Safe Spaces: Mitigating Potential Aggression in Acute Care Psychiatry.

Layla Soliman, Abhishek Jain, John Rozel, James Rachal
Author Information
  1. Layla Soliman: Department of Psychiatry, Atrium Health/Wake Forest University School of Medicine, Charlotte, North Carolina (Soliman, Rachal); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Jain); Department of Psychiatry and School of Law, University of Pittsburgh, and University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, Pennsylvania (Rozel).
  2. Abhishek Jain: Department of Psychiatry, Atrium Health/Wake Forest University School of Medicine, Charlotte, North Carolina (Soliman, Rachal); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Jain); Department of Psychiatry and School of Law, University of Pittsburgh, and University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, Pennsylvania (Rozel).
  3. John Rozel: Department of Psychiatry, Atrium Health/Wake Forest University School of Medicine, Charlotte, North Carolina (Soliman, Rachal); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Jain); Department of Psychiatry and School of Law, University of Pittsburgh, and University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, Pennsylvania (Rozel).
  4. James Rachal: Department of Psychiatry, Atrium Health/Wake Forest University School of Medicine, Charlotte, North Carolina (Soliman, Rachal); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Jain); Department of Psychiatry and School of Law, University of Pittsburgh, and University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, Pennsylvania (Rozel).

Abstract

Awareness of potential aggression and violence is crucial when treating patients experiencing mental health crises in psychiatric emergency and inpatient settings. To provide a practical overview for health care workers in acute care psychiatry, the authors summarize relevant literature and clinical considerations on this important topic. Clinical contexts of violence in these settings, possible impact on patients and staff, and approaches to mitigating risk are reviewed. Considerations for early identification of at-risk patients and situations, and nonpharmacological and pharmacological interventions, are highlighted. The authors conclude with key points and future scholarly and practical directions that may further assist those entrusted with providing psychiatric care in these situations. Although working in these often high-paced, high-pressured settings can be challenging, effective violence-management strategies and tools can help staff optimize the focus on patient care while maintaining safety, their own well-being, and overall workplace satisfaction.

Keywords

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