Patient assaults on psychiatric health staff on the rise

The number of attacks by patients on staff in psychiatric facilities across Ireland has risen significantly in recent years, according to data released by the HSE.

There were 1,478 physical assaults by patients on staff in mental health units last year according to the National Incident Management System (NIMS) which was introduced in 2015 by the State Claims Agency. In 2016, there were 965 recorded attacks by patients in psychiatric facilities between August and December, marking a significant rise in attacks over the past two years.

Statistics on assaults in psychiatric units for the first seven months of 2016 were not available as HSE staff were unable to specify the details of assaults under the previous recording system.

There were a total of 3,610 attacks by patients on staff across all HSE locations in 2017, down slightly from the 4,769 attacks reported in 2016.

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It is understood the majority of assaults recorded by NIMS were minor in nature and only a small number resulted in serious injuries. However, nurses working in psychiatric facilities have raised concerns that serious assaults by patients on staff is a growing problem.

A spokesman for the Psychiatric Nurses Association (PNA) of Ireland said he was "extremely concerned" by the 65 per cent rise in assaults between 2016 and 2017. "It is the responsibility of the HSE under Health and Safety legislation to provide a safe place of work, supported by adequate resources, for psychiatric nurses to carry out their duties. Without knowing the details of the location of these assaults, the PNA believes they relate directly to the issues of staff shortages and the lack of development of alternative services as set in the Vision for Change policy."

Injured in fire

A senior staff nurse working in a mental health facility in Mullingar, Co Westmeath, who was injured in a fire caused by a patient in August 2017, told The Irish Times he is still suffering from post traumatic stress. The male nurse, who prefers not to reveal his identity, has worked in numerous psychiatric facilities in the UK and Ireland and said he was accustomed to dealing with attacks by patients.

However, he has been unable to return to work due to the long-term effects of last August’s attack.

“I can hardly sleep and have nightmares. I get very irritable and I’ve never been irritable in my life. I can’t seem to function properly and I get flashbacks. I can still smell the smoke and feel what it was like when she sprayed the aerosol in my face.”

The nurse says he was given sick leave rather than being placed on the Revised Serious Physical Assault Scheme meaning that he is no longer receiving a salary. He is currently appealing this decision by his hospital manager.

Tony Fitzpatrick, director of industrial relations for the Irish Nurses and Midwives Organisation, attributed the high number of attacks across all hospitals to overcrowding, staffing shortages and a lack of security personnel.

‘Extremely difficult’

“If we have overcrowded emergency departments and people waiting on trolleys in excessive numbers it’s extremely difficult for nurses to provide quality care and as result people can act out. There’s little doubt that this is extremely traumatic for nurses who are assaulted and end up with physical and psychological injuries. The HSE is not doing enough for them.”

Commenting on the rise in attacks in mental health divisions, a HSE spokeswoman said she would expect an increase in recorded incidents as NIMS becomes more embedded in the complaints system. “The HSE Mental Health Service view the safety of our staff as a very serious issue.”

She said the HSE was working to improve safety in “all mental healthy settings”. “This work includes the provision of training on management of violence and aggression and improving the physical environments in which staff work from a safety perspective.”