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Psychiatric Quarterly, Vol. 76, No. 2, Summer 2005 ( CDOI: 10.1007/s11089-005-2337-z
Although there have been several studies of the characteristics of psychiatric
patient assailants, there have been only six comprehensive, empirical assessments of precipitants to these assaults and no precipitant study has focused
solely on elderly psychiatric patient assailants. This one and one-half year,
retrospective study continued the inquiry into the nature of patient assault
precipitants and focused only on elderly assailants. Older, male patients with
a diagnosis of schizophrenia and histories of violence toward others and substance use disorder physically assaulted primarily male, mental health workers. These staff victims experienced disruptions in the domains of mastery,
attachment, and meaning as well as the symptomatology associated with psychological trauma. The most common precipitants to these assaults were denial
of services and acute psychosis. The findings and implications for health careRaymond B. Flannery, Jr., Ph.D., is Senior Psychologist, Worcester State Hospital,
Massachusetts Department of Mental Health, and Associate Clinical Professor of
Psychology, Harvard Medical School, at The Cambridge Health Alliance, Cambridge, MA.Brenda Peterson, M.H.W. IV, is Training Coordinator, Westborough State Hospital,
Massachusetts Department of Mental Health, and ASAP Team Co-Leader at her facility,
Westborough, MA.Andrew P. Walker, B.A., is Information Technology Specialist, Massachusetts Department of Mental Health, Boston, MA.Address correspondence to Raymond B. Flannery, Jr., Ph.D., Department of Psychology/6B, Worcester State Hospital, 305 Belmont Street, Worcester, MA 01604.
1670033-2720/05/0600-0167/0 C 2005 Springer Science+Business Media, Inc. 2005)PRECIPITANTS OF ELDERLY PSYCHIATRICPATIENT ASSAULTS ON STAFF:
PRELIMINARY EMPIRICAL INQUIRYRaymond B. Flannery, Jr., Ph.D., Brenda
Peterson, M.H.W. IV, and Andrew P. Walker, B.A.168 PSYCHIATRIC QUARTERLYproviders in long-term care settings where elderly psychiatric patients reside
are discussed.KEY WORDS: assault precipitants; Assaulted Staff Action Program (ASAP); elderly
psychiatric patient assailants; long-term care settings.Elderly psychiatric patient assaults on health care staff in a variety of
long-term care settings where these elderly psychiatric patients reside
present an important and ongoing risk for unit safety, staff victim medical injury, and staff victim psychological distress (13). This risk is also
a seriously neglected area of scientific inquiry (4).There have been several reviews of the characteristics of psychiatric
patient assailants (511). These studies have noted two types of patients at high risk for assaulting staff. The first type is that of the older
male patient with a diagnosis...