A Prospective Study of Assault Against Staff by Youths in a State Psychiatric Hospital

OBJECTIVE: This study examined the frequency and nature of violence directed at staff in a state inpatient psychiatric hospital for children and adolescents. METHODS: A total of 215 assaults that occurred over a two-month period were examined by using information obtained from staff at the time of the assault and from the hospital database. Assaults were analyzed for situational characteristics of the incidents as well as the characteristics that best differentiated between assaultive and nonassaultive patients. RESULTS: Thirty-three percent of all hospitalized patients were involved in an assaultive incident. A majority of the patients who assaulted staff were neither involved in the juvenile justice system nor psychotic. Although youths who were involved in repeat assaults were more likely to be male, gender did not differentiate between those who were assaultive toward staff and those who were not. Some type of verbal direction or redirection (typically minor) on the part of the staff preceded a majority (68 percent) of the assaults. CONCLUSION: Preconceived notions about why youths assault staff at psychiatric hospitals do not appear to be validated by these data, which suggest a more complex picture.