Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Jan 19;17(1):59.
doi: 10.1186/s12913-017-1988-7.

A descriptive survey study of violence management and priorities among psychiatric staff in mental health services, across seventeen european countries

Seamus Cowman  1 , Anna Björkdahl  2 , Eric Clarke  3 , Georgina Gethin  4 , Jim Maguire  5 ; European Violence in Psychiatry Research Group (EViPRG)
Collaborators, Affiliations
Multicenter Study

A descriptive survey study of violence management and priorities among psychiatric staff in mental health services, across seventeen european countries

Seamus Cowman et al. BMC Health Serv Res. .

Abstract

Background: In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach.

Methods: The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG). The study aimed to incorporate an EU and multidisciplinary response in the determination of violence management practices and related research and education priorities across 17 European countries. From the EVIPRG members, one member from each country agreed to act as the national project coordinator for their country. Given the international spread of respondents, an eDelphi survey approach was selected for the study design and data collection. A survey instrument was developed, agreed and validated through members of EVIPRG.

Results: The results included a total of 2809 respondents from 17 countries with 999 respondents who self-selected for round 2 eDelphi. The majority of respondents worked in acute psychiatry, 54% (n = 1511); outpatient departments, 10.5% (n = 295); and Forensic, 9.3% (n = 262). Other work areas of respondents include Rehabilitation, Primary Care and Emergency. It is of concern that 19.5% of respondents had not received training on violence management. The most commonly used interventions in the management of violent patients were physical restraint, seclusion and medications. The top priorities for education and research included: preventing violence; the influence of environment and staff on levels of violence; best practice in managing violence; risk assessment and the aetiology and triggers for violence and aggression.

Conclusion: In many European countries there is an alarming lack of clarity on matters of procedure and policy pertaining to violence management in mental health services. Violence management practices in Europe appear to be fragmented with no identified ideological position or collaborative education and research. In Europe, language differences are a reality and may have contributed to insular thinking, however, it must not be seen as a barrier to sharing best practice.

Keywords: Coercion; Education and research priorities; European mental health policy; Violence management; eDelphi.

PubMed Disclaimer

References

    1. McDaid D, Knapp MJ, Curran C. Funding mental health in Europe. WHO European Observatory on Health systems and Policies. 2005 (Online) Available from: http://www.euro.who.int/en/about-us/partners/observatory/publications/po.... Accessed 8 Jan 2017.
    1. Cowman S. The future of mental health nursing in context -the European context. In: Barker P, editor. Psychiatric and mental health nursing; the craft of caring. 2. London: Arnold; 2009. pp. 698–706.
    1. EEC. Freedom of movement for persons. Freedom of establishment. Freedom to provide services Doctors. Obtaining of qualifications in specialized medicine. Obligation to provide remuneration for training periods limited to the medical specialties common to all the Member States or to two or more Member States and set out in Articles 5 or 7 of Directive 75/362. (Council Directives 75/362, Arts 5 and 7, 75/363, Art. 2(1)(c) and 82/76)(Online). 1975. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri = CELEX:61993CJ0277. Accessed 7 Jan 2017.
    1. UEMS - UNION EUROPÉENNE DES MÉDECINS SPÉCIALISTES: European Board of Psychiatry. Charter on specialist training of Medical Specialist in the EU; Requirements for Specialist Psychiatry. Royal College of Psychiatrists London. 2003.http://uemspsychiatry.org/wp-content/uploads/2013/09/Chapter6-11.10.03.pdf.Accessed 7 Jan 2017.
    1. EEC. Council of the European Community. Council Directive concerning the mutual recognition of diplomas and certificates and other evidence of the formal qualifications and coordination of provisions laid down by law, regulation or administrative action in respect of the activities of nurses responsible for general care Brussels. Council Directive (77 452/453EEC). (Online).1977. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?quid=1483815009638&uri=CE.... Accessed 7 Jan 2017.

Publication types

LinkOut - more resources