Recorded incidents in a high-secure hospital: A descriptive analysis

Background Incidents of violence, self-harm and security are of concern in psychiatric hospitals with regard to both patient and staff welfare.

Aim The purpose of this study was to examine the frequency and nature of incidents in all directorates in a high-security psychiatric hospital.

Methods Data were collected from the hospital's incident recording forms for the period 1 June 2007 to 30 September 2008.

Results In total, 5658 incidents were recorded, almost all patients (95%) having been involved in at least one incident. Most incidents, however, were in the categories of less serious violence and self-harm. The rate was 0.89 incidents per patient per month. The women's directorate had a significantly higher frequency of violent or self-harm incidents than the other directorates (male mental health, learning disability, personality disorder or dangerous and severe personality disorder). Violence was almost equally against fellow patients or staff. It was commonest in communal areas during day-time hours. Self-harm was most likely in a patient's own room.

Conclusions and implications for practice These findings can inform prevention and management of violence and self-harm. Dealing with such a large number of incidents is time consuming, even if they are not especially serious. Attention to environmental, as well as individual, issues is recommended.