Document Type

Conference Proceeding

Publication Date


Journal Title or Book Title

Proceedings of the 8th European Congress on Violence in Clinical Psychiatry


Publisher's PDF


Aggressive and violent behavior toward health care workers in psychiatric hospital settings is a long recognized occupational hazard with significant psychological, physical and economic costs (U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Hunter. Carmel 1992). Numerous professional publications highlight the problem and emphasize the need for formalized staff training (one of many clinical and occupational approaches) to reduce the risk of violence and the related rate and severity of staff injuries (Infantino and Musingo 1985; Lehman, Medilla and Clark1983, Carmel and Hunter 1990, American Psychiatric Association Task Force on Clinician Safety (Task Force Report 33, Beech and Leather 2006). Training programs are widely used and options include private (e.g. Non-violent Crisis Intervention, Crisis Prevention Institute) and public sector developed (States of NY, CT, et al) programs. In the United States, staff that work in psychiatric hospital settings, where restraints and seclusion are used, must meet the training requirements set forth by regulatory and accrediting bodies [Center for Medicare/Medicaid Services CFR Part 482 (CMS), The Joint Commission (TJC)]. Hospital policies and state laws (e.g., Connecticut General Statute 814e, Sec 46-154) typically include training requirements. The requirements include who should be trained (direct care staff that work in settings where restraints and seclusion are used), at what intervals (orientation and subsequent periodic reviews) and what the content must include. Competence in the theoretical knowledge as well as physical skill knowledge are commonly used measures.

Related Pillar(s)