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Int J Ment Health Nurs. 2018 Feb;27(1):33-45. doi: 10.1111/inm.12425. Epub 2017 Dec 21.

Violence in mental health settings: A systematic review.

Author information

1
Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
2
Health Services and Population Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
3
UK Centre for Tobacco and Alcohol Studies, London, UK.
4
Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK.

Abstract

The introduction of smoke-free policies is increasingly common in mental health settings, to improve health. However, a barrier to implementing smoke-free polices is staff concern that violence will increase. We conducted a systematic review comparing the rates of violence before and after the introduction of smoke-free policies in mental health settings. Two authors searched major electronic databases. We included studies reporting the prevalence of violence (verbal and/or physical or combined) before and after the introduction of a smoke-free policy in a mental health, forensic, or addiction setting. We included 11 studies in the review. A narrative synthesis was used to describe the key results of each study. Six studies measured physical violence specifically; four reported a decrease or no change and two reported a short-term increase. Five of these six studies also measured verbal violence; two found an increase, with one of the studies reporting that this increase was temporary. Three reported a decrease in verbal violence. A further five studies evaluated the rate of combined verbal and physical violence; four reported a decrease or no change and the other an increase. We conclude that the introduction of smoke-free policies generally does not lead to an increase in violence. There is a need for more robust studies to support this finding. However, the conclusions from this review may be a step in reducing staff concerns.

KEYWORDS:

mental health; policy; smoking; tobacco; violence

PMID:
29271109
DOI:
10.1111/inm.12425
[Indexed for MEDLINE]

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