The management of violence in general psychiatry

Sophie Davison is consultant forensic psychiatrist with the North Southwark Community Forensic Team at the South London and Maudsley NHS Trust (York Clinic, Guy’s Hospital, 47 Weston Street, London SE1 3RR, UK. E-mail: Sophie.Davison{at}slam.nhs.uk) and an honorary senior lecturer at the Institute of Psychiatry, London. She was previously consultant forensic psychiatrist responsible for the male special care unit at Broadmoor Hospital. Her research interests include the management of patient violence.

There is increasing concern about the level of violence within mental healthcare settings. In this article I review what is known on this subject, discuss the relationship between mental disorder and violence and summarise the different ways to prevent and manage violence. When planning strategies to prevent violence in such settings it is important to consider not only patient risk factors but also risk factors in the environment. Staff need to have all the possible techniques for managing violent behaviour available to them in order to weigh up the risks and benefits for any specific patient in any particular situation.

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