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Occupational stress with mental health clients in acute response (OSCAR)

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Violence tracked in mental health care settings

Violence in the form of physical and verbal attacks is an ongoing problem in the hospital and community based mental health workforce. Partners in the European project OSCAR have devised means whereby these incidents can be recorded and therefore subject to analysis.


Care of the mentally ill client is a demanding and sometimes stressful occupation where the dedication and commitment of the staff are frequently tested. This can then cause illness, absenteeism and ultimate burnout with consequent premature retirement. The OSCAR project aimed to evaluate occupational stress and develop relevant training packages to help staff deal with problems encountered. Partners in the Mental health and Social Work Academic group at Middlesex University researched into one of the main reasons for work burnout in this profession - violent and aggressive behaviour. The team based their study on the definition of violence coined by the International Violence and Aggression Form (IVAF). 'Any incident where staff are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, well being or health'. Forms were used to collate comprehensive information on all types of violence inflicted in the workplace. Violence can take the form of physical threats and verbal abuse including sexual and racial harassment. The witnessing of an act of physical aggression, the destruction of property or violence between patients was also reported. There were three types of forms according to the nature of the incident - verbal, physical and a third to record the consequences of violence. To ensure accuracy of reporting and security, the forms were completed within the same day of the act and secured prior to weekly collection. In total, almost 300 forms regarding the outcomes of some 400 violent incidents were collected. The reduction of stress within the European health care workforce is obviously of prime importance. A training programme was devised on methods to prevent aggression, a supplement for previous training on how to deal with it. Studies of this nature will no doubt continue to form the basis for the reduction of stress and improvement of working conditions for staff in the mental health services.

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