Background: Patient assaults are the result of a complex interaction of person x event x environment variables. Precipitants to patient assaults have received less attention than the patient characteristics of such assaults. However, reviews of the precipitants to patient assaults from 1960-2012 have documented acute psychosis, denial of services, and substance abuse as frequently occurring precipitants. The purpose of the present study was to review the international literature on precipitants to patient assaults from 2013- 2017. It was hypothesized that acute psychosis, substance abuse, and denial of services would continue to be common precipitants.
Method: Literature searches were conducted in Psych Abstracts and PsychInfo and yielded 11 international studies of precipitants to patient assaults. All papers had to report raw assault data, appear in English in peer- reviewed journals, and be from international institutions. Child and special population studies were excluded.
Results: Acute psychosis, substance abuse, denial of services, and long wait times were among the frequent precipitants.
Conclusions: The data from this study document that patient assaults continue occur worldwide, that the precipitants to those assaults are similar to those noted in earlier research. They are highly similar across the globe. As hypothesized, acute psychosis, substance abuse, and denial of services were frequent precipitants. This research broke new ground with medical as well as psychiatric assaults, general rather than psychiatric ERs, and assaults on non-clinical, support staff victims. A discussion of these issues and detailed methodological inquiry are presented.
Raymond B. Flannery, Jr., Ph.D.