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Physios hold the key to tackling boredom-related violence

Physios specialising in mental healthcare say they can play a crucial role in reducing violence within psychiatric units and facilities for people with learning disabilities.

Their comments follow an audit of violence in the two environments commissioned by the Healthcare Commission (HCC) and carried out by the Royal College of Psychiatrists. It reveals that violent and threatening behaviour has reached unacceptable levels. One of the problems identified through the national study is high levels of boredom among service users. This can lead to people who are already experiencing mental health problems becoming violent, said Caroline Griffiths, chair of Chartered Physiotherapists in Mental Healthcare.

'In an inpatient environment physios and occupational therapists can really make a difference and stave off boredom in the wards. Higher levels of boredom lead to higher levels of violence. As physios we can provide structured activities. These could involve things such as encouraging service users to use the gym and join walking and exercise groups,' said Ms Griffiths. 'Reducing stress can reduce the violence on wards,' she added.

'This is also not just about patients but staff. By offering things like massage, acupuncture and relaxation advice physios can help address the problem of stress and violence at work.' Catherine Pope is a manager for older people's mental health services at Nottinghamshire Healthcare trust. She says it is important to address the problem of violence in a mental healthcare environment without stigmatising service users.

With the growing emphasis on care in the community, inpatient facilities are sometimes understaffed, she adds. This can exacerbate the problem if there are patients with a tendency to be violent. Ms Pope says physios in a vulnerable situation need to be supported and made aware that they need not work with patients they are uncomfortable with.

The HCC audit found that one in three inpatient service users have experienced violent or threatening behaviour while in care. This ranges from raised voices and verbal aggression to the 'much rarer use of a weapon to threaten or attack'. The figure sits at 41 per cent for clinical staff working in mental health and learning disability inpatient facilities and nearly 80 per cent of nursing staff.

Apart from boredom among patients and staff shortages the report also identifies substance misuse, poor security and a lack of focus on preventing violent incidents as contributory factors to the problem.

The CSP strongly advocates risk assessment to help reduce the number of attacks on staff. Briefing packs on violence at work, lone working and risk assessment are available at:


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15 June 2005

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