Patient assaults on staff in mental health units – statement

16 Jan, 2019

STATEMENT

The Mental Health Foundation is aware of increasing public concern about assaults on staff in mental health units.

No one should ever be assaulted at work – we hope that goes without saying. We share concerns for nurse and staff safety and want to see urgent action to address it.

Some of the stories we’ve read in the media have been deeply concerning. Violent incidents in hospitals have led to nurses and staff being seriously injured. This is not acceptable – our health system needs to provide safe working environments so those who work in our hospitals feel safe and able to do their jobs well, and those receiving treatment can get the support they need to recover.

However, it is disappointing that some media discussions of these incidents have reinforced tired old stereotypes about people who live with mental distress being unstable, unpredictable and unsafe, instead of looking at why violence is occurring in mental health units and what we can do to prevent it.

Research is clear that people who live with mental illness are more likely to be the victims of violence than its perpetrators. They are not inherently dangerous or violent because they are going through significant mental distress, and not all mental health services experience significant levels of violence. Many of the violent incidents reported within hospitals over the last year have occurred outside of mental health units, and have not involved people receiving mental health treatment.

It is incorrect to think that violence is an inevitable part of providing mental health services, or that people in mental health units are typically malicious and aggressive. Those who are in mental health units are some of New Zealand’s most vulnerable people. Many have been through significant trauma. They are often experiencing some of the most challenging times in their lives, and may be feeling scared and alone. Instead of finding respite and a place to recover, they are often placed in environments that can’t keep them safe, and, in many cases, that increase their trauma.

Last year’s Government Inquiry into Mental Health and Addiction confirmed what we already knew: our mental health system is under huge pressure. It’s under-staffed, under-resourced and most units are over-crowded. This creates safety risks for staff and patients alike.

The overuse of compulsory treatment in our mental health services creates an environment where distrust and anger are heightened, and the continued use of untherapeutic practices like restraint and seclusion create further risk and trauma.

We have seen no mention of this in any of the media coverage or public discussion of these incidents. The views and interests of people who live with mental distress have not been well represented – as far as we can tell no one is asking patients why these incidents are happening or how they could be prevented. 

We would like to see more discussion of why people in mental health units are becoming so distressed that they are acting aggressively and hurting staff, rather than an unchallenged acceptance of the outdated and cruel stereotype that people who live with mental illness are dangerous and violent.

We urgently need a mental health system that is caring, empathetic and safe for all. Those who use our mental health services should feel safe and able to recover, and their experiences should inform how we design support systems so they work well for the people who use and work in them.

One in five New Zealanders will experience mental distress or illness this year. Up to 80 percent of us will experience some form of mental distress in our lifetimes. When we’re going through hard times, we all deserve support, compassion, empathy and respect.

We hope you will join us in changing the conversation about mental illness and distress to ensure it is fair, humane and focused on creating an Aotearoa where we are all safe, supported and included.

We invite you to look at our new media guidelines created as part of our Like Minds, Like Mine programme. The guidelines are designed to help the media report on mental health issues, and people with mental distress in a fair, accurate and balanced manner.

Ngā mihi,

Shaun Robinson
Chief Executive
Mental Health Foundation of New Zealand

 

Further reading:

In New Zealand, both stats and stories tell us that patients are not always safe in services.

https://www.hdc.org.nz/media/4688/mental-health-commissioners-monitoring-and-advocacy-report-2018.pdf

Our overuse of compulsory treatment, and restrictive practices like seclusion and restraint, are symptoms of a system that is not well designed to give people choices and support towards recovery.

https://www.hrc.co.nz/files/1815/4102/3498/Mental_health.pdf

The Mental Health and Addictions Inquiry has highlighted the need for action, both in the short term and over the next decade, to build a system that meets people’s needs for support when they are going through distress. This includes making sure that services are designed to support recovery, ending the use of restrictive practices like seclusion and restraint, and reforming our mental health law to make sure services are provided with free and informed consent.

https://mentalhealth.inquiry.govt.nz/inquiry-report/

A study in one DHB found that:

  • Most hospital staff experienced violence or aggression from patients. This was worst for nurses but happened to most staff. No gender differences were found.
  • More than one-third of staff were physically assaulted in the previous year, resulting in physical injury for just under one-third of those. This is higher than our national rates of domestic violence.
  • 93 percent of healthcare workers had experienced verbal anger.
  • There were few effects of working in mental health compared to other areas of the hospital.

https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no.-1394/6125