title: Observational study of aggressive behaviour and coercion on an Indian acute ward.
abstract: OBJECTIVE
  We evaluated prevalence of aggressive behaviour and coercive measures on an acute Indian psychiatric ward where relatives are always present at the ward.
  
  
  METHODS
  Non-interacting, independent observers (specifically trained mental health clinicians) on an Indian acute, 20-bedded psychiatric ward gave structured reports on all violent episodes and coercive measures during a 30-day period. They used the Staff Observation Aggression Scale -Revised, Indian (SOAS-RI). The severity of the SOAS-RI reports were independently analysed by one of the authors.
  
  
  RESULTS
  229 violent incidents were recorded, involving 63% of admitted patients. 27% of all admitted patients were subjected to intravenous injections. Relatives provoked 35% of the incidents and were the target in 56% of the incidents. Patientś own relatives were involved in managing the aggression in 35% of the incidents. Relatives of other patients were involved in 14% of the incidents. The likelihood of a patient to be physically restrained and that a relative would be participating in the coercive measures was increased when medical staff was targeted.
  
  
  CONCLUSIONS
  Relatives are commonly triggers and victims of aggressions on the inverstigated acute Indian psychiatric wards. Doctors and nurses are less likely to be victims but aggression towards them leads more commonly to coercive measures.
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India. Electronic address: vijaydanivas@gmail.com.
authors: Vijay
authors: V
authors: Danivas
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India; Betsi Cadwaladr University Health Board, Wrexham, United Kingdom; Centre for Mental Health and Society, Bangor University, Wrexham, United Kingdom.
authors: Peter
authors: P
authors: Lepping
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India.
authors: Shivanna
authors: S
authors: Punitharani
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India.
authors: Handithavalli
authors: H
authors: Gowrishree
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India.
authors: Kundapur
authors: K
authors: Ashwini
authors: Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India; Dharwad Institute of Mental Health and Neurosciences, Dharwad, India.
authors: Bevinahalli Nanjegowda
authors: BN
authors: Raveesh
authors: Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden; Norwegian University of Science and Technology, Department of Neuroscience, St. Olav's University Hospital, Forensic Research Unit, Brøset, Trondheim, Norway.
authors: Tom
authors: T
authors: Palmstierna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D003068:Coercion; D005195:Family Relations; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data*; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Coercion; Inpatients; Relatives; Violence