Authors' objectives: To compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors in psychiatric patients in acute care settings, including interventions aimed specifically at reducing use of seclusion and restraint.

Authors' recommendations: Given the ethical imperative for treating all patients with dignity, the clinical mandate of finding evidence-based solutions to these mental health challenges, and the legal liability associated with failure to assess and manage violence risk across the treatment continuum, the need for evidence to guide decisionmaking for de-escalating aggressive behavior is critical. The available evidence about relevant strategies is very limited. Only risk assessment decreased subsequent aggression or reduced use of seclusion and restraint (low SOE). Evidence for de-escalating aggressive behavior is even more limited. More research is needed to guide clinicians, administrators, and policymakers on how to best prevent and de-escalate aggressive behavior in acute care settings.

Project Status: Completed

Year Published: 2016

URL for published report: https://www.effectivehealthcare.ahrq.gov/ehc/products/613/2257/aggression-report-160713.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)