Management strategies for disturbed and violent patients should be monitored and audited. General issues Individual care plans, agreed by the multidisciplinary team, should take into account the propensity of the patient for disturbed or violent behaviour and include an explicit assessment of the degree of risk posed by the patient. It is recognised that risk assessment is an area which is in need of further refinement and, as such, training is needed for all disciplines. Appropriate management strategies to reduce the likelihood of violence should be defined for all individuals. Care plans should include clear indications of any previously known antecedents and effective interventions.
Adequate resources are important, particularly in terms of staffing, training and facilities.
On a more general level, any institutional system which cares for the violent patient must take account of the special issues which arise from this work. Thus the management might periodically seek external consultancy about the organisation, its staff and their work in this field. The environment All psychiatric units should have the means to manage violent patients. Depending on the nature and size of the unit, there should be an intensive care facility. It should be supported by adequate facilities including a toilet, wash area and recreational space.