Abstract
Introduction
Instances of violence in acute psychiatric settings are frequent, can be devastating for service users and staff, and are costly. Such settings would benefit from a greater understanding of violence.
Aim
We analysed the association between current and historical variables and rates of inpatient violence. To address gaps in current research we included instances of self-harm and being the target of violence. We also included seldom used service metrics.
Method
Data was extracted on admissions to acute adult wards and PICUs 2017-2020 within South London and Maudsley NHS Foundation Trust. A zero-inflated negative binomial regression mixed model was used to analyse the impact of variables on rates of violence.
Results
Variables associated with an increased rate of violence were: an increased number of violent incidents in the year before admission, being admitted on MHA section, being admitted to PICU, instances of self-harm, being the target of violence and referral to a Psychiatric Liaison Team.
Discussion
The novel associations found between enacting violence, self-harm and being the target of violence indicate trauma-informed care is crucial to reduce violent presentations of distress.
Implications for practice
System level interventions are crucial to ensure mental health nurses are supported to provide trauma-informed care.