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Family violence is a significant social and public health problem. In 2015 a Royal Commission into Family Violence was established in Victoria, Australia, following a number of family violence deaths that received a high coverage in the media. The commission findings were released in 2016. These emphasised the significant physical and psychological harm that is caused by family violence, and that this has wide ranging community impacts. Among the Commission's 227 recommendations a number pertained specifically to improving the response of the healthcare system, with a whole-of-hospital model for responding to family violence recommend-ed for all public hospitals.

Royal Melbourne Hospital (RMH) received a state government grant as part of the SHRFV project. RMH was formally partnered with Tweddle Child and Family Health Service and Dental Health Services Victoria, and also worked with associated service NorthWestern Mental Health, as part of the project. This document outlines the RMH Family Violence Training Framework, a whole-of-hospital transformation change project designed to implement Recommendation 95 from the Royal Commission. All funded services were encouraged to adapt the SHRFV project model to suit the local environment of their health service. This document outlines the RMH approach. RMH specifically focused on using an evidence based research and evaluation framework with a focus on in-depth training, underpinned by a clinical champions network.

This paper aims to conceptualise the residential and psychiatric hospital as a space where criminality and social harms can emerge. Because of recent media scandals over the past 10 years concerning privately-owned hospitals, this study examines the lived experiences of service users/survivors, family members and practitioners to examine historic and contemporary encounters of distress and violence in hospital settings.

The study consists of 16 biographical accounts exploring issues of dehumanising and harmful practices, such as practices of restraint and rituals of coercive violence. A biographical methodology has been used to analyse the life stories of service users/survivors (n = 9), family members (n = 3) and professional health-care employees (n = 4). Service users/survivors in this study have experienced over 40 years of short-term and long-term periods of hospitalisation.

The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. Practitioners recalled comprehensive experiences of violence within historic mental hospitals, although violence that may be considered criminal appeared to disappear from hospitals after the Mental Health Act (1983). These reports of criminal violence and coercive abuse appeared to be replaced with dehumanising and harmful procedures, such as practices of restraint.

The data findings offer a unique interpretation, both historical and contemporary, of dehumanising psychiatric rituals experienced by service users/survivors, which are relevant to criminology and MAD studies. The study concludes by challenging oppressive psychiatric “harms” to promote social justice for service users/survivors currently being “treated” within the contemporary psychiatric system. The study intends to conceptualise residential and psychiatric hospitals as a space where criminality and social harms can emerge. The three aims of the study examined risk factors concerning criminality and social harms, oppressive and harmful practices within hospitals and evidence that violence occurs within these institutionalised settings. The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. These reports of violence include dehumanising attitudes, practices of restraint and coercive abuse.

Workplace violence against medical staff has become an endemic problem in the healthcare sector in Jordan. This study investigates the perceived main causes of workplace violence (medical staff, administrative, patients, patient's escorts and legislative) against physicians and nurses in public hospitals.

A self-administered questionnaire was used to collect data from a convenient random sample of 334 physicians and nurses employed in Jordanian public hospitals. Descriptive statistics and analysis of variance were used to answer questions and test hypotheses.

Findings indicated that the practice of the causes of workplace violence behaviors assessed by the participants is at a moderate level in Jordanian public hospitals with a mean value of 3.26. The causes of violence were reported as most causative to least causative: patient escort (M = 3.60), legislative (M = 3.56), patients (M = 3.40), administrative (M = 3.16) and medical staff related (M = 2.74), respectively. Analysis showed statistical differences in the participants' attitudes toward the causes of workplace violence behaviors due to their gender, job title, education level, experience and income.

This study has a significant practical contribution in providing information about the causes of workplace violence that will help health policymakers and hospital administrators to deter violence against medical staff. To reduce or eliminate the potential causes of violence, several actions can be taken, such as criminalizing violent behaviors, managing work pressure, staff shortages, developing comfortable and secure medical treatment settings, training the medical staff on aggression and stress management, and enhancing their communication skills with patients and their escorts. Findings also highlight the need for hospital management to develop protocols for reporting and dealing with workplace violence.

