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This paper briefly reviews systemic factors contributing to aggression and violence before focussing on techniques first to identify high\u2010risk patients and then sufficiently defuse their behaviour to enable a clinical assessment to be undertaken. General guidance is offered to enable compliance with relevant guardianship and mental health acts. Emphasis is placed on the importance of post\u2010incident debriefing and, where necessary, counselling and for there to be systems in place to ensure supportive and efficient reporting. Training in the management of such patients should be included in both junior medical officer and specialty training programmes.<\/jats:p>","DOI":"10.1111\/imj.70622","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T01:40:03Z","timestamp":1787535603000},"page":"1695-1698","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dealing with aggressive patients"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-7205","authenticated-orcid":false,"given":"Bruce","family":"Boman","sequence":"first","affiliation":[{"name":"Department of Psychiatry Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Framework Guidelines for Addressing Workplace Violence in the Health Sector","author":"International Labour Office","year":"2007"},{"key":"e_1_2_6_3_1","unstructured":"Newstalk ZB.New data reveals there were over 7 000 reports of assaults against Health NZ staff. Available from URL:https:\/\/www.newstalkzb.co.nz\/news\/national\/new-data-reveals-there-were-over-7-000-reports-of-assault-against-health-nz-staff\/."},{"key":"e_1_2_6_4_1","unstructured":"Australian Medical Association.Position statement. Managing and responding to violence in the medical setting. Available from URL:AMA_position_statement_on_managing_and_responding_to_violence_in_the_medical_workplace.pdf."},{"key":"e_1_2_6_5_1","unstructured":"Australasian College for Emergency Medicine.Breaking Point. An urgent call to act on emergency department safety. Available from URL:https:\/\/acem.org.au\/Content-Sources\/Advancing-Emergency-Medicine\/Better-Outcomes-for-Patients\/Breaking-Point-An-Urgent-Call-to-Action-on-Emerge."},{"key":"e_1_2_6_6_1","unstructured":"RACGP.Managing patient aggression and violence. Available from URL:https:\/\/www.racgp.org.au\/running-a-practice\/practice-resources\/general-practice-guides\/preventing-and-managing-patient-aggression."},{"key":"e_1_2_6_7_1","unstructured":"Workplace and work\u2010related violence and aggression. Safe Work Australia Data Report. Safe Work Australia. August 2024.https:\/\/data.safeworkaustralia.gov.au\/sites\/default\/files\/2024-08\/Work-related-violence-and-aggressionReportAugust2024.pdf"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.10444"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-105849"},{"key":"e_1_2_6_10_1","unstructured":"NSW Health Guideline GL 2015_007.Management of patients with acute severe behavioural disturbance in emergency departments. Available from URL:https:\/\/www1.health.nsw.gov.au\/pds\/ActivePDSDocuments\/GL2015_007.pdf."},{"key":"e_1_2_6_11_1","unstructured":"Queensland Health.Management of patients with acute severe behavioural disturbance in ED. Queensland Health Guideline. QH\u2010GDL\u2010438. Available from URL:Management of patients with Acute Severe Behavioural Disturbance in ED."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102641"},{"key":"e_1_2_6_13_1","unstructured":"Australasian College for Emergency Medicine.FACEM Training program 2022. Medical expertise. Clinical management in emergency medicine. 3.7 Acute psychiatric and addiction related presentations. Available from URL:https:\/\/acem.org.au\/getmedia\/9af41df8-677f-44ed-b245-440164155f56\/FACEM-Curriculum."},{"key":"e_1_2_6_14_1","unstructured":"RANZCPTraining accreditation standard 3.6.1. 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