Aggression and violence may be a manifestation of underlying psychiatric disorders. These include drug psychosis, delusional states, mania and personality disorder. Some patients try to use aggression as means of achieving a particular goal, such as being seen earlier or obtaining drugs.Medical illness may result in behaviour disturbance. It can also coexist in patients with mental health, drug and alcohol problems or other conditions. Successful treatment of aggressive behavior depends on promptly addressing it, preventing violence by timely intervention, and proceeding with differential diagnosis and definitive medical or psychiatric treatment. Whenever a frightened, threatened, or hostile patient is identified, the staff should address this mood and begin measures to prevent a violent outcome, keeping safety uppermost in mind.
Some simple preparatory steps may be helpful in averting trouble or in dealing with difficult situations as they arise. A sign should make clear that aggression and violence are not tolerated. The practice or emergency department should have a functioning duress system and protocols for responding. Ideally the assessment area should have no dangerous objects easily at hand and should have more than one exit. Some medical practices and hospitals have systems to alert staff that a presenting patient may be difficult to manage, or pre-agreed management plans for particular patients. A number of studies have found benefits from education and training programs to help healthcare workers develop skills and increase confidence in managing these situations. Staff should be advised that their personal safety is a priority. They should not see patients for a late appointment when they are alone
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