One in three doctors in Great Britain has been a victim of physical or
verbal attack in the past year, but most do not report it, research by the
BMA indicates.
In the last six months alone, there have been two horrific cases of violence
towards doctors in the Glasgow area and, unfortunately, this new research
shows that these are not isolated incidents. In November, a GP was beaten up
by a patient in his consulting room and, in August, another GP was stabbed
by a patient in her practice.
Around 600 doctors from across Great Britain responded to a BMA survey on
their experiences of violence in the workplace in the past year. A third had
experienced some form of violence – including threats and verbal abuse – and
one in ten had been physically attacked, including being stabbed, kicked,
punched, bitten and spat at. Of these, one in three received minor injuries,
and one in 20 was seriously injured.
More than half (52 per cent) of doctors who suffered violence did not report
the incident. This suggests both a degree of under-reporting and increasing
acceptance of violence, the report states.
The most frequently stated reason for workplace violence was dissatisfaction
with the service, including frustration with waiting times and refusal to
prescribe medication. This has doubled as a cause of violence since 2003,
when the BMA last conducted the survey.
Dr Dean Marshall, a member of the BMA’s Scottish Council and Chair of the
Scottish General Practitioners Committee, said:
“It is incredibly disturbing that more than half of the violent incidents
against doctors are not being reported. Sadly, this means that official
statistics are only the tip of the iceberg and do not reflect the true
number of attacks against NHS workers in Scotland.
“The apparently increasing level of acceptance of such incidents by the
medical profession needs to be addressed; violence should not be an accepted
part of any health care professional’s working life.
“It is encouraging that the Scottish Government has brought forward
legislation to extend the Emergency Workers Act to include all doctors,
including those who work in the community. Once approved, this will mean
that there will be tougher penalties for those people committing these acts
of violence and make the offenders easier to prosecute. The extension of
this legislation sends out a powerful message that violence will not be
tolerated and will not go unpunished.
“While it will not eliminate this violence altogether, it adds an additional
layer of protection which is to be welcomed. However, more must also be done
to reduce the number of violent incidents against health workers who
dedicate their careers to looking after their patients. Training on managing
potentially violent situations should be available across the NHS and
patients should be made aware of their responsibilities and what is
acceptable behaviour. When incidents are reported they must be followed up
by the appropriate action and counselling.”
Dr Hamish Meldrum, Chairman of Council at the BMA, added:
“These are worrying figures - both in terms of the potential numbers
involved and the fact that so few doctors tend to report violence. We hope
that this is not because they feel the problem is not being taken seriously.
“Ministers have repeatedly stated that there should be zero tolerance to
violence of any sort in the NHS. We heartily agree. The mechanisms must be
there to minimise the likelihood of attacks, to support staff who experience
them, and to ensure that anyone who commits an act of violence is dealt with
appropriately. “
Other findings from the research include:
* Half of doctors say that violence in the workplace is a problem
* More than half had witnessed violence against other staff, such as
nurses and receptionists
* Female doctors are more likely to experience violence in the workplace
than males (37% compared to 27%)
* Junior doctors are the most likely to experience violence, followed by
GPs
* Almost two thirds of psychiatrists report that violence in their
workplace is a problem, compared with a fifth of surgeons
* Most doctors have not received any training in dealing with violent
patients
* Only one in ten doctors has access to a secure facility in which to
treat violent patients
June 2006
Abstract: The Prevalence and Correlates of DSM-IV Intermittent Explosive
Disorder in the National Comorbidity Survey Replication
By:
Ronald C. Kessler, PhD; Emil F. Coccaro, MD; Maurizio Fava, MD; Savina
Jaeger, PhD; Robert Jin, MS; Ellen Walters, MS
Little is known about the epidemiology of intermittent explosive
disorder (IED).
Objective:
To present nationally representative data on the prevalence and
correlates of DSM-IV IED.
Design:
The World Health Organization Composite International Diagnostic
Interview was used to assess DSM-IV anxiety disorders, mood disorders,
substance use disorders, and impulse control disorders.
Setting:
The National Comorbidity Survey Replication, a face-to-face household
survey carried out in 2001-2003.
Participants:
A nationally representative sample of 9282 people 18 years and older.
