[NRSKarenRN]

Found @ ANA Smart Briefs:

Link between mental illness, violence unclear
Article title: Can Psychiatric Nurses Predict Violent Acts?

Media representations of mentally ill people who commit acts of violence, such as the Virginia Tech shooter, lead some to question how warning signs could have been missed. However, psychiatric nurses and mental health experts say it is difficult to predict violent acts among mentally ill patients, who are usually more likely to commit suicide or become victims of violence than they are to strike out against others. Nurse.com (Gannett Healthcare Group)

[HM2Viking]

Violemce predicition is a "crystal ball." I have worked with aggressively mentally ill patients for over 20 years. It is extremely difficult to recognize the triggers for violence.

[CHATSDALE]

it all depends on the patient
we had one woman who when she was losing it would smear make up over her face like a two y/o she would attack the female cnas but she was not that way with the nurses [either sex] or the orlderies

others would be talking away, then suddenly flipped out and would starrt a fight with someone who they swore were going to kill them

[Mariah1952]

Mental illness and prediction of future violence can only take into account previous behavior as an indicator. It seems simple, but its the best indicator of future behavior.

[oramar]

IF you ask me the real problem is lack of access to mental health facilities. There are so many people that need help that are not getting it because of lack of resources. I would say for everyone getting help there are 5 or 10 not getting help at all. That is just my opinion from 60 years of living in this world.

[oneLoneNurse]

in a word: "no".

I have worked in psych since 84. One of my ex GF's ended up in ICU via a forensic unit at AHE. The province denied benefits, she took them to court and won.

Its very hard to predict. Initially, I thought the question pertained to violence on the unit. We always ask for a verbal contract for safety with the patient and hope that works.

[kclarke4]

Can you predict violence? No. As a psychiatric nurse for over 32 years there is no magic assessment that allows one to predict the potential for violence.
Past behaviors may be indicative of future acts but not necessarily true for all. In other words, just because a patient was violent in the past it does not mean they will be violent in the future. They could be.

In a controlled environment, an inpatient unit, most of the time the potential for violent behaviors can be predicted. How? A change in their behaviors while on the unit can be an indication. Doesn't mean all will become violent.

Having a team with a keen sense of observation can prevent violence through early intervention. Thus, is the philosophy of the unit I direct. By observation and early intervention violence on the unit has been reduced. There were only 2 episodes of the need for restraints in the past 3 years because of observation and early intervention.

In the real world, no way can this be predicted, in my opinion. We do not go around assessing people because of the "potential" for violence. The human mind is very complex and not easy to understand.

[Mariah1952]

So right. Mental illness is not given the same attention/tretament as other physical illnesses, even though they are all biological. Its a shame

[Sharon411]

Of course disparities exist between mental health and the preceeption of "real" medical conditions. This is very sad indeed. Hopefully I will make a contribuition to nurses who recognize s/s of anxiety which often serves as a precursor to violence.


Sharon