title: Systemic perspective of violence and aggression in mental health care: towards a more comprehensive understanding and conceptualization: part 1.
abstract: Aggression and violence (A/V) in mental health care are all too frequent occurrences; they produce a wide range of deleterious impacts on the individual client, staff, organizations, and the broader community. A/V is a multifaceted and highly-complex problem, and is associated empirically with a wide range of phenomena. However, most attempts to reduce A/V in mental health care have invariably focused on one or two aspects of the problem at the expense of a more comprehensive, systemic approach; these have produced inconclusive results. As a result, this two-part paper seeks to: (i) recognize the wide range of phenomena that have been found to have an association with A/V in mental health care; (ii) synthesize these propositions according to fit or congruence into a systemic model of A/V; (iii) explore empirical evidence pertaining to these propositions; and (iv) begin to consider the application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The paper advances a systemic model of these phenomena comprised of four thematic categories, with Part 1 of this paper focusing on the first two categories: environmental and intrapersonal (client-related) phenomena.
authors.affiliation: Faculty of Health Sciences, University of Ottawa, Ottawa; School of Nursing, University of Coimbra, Coimbra, Portugal; Department of Nursing, University of Malta, Msida, Malta; Cutcliffe Consulting, Hampden, Maine, USA.
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*; D001143:Arousal; D056348:Emotional Intelligence; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000451:nursing* / Q000523:psychology; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing; D012307:Risk Factors; D012931:Social Environment; D012951:Socialization; D013598:Systems Theory; D014754:Violence / Q000523:psychology*
keywords: aggression; environmental phenomena; intrapersonal (client-related) phenomena; mental health care; systemic approach; violence