This is one of the first studies in the Arab context that examines the causes of workplace violence against medical staff.

The purpose of this paper is to examine the consequences of workplace violence against healthcare staff in Jordanian public hospitals.

A convenient sample included 334 physicians and nurses employed in eight different public hospitals, different departments and different working shifts were surveyed by filling the designed questionnaire.

The findings indicated workplace violence had a clear moderate impact on the respondents’ interaction with patients, performing work responsibilities, ability of making decisions, and professional career. The most frequent workplace violence consequences were damaging staff’s personality and prestige, increasing laziness and unwillingness to serve patients. Workplace violence consequences also included aggressive behavior, fear while dealing with patients, increase job insecurity, and lack of professional responsibility. In addition, demographic variables such as gender, education, job title, working shift, and income showed statistical significant differences in the attitudes of participants toward the consequences of workplace violence.

This study highlighted the necessity of healthcare policy makers and hospital administrators to establish violence free and safe working environments in order to retain qualified healthcare staff that in turn improves the health services quality.

There is a lack of research and documentation on violence in the healthcare settings in developing countries. This study is one of the first to examine the consequences of workplace violence that affect public physicians and nurses.

Inpatient violence can have a major impact in terms of traumatic experiences for victims and witnesses, an unsafe treatment climate, and high-financial costs. Therefore, the purpose of this paper is to gain more insight into patterns of violent behavior, so that adequate preventive measures can be taken.

Data on inpatient violence in a Dutch forensic psychiatric hospital between 2008 and 2014 were extracted from hospital files on 503 patients.

More than half of all the patients (n=276, 54.9 percent) displayed verbal aggression on at least one occasion, whereas 27.2 percent of all patients (n=137) exhibited one or more incidents of physical violence. Female patients were responsible for more physically violent episodes than male patients. Patients admitted with a civil court order exhibited more violent behavior than patients with a criminal court order. Violent patients with a civil commitment had a significantly longer length of stay than non-violent patients with a civil commitment. More violence was found to take place on the earlier days of the week.

This study points at important differences between groups of forensic inpatients in frequency and type of inpatient violent behavior and in temporal factors. Interventions aimed at reducing the number of violent incidents should take these differences into account. Further research is necessary to gain more insight into the background of inpatient violence.

Youth violence victimisation impacts on health, mental health and future risk trajectories. A London hospital emergency department (ED) outreach youth service provides a unique intervention opportunity to support adolescents involved in violence. The purpose of this paper is to describe the set‐up of the service.

Young people (YP) targeted were aged 12‐18, from two London boroughs and attended ED with injuries from a violent incident. They were referred to Oasis youth workers for a mentoring/youth work intervention. Lifestyle and symptom scales were used to assess risk profile. Hospital staff questionnaires determined service awareness in the first six months, and interviews/focus group identified potential barriers to service uptake.

By 12 months, the service was operating smoothly. Of the first 505 YP attending ED, a third were referred, a third ineligible and a third non‐contactable/refused. Detailed analysis of the first 30 attending found most were male (87 per cent), equal White or Black ethnicity (40 per cent) with 20 per cent “Other” ethnicities, with only a third living with both biological parents. This was similar to the full population attending. Nearly half (49 per cent) had been assaulted, 30 per cent had injuries self‐generated through poor anger management, the remainder injured in fighting. Over half (57 per cent) had disorder, mostly behavioural, correlated with lifestyle risk scores. Barriers to service use/implementation included YP mistrust and fear of reprisals, problems with service visibility in the busy hospital environment and ineffective staff communication with YP, all countered during the running of the service. Gauging outcome at follow‐up is the second evaluation stage.

The youth violence project is an important initiative for intervention in youth violence.

The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS).

This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, χ² and Fisher’s exact tests as well as univariate and adjusted logistic regression.

The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56–4.32) and having shift work (AOR=3.13, CI: 1.67–5.84) were the most significant risk factors for total WPV.

