Violence and Aggression: Short-Term Management in Mental Health, Health and Community Settings

Excerpt

This guideline has been developed to advise on the short-term management of violence and aggression in mental health, health and community settings in adults, children (aged 12 years or under) and young people (aged 13 to 17 years).

This guideline updates Violence: the Short-term Management of Disturbed/Violent Behaviour in In-Patient Psychiatric Settings and Emergency Departments (NICE clinical guideline 25), which was developed by the National Collaborating Centre for Nursing and Supportive Care and published in 2005.

Since the publication of the 2005 guideline, there have been some important advances in our knowledge of the management of violence and aggression, including service users’ views on the use of physical intervention and seclusion, and the effectiveness, acceptability and safety of drugs and their dosages for rapid tranquillisation. The previous guideline was restricted to people aged 16 years and over in adult psychiatric settings and emergency departments; this update has been expanded to include some of the previously excluded populations and settings. All areas of NICE clinical guideline 25 have been updated, and this guideline will replace it in full.

The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, people with mental health problems who have personally experienced management of violent or aggressive behaviour, their carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high-quality care for the management of violence and aggression, while also emphasising the importance of the experience of these service users’ care and the experience of their carers (see Appendix 1 for more details on the scope of the guideline).

Although the evidence base is rapidly expanding, there are a number of major gaps. The guideline makes a number of research recommendations specifically to address gaps in the evidence base. In the meantime, it is hoped that the guideline will assist clinicians, service users and carers, by identifying the merits of particular treatment approaches where evidence from research and clinical experience exists.