Main Outcome Measure:
Diagnoses of DSM-IV IED
Results:
Lifetime and 12-month prevalence estimates of DSM-IV IED were 7.3% and
3.9%, with a mean 43 lifetime attacks resulting in $1359 in property damage.
Intermittent explosive disorder–related injuries occurred 180 times per 100
lifetime cases. Mean age at onset was 14 years. Sociodemographic correlates
were uniformly weak. Intermittent explosive disorder was significantly
comorbid with most DSM-IV mood, anxiety, and substance disorders. Although
the majority of people with IED (60.3%) obtained professional treatment for
emotional or substance problems at some time in their life, only 28.8% ever
received treatment for their anger, while only 11.7% of 12-month cases
received treatment for their anger in the 12 months before interview.
Conclusions:
Intermittent explosive disorder is a much more common condition than
previously recognized. The early age at onset, significant associations with
comorbid mental disorders that have later ages at onset, and low proportion
of cases in treatment all make IED a promising target for early detection,
outreach, and treatment.
Author Affiliations:
Department of Health Care Policy, Harvard Medical School, Boston (Drs
Kessler and Jaeger, Mr Jin, and Ms Walters); the Clinical Neuroscience and
Psychopharmacology Research Unit, Department of Psychiatry, Pritzker School
of Medicine, University of Chicago, Chicago, Ill (Dr Coccaro); the
Depression Clinical and Research Program, Massachusetts General Hospital,
Boston (Dr Fava).
January 17, 2006
Forty-seven million Americans are victims of workplace aggression
Nearly half of American workers are victims of workplace aggression, with
customers, clients or patients the most likely source of attacks, according
to a new comprehensive national survey.
"The stereotypical belief that large numbers of employees are 'going postal'
is a bit of a myth," says Aaron Schat, assistant professor at the DeGroote
School of Business at McMaster University. "47 million Americans experience
psychological or physical aggression while on the job. Interestingly,
workers pinpoint the general public as the most significant source of this
aggression, as opposed to other co-workers or supervisors."
The findings are drawn from a comprehensive national survey of workers on
the prevalence of U.S. workplace aggression.
The survey found more than 40 per cent of American workers – about 47
million people – experience acts of psychological aggression, such as being
screamed at, insulted, or threatened with physical violence, while at work.
Acts of physical violence at work, such as being slapped, kicked or attacked
with a weapon, were less common, with about 6 per cent of workers – nearly 7
million people – reporting exposure. Almost all workers (96 per cent) who
experience physical violence also experience some form of psychological
abuse. Only a small percentage of workers (0.26 per cent which represents
about 300,000 workers) experience physical violence alone.
Nearly one-quarter of respondents indicate they were victims of aggression
from members of the public (customers, clients or patients), while 15 per
cent report being victims of aggression from other employees and 13 per cent
experienced aggression from supervisors or bosses.
Schat explains, "Exposure to aggressive behaviour at work is associated with
a wide range of negative consequences for individuals and organizations,
including negative work attitudes, reduced well-being, and, in cases of
physical violence, bodily injury or death. The fact that such a large
percentage of the American population has experienced workplace aggression
demonstrates the need to address it."
A report on the survey and its findings is included in Handbook of Workplace
Violence to be published in February 2006 by Sage. The report is co-authored
by Schat, Michael R. Frone of the State University of New York at Buffalo,
and E. Kevin Kelloway of Saint Mary's University in Halifax. Funding for
this study was provided by the National Institute on Alcohol Abuse and
Alcoholism.
###
McMaster University, a world-renowned, research-intensive university,
fosters a culture of innovation, and a commitment to discovery and learning
in teaching, research and scholarship. Based in Hamilton, the University,
one of only four Canadian universities to be listed on the Top 100
universities in the world, has a student population of more than 23,000, and
an alumni population of more than 115,000 in 128 countries.
For more information, please contact:
Television Editors – Live interviews with Aaron Schat can be arranged
using the DeGroote School of Business's broadcast studio. Call Julia Thomson
at 905-525-9140 ext. 27436 to schedule airtime and book a live feed from
campus.
Aaron Schat
Assistant Professor
DeGroote School of Business
McMaster University
905-525-9140 ext. 23946 schata@mcmaster.ca
Julia Thomson
Communications Officer
DeGroote School of Business
McMaster University
905-525-9140 ext. 27436 thomsoj@mcmaster.ca