The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV.

Current government policy aims to tackle youth anti-social behaviour and its psychological and social impacts. Given an increased likelihood that young victims of crime are also likely to engage in aggressive or deviant behaviour and to have psychological and social difficulties, interventions are needed which access vulnerable youth with adverse lifestyles to increase well-being and reduce offending. The current project utilised a hospital emergency department (ED) as an appropriate location to identify and interact with youth victims of violent crime; to support key lifestyle risk and mental health difficulties; and build resilience. The purpose of this paper is to use a youth work paradigm, to target vulnerable youth in a health setting at a crisis point where intervention may have a higher chance of uptake.

The study applied a quasi-experimental, longitudinal design. Using the strengths and difficulties questionnaire and the “What Do You Think” component of the ASSET risk assessment, data were collected from 120 youth aged 12-20, at baseline with 66 youth who successfully completed the programme with assessments at baseline and follow-up, at an average of 14 weeks.

There was significant reduction in both psychological problems and lifestyle risk at follow-up.

These findings support the government initiative to intervene in youth violence in healthcare settings. Challenges revolve around increasing participation and greater formalisation of the intervention.

The youth work led violence intervention in the ED is successfully tackling psychological problems and lifestyle risk following injury.

The purpose of this paper is to present strategies for cultivating internal support, community partnerships and practitioner engagement for Hospital-based Violence Intervention Programs (HVIPs). In response to growing concerns about community violence and calls to engage the community in its solutions, HVIPs have increased in popularity as innovative and transdisciplinary approaches to violence intervention. HVIPs are one strategy under the broad purview of public health approaches to crime and violence – focusing on reaching recent victims of violence in emergency departments and leveraging this “teachable moment” to offer wrap-around services geared toward preventing future violence or revictimization.

This paper uses an autoethnographic and case study approach of Project HEAL (Help, Empower and Lead), a newly established HVIP at Jersey Shore University Medical Center.

While there is no “standard” approach, the importance of strong community partnerships and practitioner engagement prior to and during the HVIP implementation process is second to none.

This case study of Project HEAL’s initial implementation will provide information that can assist other HVIPs in creating and sustaining necessary internal support, community partnerships and practitioner engagement, and potentially help navigate forthcoming statewide and federal efforts.

Development of meaningful community partnerships and achievement of a high level of engagement from practitioners are key to the successful implementation of HVIPs, the processes of which are not always documented in literature.

Ambulance services staff worldwide have long been at risk of encountering violence and aggression directed towards them during their work. Verbal forms of violence and aggression are the most prevalent form, but sometimes incidents involve physical injury, and on rare occasions homicides do occur. Exposure to such violence and aggression can have a lasting negative impact upon ambulance staff and has been associated with increased levels of stress, fear, anxiety, emotional exhaustion, depersonalisation and burnout syndrome. Despite the significance of this issue, little progress has been made to tackle it. The purpose of this paper is to describe this multi-agency approach being taken in Wales (UK) to reduce such harms from violence and aggression directed towards ambulance services staff.

An interpretative post-positivist narrative methodology and policy analysis approach was followed. Snowball methods of gathering data were used to construct this narrative involving meetings, telephone calls, review of policy documents, legislation and academic literature.

The authors report how tackling violence and aggression directed towards emergency workers has become a priority within Wales (UK), resulting in policy developments and initiatives from groups such as the UK and Welsh Government, the Welsh Ambulance Services National Health Services (NHS) Trust, Health Boards, the NHS Wales Anti-Violence Collaborative and the Joint Emergency Services Group (JESG) in Wales. This has included changes in legislation such as the Assaults on Emergency Workers (Offences) Act 2018 that came into force on 13th November 2018 and policy changes such as the obligatory responses to violence in health care and the JESG #WithUsNotAgainst Us campaign. Our study however reflects the complexity of this issue and the need for further high-quality research.

The experiences and activities of Wales (UK) reported in this paper adds to the international body of knowledge and literature on violence and aggression directed towards ambulance services staff.