{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:17:17Z","timestamp":1785374237687,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatric Ment Health Nurs"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Accessible Summary<\/jats:title><jats:sec><jats:title>What is known on the subject?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Service users who behave violently may suffer. This is because violence can lead to unnecessary medication, seclusion on the ward and strained relationships with other people. It can also affect a service user's self\u2010esteem and lead to feelings of shame.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Service users who behave violently can also make life frightening and unpredictable for members of staff, and other service users on the ward.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>It is important to gain a sound understanding of violence in order to help reduce it.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>What the paper adds to existing knowledge?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Previous research has shown that having a past history of violence, being admitted to PICU and being admitted to hospital under section is associated with violent behaviour on the ward.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>We identified several new factors associated with violent behaviour, such as engaging in self\u2010harm, being the target of another person's violence and being referred to a Psychiatric Liaison Team.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for practice<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>For some service users, behaving violently may be a response to previous trauma and an expression of distress.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>It is therefore important that mental health nurses are supported by their employers to work with service users in a trauma\u2010informed manner.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Nurses employed across a range of psychiatric settings could benefit from direct interventions such as comprehensive trauma\u2010informed care training and psychological debrief spaces, or systemic interventions to address staff shortages and improve ward conditions.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><\/jats:sec><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Instances of violence in acute psychiatric settings are frequent, can be devastating for service users and staff, and are costly. Such settings would benefit from a greater understanding of violence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We analysed the association between current and historical variables and rates of inpatient violence. To address gaps in current research, we included instances of self\u2010harm and being the target of violence. We also included seldom used service metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data were extracted on admissions to acute adult wards and PICUs 2017\u20132020 within South London and Maudsley NHS Foundation Trust. A zero\u2010inflated negative binomial regression mixed model was used to analyse the impact of variables on rates of violence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Variables associated with an increased rate of violence were as follows: an increased number of violent incidents in the year before admission, being admitted on MHA section, being admitted to PICU, instances of self\u2010harm, being the target of violence and referral to a Psychiatric Liaison Team.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The novel associations found between enacting violence, self\u2010harm and being the target of violence indicate trauma\u2010informed care is crucial to reduce violent presentations of distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for practice<\/jats:title><jats:p>System level interventions are crucial to ensure mental health nurses are supported to provide trauma\u2010informed care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpm.12872","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T03:04:58Z","timestamp":1662606298000},"page":"451-460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations between violence, self\u2010harm and acute psychiatric service use: Implications for inpatient care"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3464-0367","authenticated-orcid":false,"given":"Lucy","family":"McIvor","sequence":"first","affiliation":[{"name":"South London and Maudsley NHS Mental Health Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Payne\u2010Gill","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Mental Health Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Beck","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Mental Health Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101819.2008.01790.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40865\u2010017\u20100068\u20103"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12129"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840802710829"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113643"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2019.104256"},{"key":"e_1_2_11_8_1","unstructured":"Care Quality Commission. 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