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NICE guidance on dealing with violent mental health patients updated

29 May 2015

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NICE has updated its guidelines on the management of violent and aggressive behaviour in people with mental health problems in NHS primary care.

Between 2013 and 2014 there were 68,683 reported assaults on NHS staff in England, 69% of these occurred in mental health or learning disability settings.

This number includes incidents involving the families or carers of service users as well as service users themselves.

Professor Peter Tyrer, professor of community psychiatry, Centre for Mental Health, Imperial College London and chair of the group that developed the NICE guideline, said:“What became abundantly clear during the discussions of the guideline development group was that violence prevented is NHS money saved.”

“We have many programmes in the country that concentrate on dealing with actual violence but not enough on preventing and de-escalating violence when it is beginning to emerge. Greater understanding of the suffering that leads to violence is an essential part of management,” he said.

The guideline focuses on how to assess risk and prevent violence, how to recognise warning signs, calm potentially violent patients and manage difficult situations (de-escalation), as well as how to intervene safely when violence happens.

Dr Peter Staves, service user, information and healthcare scientist, Public Health England, and member of the group that developed the guideline, said:“Patient recovery rate and service user experience and wellbeing are directly affected by the management of challenging behaviour.

“This updated guidance has many suggestions on how to engage with the patient, even when the use of restraint or rapid tranquilisation is required, that if adopted with global aims of compassion, caring and positive enthusiasm can make mental health services more tolerant environments in which to be a patient, carer or NHS employee,” he said.

View the updated guidance here