Past Violence, Substance Use, and Precipitants to Psychiatric Patient Assaults: Eleven-year Analysis of the Assaulted Staff Action Program (ASAP)

Thirty-five years of empirical research on assaultive psychiatric patients has documented the presence of consistent patient assailant characteristics. However, these characteristics studies have yielded little in the way of predictor variables. This study examined three commonly present, patient clinical variables (past violence toward others, personal victimization, and substance use disorder) singly and in combinations as potential predictor variables. An additional subset analysis of patient precipitants was added to ascertain whether precipitant data would add further predictive power The combinations of past violence toward others and personal victimization with and without substances use disorder during an eleven-year period were associated with 61% of the subsequent assaults. A trend for denial of services to female patients during a three-year period was also associated with subsequent assaults. The predictive implications of these findings and their relevance for emergency services personnel are examined.