title: Understanding inpatient violence in a New Zealand child and adolescent psychiatric setting.
abstract: This paper describes the rate of violent episodes at a youth psychiatric unit, identifies significant clinical and demographic differences between service users who had admissions with violent episodes and those who did not, and describes characteristics of violent incidents, including antecedents, consequences, victim type, and severity of violence. A retrospective file audit over a 2-year period reviewed 303 admissions. Characteristics of violent incidents (n = 242) and service users (violent/non-violent) were recorded. Of 263 service users, 21.7% exhibited violent behaviour. Significant differences between admissions with and without violent episodes were found in terms of ethnicity, legal status, length of admission, and diagnosis. Staff were the most frequent victims and less severe incidents were most common. The most frequent antecedents to violence were positive symptoms of psychosis, hostility, and agitation, while the most common consequences were seclusion, physical restraint and 'as-required' medication. This study has identified that violent incidents are a common and significant issue. The findings might help staff in reviewing current management approaches. Future areas of study have been identified.
authors.affiliation: Child and Family Unit, Starship Children's Health, Auckland Hospital, Auckland, New Zealand. kvankess@aut.ac.nz
authors.forename: Kirsten
authors.initials: K
authors.lastname: van Kessel
authors.forename: Duncan
authors.initials: D
authors.lastname: Milne
authors.forename: Kessiah
authors.initials: K
authors.lastname: Hunt
authors.forename: Peter W
authors.initials: PW
authors.lastname: Reed
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D009520:New Zealand / Q000453:epidemiology; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*