Fact or fiction Mental illness or just bad behaviour…..

• If you have any emotional trauma from past incidence of aggression or trauma you should avoid engaging too deeply with this activity.

• Can leave freely with no judgment.

• Discuss privacy and confidentiality – open and mutual sharing.

• Always open for debrief afterwards.

Activity

For this exercise, everyone will have to stand up. One side of the room will be FALSE, the other side of the room will be

TRUE…

When the Myth is presented….. Pick your side!

True OR False….

Violence is a symptom of mental illness.

False

• The evidence and casual link remains inconclusive. • Slightly higher rates of violence among people with a psychotic

illnesses however, when controlled for genetic and social vulnerabilities this is not statistically significant.

True or False

• International studies on public perception of mental illness in western countries indicate that most people believe that individuals with mental illness are violent/dangerous.

True

• Public perception studies in the US and Australia indicate that over 60% of individuals believe that people with mental illness are violent and/or dangerous.

True or False

• Having a history of violence is the single most powerful predictor of future possible violence or aggression.

True

• Having a history of acts of aggression or violence increases the likelihood of future violence.

True or False

• Rates of violence in Australian Emergency Departments are similar to the rates of violence in Emergency Departments in the U.S.

True

• Population based data has demonstrated that rates of violence in Australian Emergency Departments is not statistically higher or lower than violence in the U.S.

True or False

• Consumers of mental health services are more likely than the general population to be victims of aggression and homicide than that of general population.

True

• Prevalence of violence and homicide in the mentally ill is statistically higher than that of the general population.

• International and population based data on trauma histories indicate weighted averages of up to 90% of public MH clients had been exposed to multiple physical and sexual abuse traumas.

True or False

• Childhood trauma is the main reason someone will end up presenting to Emergency Department for a mental health admission.

True

• Childhood Trauma is the SINGLE most significant PREDICTOR that an individual will end up in a mental health system.

True or False

• Those who witnessed or experienced childhood violence were more likely to be the victim or perpetrator in later life.

True

• Childhood violence increases the likelihood or victimisation or becoming a perpetrator in later life.

True or false

• There is absolutely no statistically significant evidence that suggests seclusion or restraint maintains safety for consumers.

True

• The therapeutic value of seclusion and restraint has never been

demonstrated.

• There is no evidence that seclusion and restraint maintains safety for patients or staff or that reduction of seclusion and restraint increases

incidents (Sailis & Fenton, 2012; Duxbury, 2015; Bowers et al., 2015; Goulet et

al., 2017).

True or False

• De-escalation is an evidence based strategy for managing aggression in psychosis.

False

• There are no current well designed randomised control trials for inclusion in a systematic review that can demonstrate de-escalation is an evidence based approach to managing aggression in psychosis.

What do you do in your ED’s to support staff following critical incident’s?