More than 80% of psychiatric trainees have experienced some kind of verbal, physical, or sexual assault from patients, and approximately one-third have been physically attacked multiple times, new survey results show.
Dr. Victor Pereira-Sanchez
The rate of reported assaults is probably low because trainees view it as "part of the job to get insulted," said Dr. Victor Pereira-Sanchez. "It's part of the job to suffer minor physical violence."
Such incidents, said study investigator Victor Pereira-Sanchez, MD, from the department of child and adolescent psychiatry at New York University take a toll on the trainees’ well-being and may ultimately affect the quality of patient care.
“The extent of violence against psychiatric trainees is alarming and calls for the implementation of effective training, prevention, and intervention measures,” Dr. Pereira-Sanchez said in an interview.
The findings were presented at the European Psychiatric Association (EPA) 2020 Congress, which was virtual this year because of the COVID-19 pandemic.
Widespread problem
Violence against health care professionals is widespread among clinicians in EDs with psychiatry trainees “more exposed and vulnerable,” Dr. Pereira-Sanchez said during his presentation.
In 2017, the European Federation of Psychiatric Trainees established a group of researchers to describe “the extent and consequences of violence against psychiatric trainees in Europe and beyond,” he said. The group developed a 15-item questionnaire asking young clinicians about experiences of physical, sexual, and verbal assault at work. The survey was posted online by partner institutions via social media.
A total of 827 psychiatric trainees, the majority of whom were from France and the United Kingdom, completed the survey. Respondents had an average age of 31 years, and 68% were women. On average, respondents had completed 51.3% of their psychiatric training.
with 92.0% reporting verbal assaults, 44.1% physical assaults, and 9.3% sexual assaults. In addition, 14.2% had been assaulted once, 51.9% had been assaulted two to five times, and 33.9% had been assaulted more than five times during their training. Results also showed that assaults were more likely to occur on an inpatient ward (63.4%) or the ED (56.9%), although 37.2% occurred in an outpatient setting and 4.2% in community settings. The majority of respondents (69.0%) did not report their assaults, and 67.3% did not call police or security personnel.
The most common emotions experienced by trainees following an assault were fear, rage, and anxiety. Guilt, sadness, feeling unsupported, and self-doubt were also reported.
Dr. Pereira-Sanchez noted the low rate of reported assaults is likely because trainees view it as “part of the job to get insulted, it’s part of the job to suffer minor physical violence.”
Individuals who did report assaults tended to be those who had been assaulted more than five times and those who felt more anxiety, rage, and fear.
“Basically, those who experience more emotional consequences and physical consequences tend to report more,” he said.
In addition, trainees tended to report assaults if they worked in an institution that provided protocols and training in prevention and management of patient aggression.
However, he added, most respondents reported they were not aware of their center’s protocols with respect to assaults and were not trained in the management or prevention of patient violence.