manage violence and aggression in these settings.