Systemic perspective of violence and aggression in mental health care: towards a more comprehensive understanding and conceptualization: part 2

Int J Ment Health Nurs. 2013 Dec;22(6):568-78. doi: 10.1111/inm.12028. Epub 2013 Jun 11.


This is the second of a two part paper which seeks to explore a wide range of phenomena that have been found to have an association with aggression and violence (A/V) in inpatient mental health care, synthesize these propositions according to fit or congruence into a systemic model of A/V, explore the empirical evidence pertaining to these propositions, and begin to consider application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The systemic model is comprised of four thematic categories with part two of the paper focusing on the final two categories: mental health-care system-related phenomena and clinician-related phenomena. The paper then discusses a number of implications arising out of embracing a more systemic model of A/V in mental health care. In broadening our understanding to include all the phenomena that contribute increased risk of A/V incidents, we are able to move away from inaccurate views that disproportionately assign 'responsibility' to clients for causing A/V when the evidence indicates that the client-related phenomena may only account for a small portion of these incidents.

Keywords: aggression/violence; broader conceptualization; clinician phenomena; mental health-care system phenomena; systemic approach.

Publication types

  • Review

MeSH terms

  • Aggression / psychology*
  • Hospitals, Psychiatric
  • Mental Disorders / nursing*
  • Mental Disorders / psychology
  • Models, Nursing
  • Nurse-Patient Relations
  • Nursing Theory*
  • Psychiatric Nursing*
  • Risk Assessment
  • Risk Management
  • Social Environment
  • Social Responsibility
  • Systems Theory*
  • Violence / psychology*