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Patient aggression: a serious issue requiring a dedicated organisational response

Brett McDermott
Med J Aust 2012; 196 (3): . || doi: 10.5694/mja12.10112
Published online: 20 February 2012

Staff safety is improved by clear procedures for managing abuse and assault

Hopper and colleagues describe a scenario familiar to many hospital clinicians and managers: staff reports of verbal abuse and physical assaults from patients.1 This is often in an organisational context of scarce reliable data about the phenomenon, an ad-hoc management response and no specific training of staff to manage aggression. Aggression is not defined in the Hopper et al article but it is useful to remember that it is a broad term, inclusive of behaviour that is destructive to self, others and property.2 As with many other behaviours, a therapeutic framework can be applied to aggression. The origin of aggression in children and adolescents is often a developmental failure to regulate impulsivity and behaviour following prejudicial early-life experiences, including exposure to coercive parenting. Aggression is often a feature of a developmental or mental health disorder.3


  • Child and Youth Mental Health Service, Mater Medical Research Institute, Brisbane, QLD.



Competing interests:

No relevant disclosures.

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  • 2. Connor DF, Carlson GA, Chang KD, et al. Juvenile maladaptive aggression: a review of prevention, treatment, and service configuration and a proposed research agenda. J Clin Psychiatry 2006; 67: 808-820.
  • 3. Dean AJ, Gibbon P, McDermott BM, et al. Exposure to aggression and the impact on staff in a child and adolescent inpatient unit. Arch Psychiatr Nurs 2010; 24; 15-26.
  • 4. Gullick K, McDermott BM, Stone P, Gibbon P. Seclusion of children and adolescents: psychopathological and family factors. Int J Ment Health Nurs 2005; 14: 37-43.
  • 5. Sukhodolosky DG, Cardona L, Martin A. Characterizing aggressive and noncompliant behaviors in a children’s psychiatric inpatient setting. Child Psychiatry Hum Dev 2005; 36: 177-193.
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  • 7. Martin T, Daffern M. Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatry setting. J Psychiatr Ment Health Nurs 2006; 13: 90-99.
  • 8. Dean AJ, Duke SG, George M, Scott J. Behavioral management leads to reduction in aggression in a child and adolescent psychiatry inpatient unit. J Am Acad Child Adolesc Psychiatry 2007; 46: 711-720.

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