The content of management of violence policy documents in United Kingdom acute inpatient mental health services.
OBJECTIVE
The aim of the study was to examine the content of Trust policies concerning the prevention and management of violence in acute in-patient settings in order to establish their usefulness as guidance for staff in this difficult, complex, and controversial aspect of inpatient psychiatric care.


BACKGROUND
Violence is a commonly encountered problem in inpatient psychiatric settings. There are legal requirements for workplaces in general and mental health care facilities in particular to develop safe systems of work based upon the findings of assessments of this risk. Policies have a key role to play in making explicit the responsibilities of both employer and employees, and specifying standards of acceptable practice.


METHODS
A cross-sectional survey methodology was used, which entailed examination of the content of management of violence policies that had been forwarded to the authors from 40 Trusts providing acute inpatient psychiatric care throughout England, Scotland, Wales, and Northern Ireland.


RESULTS
Policies were found to vary widely in their content, and serious shortcomings were noted in the extent to which policies included information regarding their status and review, advice on the prevention of violence, the management of violent incidents, and postincident action.


CONCLUSIONS
Further research is needed to tease out the extent to policies which are lacking in content, reflect shortcomings in the organizational approach to the prevention and management of violence by Trusts, and the extent to which such shortcomings result in harm being suffered by staff and/or patients. An alternative format for the presentation of management of violence policies is discussed, and items that should be included in inpatient units' management of violence policies are suggested.
Noak
James
J
Robert Baxter Research Fellow, Health Service Research Department, Institute of Psychiatry, London, UK. j.noak@jop.kcl.ac.uk
Wright
Steve
S
Sayer
Jane
J
Parr
Ann-Marie
AM
Gray
Richard
R
Southern
Dylan
D
Gournay
Kevin
K
D003430:Cross-Sectional Studies; D006291:Health Policy; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D016134:Organizational Policy; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D006113:United Kingdom; D014754:Violence