There has been a reported increase in aggression in health-care and there are growing concerns about its management. Aggression and violence among in patients constitute a significant workplace hazard for both mental health nurses and even the mental health patients. The mental health nurses have to take a lot of things into account when handling mental health patients that are potentially aggressive. There is a link between aggression and mental health; and this is justification as to why an aggression management program would benefit not only the mental health nurses, but the patients as well. By being aggressive, mental heal patients also pose a risk to themselves in terms of possible injury due to violent behavior and aggression can exacerbate mental health problems. Research shows that 25% of mental health nurses in the public sector experience violent and/ or aggressive behavior from mentally ill patients, resulting in serious personal injury to the nurses each year. This is a very high prevalence which is almost three times the prevalence in other vocational groups. Aggression and agitation are acute behavioral emergencies that require immediate attention; if undertaken using methods other than coercion, there is a chance of better outcomes, such as through verbal engagement. Violent and aggressive incidents can cause injury to staff, resulting in absent days and hampering the efficiency and effectiveness of mental care outcomes, hence it is imperative that Aggression Minimization Programs are practiced.
To determine the best approaches that can reduce incidences of aggression by mental health patients through a functional aggressive management program
To implement a holistic mental health care program that improves mental health patients outcomes
To reduce the physical and psychological risks for mental health care nurses from aggression by mental health patients
To reduce aggressive behavior by mental health patients as a way of ensuring safety and health for the entire community, including the mental patients
The hospital I work in has, as one of its main objectives, a desire to provide the best, holistic clinical care to all the patients, including mental health patients. The psychological well being of mental health patients is shaped by a myriad of interrelated factors and systems, including medical, social, psychological, psychiatric, lifestyle, behavioral, and spiritual (Meglathery, 2017). While doctors refer patients with mental conditions for psychological care, not many patients benefit from a holistic cognitive behavioral therapy. Violence from aggression is in itself a serious condition with equally serious implications for society and psychiatric care. It indirectly and directly impacts the quality of life of the community as a while, including family, the patients themselves, and mental health-care workers (Rueve& Welton, 2008). The spectre of aggression and violence in psychiatric practice requires the stratification and management of risk as part of the holistic patient assessment and treatment. Risk factors as well as symptoms of aggressive behavior and tendency towards violence must be addressed by psychiatric care givers while working with both outpatient and inpatient persons ad treatment teams. When appropriately treated and cared for, mentally ill patients do not generally pose an increased risk of violence when compared to the general population. Immediate and ongoing treatment as well as support for mentally ill patients is the key to minimizing aggression and violence among these patients. The hospital where I work has faced a significant challenge in providing mental health patients better and holistic care due to aggression and aggressive behavior; ultimately resulting in less-than-desired outcomes for these patients. Given the negative impact that aggression has on society, implementing an AMP at the hospital would not only improve the mental health of the mentally ill patients, but it will provide multiple benefits to society as a whole, including for the care givers. This is because the most affected group are the mentally ill patients’ nurses and care givers; they experience violence, injury, and are at risk of aggressive behavior, which also has psychological effects on them. Aggressive behavior is not only exhibited as physical violence can cause physical harm, it is also exhibited as verbal aggression. The aggressive behavior from mental ill patients will also have adverse psychological impacts on nurses working with the mentally ill patients, which can be severe (Inoue et al., 2006). Aggression can have a significant toll on the victim by creating mental health problems for victims; it can also be manifested as physical effects too. Some of the mental effects include stress and a feeling of fear and apprehension while the physical effects are myriad and include heart palpitations, high blood pressure, heart attacks, overwhelming anxiety and panic attacks, fibromyalgia, sleep disruption, loss or memory and concentration, tension headaches and migraine, uncontrolled mood swings, and irritable bowel syndrome among others (Boulanger, 2013). Clearly, these are serious effects that apart from adding to the burden of the mentally ill, it will deprive the hospital the experienced and much needed mental health-care nursing personnel. The indirect effects at the hospital includes reduced or low productivity,high employee turnover, lost motivation; these are very costly side effects that are caused by aggression from mentally ill patients. It is therefore of absolute importance that an AMP is introduced at the hospital to help ensure mentally ill patients receive holistic care and achieve better outcomes as well as to protect the nurses handling these patients. This is also important from a management point of view as productivity, employee safety, and reduced physical and psychological risks to the nursing staff and other employees.
Boulanger, A., 2013. Physical Effects Of Workplace Aggression: The Toll Bullying Takes On Your Mind And Body. Medical Daily. Available at: https://www.medicaldaily.com/physical-effects-workplace-aggression-toll-bullying-takes-your-mind-and-body-247018 [Accessed April 9, 2017].
Inoue, Makoto, Tsukano, Ken, Muraoka, Mitsutaro, Kaneko, fumiko, Okamura, Hitoshi, (2006). Psychological impact of verbal abuse and violence by patients on nurses working in psychiatric departments. Psychological Impact of Verbal Abuse and Violence by Patients on Nurses Working in Psychiatric Departments. Blackwell. https://ir.lib.hiroshima-u.ac.jp/metadb/up/ZZT00003/PSN_60_29.pdf.
Rueve ME, & Welton RS. (2008). Violence and mental illness. Psychiatry (Edgmont (Pa. : Township)). 5, 34-48.
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