Violence and aggression: short-term management in mental health, health and community settings

Understanding what makes you upset or angry

The care team should get to know you so that they can tell when you're starting to become upset or angry. They should learn what your 'triggers' (things that are likely to anger or upset you) are and try to avoid setting off these triggers. They should also encourage you to get to know your own triggers and ways that you can control them. For example, if you feel angry because you've been told that you can't have something you've asked for, you could talk about what other options there are.

Support to stay calm in a psychiatric hospital or unit

If you're in a psychiatric hospital or unit, your ward should be as pleasant and comfortable as possible. It should be easy to find your way around and doors shouldn't be locked unless necessary. There should be opportunities for privacy and you should be able to go outside if you wish.

You should be offered opportunities for physical exercise and leisure activities such as a film club, or a reading or writing group. You should also be offered psychological therapies if they're suitable for you.

The care team in the ward should watch out for any teasing, bullying or other upsetting behaviour in the ward. They should also be aware of things that might upset you, for example if you're not allowed to leave the ward or you have worries about family or money problems.

Medication to help you stay calm

If you need medication to help you stay calm, the care team, including a psychiatrist and a specialist pharmacist, should make a medication plan for you. This plan should include any medication that you take regularly as well as medication that you take only when you need it (known as 'pro re nata' medication, or 'p.r.n.' medication for short). All the medication you take should be checked by the care team at least once a week, and more often if your risk of becoming violent or aggressive increases or you're having a restrictive intervention (for information on restrictive interventions see stopping violence or aggression).

Searching possessions and clothing to prevent violence

Sometimes searches of people's possessions and clothing need to be done to prevent violence and keep everyone safe. Health and social care services should have a policy (a set of rules) about searching service users and their carers or visitors. The policy should include the reasons a search can be done, who can do the searching and what can be searched (for example, a person's clothing or their room). There should bea summary of the policy that you and your carers or visitors can have.

If it's decided to do a search, you should first be given the summary of the policy on searching. You should be asked if you consent (agree) to the search. If you don't give your consent, the care team should have a meeting to decide whether they should use physical force to do the search. Different types of professionals should take part in this meeting. Physical force should be used only as a last resort.

During the search, it should be explained to you what is being done and why. Your dignity and privacy should be respected during the search. The search should be carried out by two members of the care team. At least one of them should be the same sex as you.