title: Systemic perspective of violence and aggression in mental health care: towards a more comprehensive understanding and conceptualization: part 2.
abstract: This is the second of a two part paper which seeks to explore a wide range of phenomena that have been found to have an association with aggression and violence (A/V) in inpatient mental health care, synthesize these propositions according to fit or congruence into a systemic model of A/V, explore the empirical evidence pertaining to these propositions, and begin to consider application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The systemic model is comprised of four thematic categories with part two of the paper focusing on the final two categories: mental health-care system-related phenomena and clinician-related phenomena. The paper then discusses a number of implications arising out of embracing a more systemic model of A/V in mental health care. In broadening our understanding to include all the phenomena that contribute increased risk of A/V incidents, we are able to move away from inaccurate views that disproportionately assign 'responsibility' to clients for causing A/V when the evidence indicates that the client-related phenomena may only account for a small portion of these incidents.
authors.affiliation: University of Ottawa, Ottawa, Ontario, Canada; School of Nursing, University of Coimbra, Coimbra, Portugal; University of Malta, Msida, Malta.
authors.forename: John R
authors.initials: JR
authors.lastname: Cutcliffe
authors.forename: Sanaz
authors.initials: S
authors.lastname: Riahi
mesh_terms: D000374:Aggression / Q000523:psychology*; D006778:Hospitals, Psychiatric; D001523:Mental Disorders / Q000451:nursing* / Q000523:psychology; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D009742:Nursing Theory; D011568:Psychiatric Nursing; D018570:Risk Assessment; D012308:Risk Management; D012931:Social Environment; D012941:Social Responsibility; D013598:Systems Theory; D014754:Violence / Q000523:psychology*
keywords: aggression/violence; broader conceptualization; clinician phenomena; mental health-care system phenomena; systemic approach