Past violence, substance use, and precipitants to psychiatric patient assaults: eleven-year analysis of the Assaulted Staff Action Program (ASAP).

Thirty-five years of empirical research on assaultive psychiatric patients has documented the presence of consistent patient assailant characteristics. However, these characteristics studies have yielded little in the way of predictor variables. This study examined three commonly present, patient clinical variables (past violence toward others, personal victimization, and substance use disorder) singly and in combinations as potential predictor variables. An additional subset analysis of patient precipitants was added to ascertain whether precipitant data would add further predictive power The combinations of past violence toward others and personal victimization with and without substances use disorder during an eleven-year period were associated with 61% of the subsequent assaults. A trend for denial of services to female patients during a three-year period was also associated with subsequent assaults. The predictive implications of these findings and their relevance for emergency services personnel are examined.

Precipitants of psychiatric patient assaults on staff: preliminary empirical inquiry of the Assaulted Staff Action Program (ASAP).

Although there has been extensive empirical research on the characteristics of psychiatric patient assailants and their staff victims, there has been a dearth of empirical research on the nature of the precipitants of these patient/staff interactions. Building on the few earlier studies, this year-long, retrospective, empirical study of patient precipitants was conducted within the context of the Assaulted Staff Action Program (ASAP) in ten public sector health care facilities. Excessive sensory stimulation, staff restrictions on patient behaviors (restraints), and acute psychosis were the most frequently occurring precipitants. There were no specific patterns to patient assailant and staff victim characteristics by assault precipitant. The implications of this study and future research needs are addressed.