Patient aggression: a serious issue requiring a dedicated organisational response

Staff safety is improved by clear procedures for managing abuse and assault

Hopper and colleagues describe a scenario familiar to many hospital clinicians and managers: staff reports of verbal abuse and physical assaults from patients.1 This is often in an organisational context of scarce reliable data about the phenomenon, an ad-hoc management response and no specific training of staff to manage aggression. Aggression is not defined in the Hopper et al article but it is useful to remember that it is a broad term, inclusive of behaviour that is destructive to self, others and property.2 As with many other behaviours, a therapeutic framework can be applied to aggression. The origin of aggression in children and adolescents is often a developmental failure to regulate impulsivity and behaviour following prejudicial early-life experiences, including exposure to coercive parenting. Aggression is often a feature of a developmental or mental health disorder.3