Upsurge of abuse on mental health workers at Waikato DHB

There were 162 assaults on mental health staff at the Waikato District Health Board last year.

There were 162 assaults on mental health staff at the Waikato District Health Board last year.


Violence against mental health workers by patients and their families is on the rise and nursing staff bear the brunt of it.

There were 162 physical assaults on staff working for the Waikato District Health Board's mental health and addictions service last year, compared with 140 in 2014.

An Official Information Act request revealed 95 per cent of those assaults were on nurses and psychiatric assistants.

The nurses union blame "chronic staff shortages" for putting staff at risk.

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But the DHB director of mental health and addictions Derek Wright disagrees, saying it's the skill mix that requires evaluation.

"That's always the question, do you need more staff? To be honest, if we put more staff in, you wouldn't put them into an inpatient facility," Wright said.

"And the reason for that is when you have a ward that has 16 patients on it and seven to eight staff, once you start putting more staff on, you create an environment that becomes even busier. And the busier it becomes, the more volatile it is.

"I think our staff mix is about right. What we're looking at is our skill mix.

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"We deal with a lot of Māori clients, for instance, so it's about asking whether we have the right mix between Māori and non-Māori because often, someone can de-escalate a situation because of a cultural connection that maybe [a non-Māori] could not.

Wright blames a more violent and aggressive society.

He also said reporting has changed over the past few years and every physical assault, whether the person is injured or not, is recorded.

"If you look at the police staff, say between last year and this year, assaults increased by 25 per cent in the Waikato region," Wright said.

"And just a few years ago, it was rare to see an assault on someone in the emergency department, but now it's common. All the drunks come in, people are high on whatever and assault people, and I think we've seen exactly the same thing happen here.

"With mental health issues, you've always had that kind of tendency - that someone might lash out. But what we have seen, especially over the last 10 years, is more aggression from some visitors, too, which reflects what's going on in the community."

New Zealand Nurses Organisation adviser Suzanne Rolls said nursing can be a risky occupation, as are other professions with public contact.

"Assault rates are too high and that is not accepted by nurses. DHBs have a zero tolerance for violence, but chronic staff shortages are routinely experienced in mental health and add to the risk of violence," Rolls said.

"Where DHBs have seen a reduction in assaults on staff, a multipronged strategy has been used. This includes looking at cultural and gender mix, regular monitoring of staff levels, special attention to the environment, and consultation with consumers."

Rolls said an article published in The New Zealand Medical Journal estimated that nurses experience the highest rates of violence of all health professionals.

"There should be ongoing national monitoring of violence in mental health units and research on how it can be addressed and mitigated," she said.

"Reports of violence should be audited regularly ... reporting needs to be easy, with support and action provided in a timely way. If these things don't follow, nurses will feel at risk."

Wright said staff get de-escalation training and there is work going on nationally to create a new restraint process.

Assaults on Waikato DHB staff working in mental health services

2012 - 136 assaults
2013 - 145 assaults
2014 - 140 assaults
2015 - 162 assaults
2016 (Jan - May) - 58 assaults

* Assaults recorded include forensic, mental health services for older persons and adult mental health and addictions services. It does not include community services.

Assaults by staff type*

Nursing (nurses and psychiatric assistants):

2012 (128)
2013 (137)
2014 (134)
2015 (154)

Allied (includes social workers and occupational therapists):

2012 (7)
2013 (6)
2014 (3)
2015 (5)

Medical (doctors):

2012-2015 no assaults

Non-clinical (includes orderlies):

2012 (1)
2013 (2)
2014 (0)
2015 (1)

* Some staff types were unable to be identified from the data available

 - Stuff

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