Abstract
The prevention and management of violence around individuals with mental health-care problems is of paramount importance for the well-being of both service users and health-care staff. However, previous guidelines have focused on violence in either inpatient or community settings, and there have not been recent policies on this difficult topic. This book was written by a multidisciplinary team of expert psychiatrists, nurses, psychologists and pharmacologists and provides specific advice and policy recommendations for the prevention and management of violence in a wide variety of mental health-care settings and patient populations. As such, it is highly relevant for all members of the multidisciplinary team as well as managers involved in the organisation of mental health-care services. This book amalgamates relevant aspects of previous official guidelines with a critical appraisal of the latest evidence base and represents official policy recommended by the Royal College of Psychiatrists.
Khwaja and Beer have divided this book into 13 chapters. Chapter 1 details region-specific UK legislation relevant to the management of violence by persons with mental disorders. Mentally ill persons are 10 times more likely to be victims than perpetrators of violence, and Chapter 2 contains recommendations for safeguarding mentally ill individuals. Chapter 3 covers the assessment of risk of violence in mental health-care settings, while Chapter 4 proceeds to methods of reducing such risk and non-pharmacological methods for managing acute episodes. The importance of a strong therapeutic relationship and non-coercive methods is stressed, such as de-escalation, time-out, observation and break-away training. The use of medication in the short-, medium- and long-term management of violence is covered in Chapter 5, including above maximum-recommended doses, appropriate routes of administration, managing adverse drug reactions and medication in specific populations such as the young, elderly or pregnant. Since not all violent behaviour can be prevented, specific procedures for the post-incident management of both victims and perpetrators are contained in Chapter 6. Chapter 7 concerns violence in the community and outpatient settings, including risk management, lone working and mental health act assessments. Chapters 8–10 focus on violence in the elderly, those with intellectual disabilities and the prison population respectively, while Chapter 11 provides guidance on liaising with the police and information sharing via Multi-Agency Public Protection Arrangements (MAPPA). This book concludes with advice on information sharing with victims of crime committed by persons with mental disorders and aspects of clinical governance relating to violence in the mentally ill.
Overall, this text is easy to read and has a clear and consistent layout. It comprehensively addresses the prevention and management of violence in all potential clinical settings and patient populations and provides both specific, practical advice for mental health-care professionals and suggested strategies by which service providers can meet their obligations. Relevant legislation and the evidence base for recommendations made are referenced and included at the end of each chapter along with appropriate further reading, making it simple to find further information on this important topic. This book is ideal for all mental health-care professionals and managers involved in the care of mentally ill individuals.