Mental Health and Behavioral Sciences Service Program Guide: Management of the Violent and Suicidal Patient

摘要

The program guide was prepared to assist VA professional, technical, and administrative staff in hospitals, clinics, and domiciliaries where behavioral management problems involving emotional crises manifesting violent and aggressive behavior potentially exist. The program's objectives are to reduce incidents of aggressive and destructive behavior, to improve treatment techniques, to care for patients who are disturbed, to reduce inter-hospital transfers for aggressive and violent patients, and to eliminate transfer to institutions outside the VA system for patients who are violent and assaultive. The guidelines provide suggestions for quality care for these high-risk patients while providing optimal protection for employees of the VA. Directions are provided so that skills may be developed to enable staff in hospitals and clinics to handle disturbed patients within the following parameters: (a) The anticipation and clinical assessment of risk; (b) The development of interpersonal intervention processes, physical restraint techniques, proper use of seclusion rooms, and use of psychotropic medications for calming disturbed patients; and (c) Staff awareness as to the problem of violence and the use of the total milieu in recognizing and coping with violence in patients.