Psychiatr Q (2006) 77:239–249
Characteristics of Assaultive Psychiatric Patients:
Fifteen-Year Analysis of the Assaulted Staff Action
Raymond B. Flannery, Jr., Ph.D. ·
Jerry Juliano, L.I.C.S.W. · Susan Cronin, R.N. ·
Andrew P. Walker, B.A.
Published online: 4 August 2006
Springer Science+Business Media, Inc. 2006
Abstract This study reports on a ﬁfteen-year longitudinal analysis of the characteristics of
assaultive patients in one public-sector mental health care system. The data were gathered
within the context of the Assaulted Staff Action Program (ASAP), a crisis intervention
service for staff victims. The ﬁfteen-year ﬁndings were consistent with previous worldwide
research on assaultive patients and included both older male patients with schizophrenia and
younger personality-disordered patients as high-risk assailants. Both groups had appreciable
histories of violence toward others, personal victimization, and substance use disorders.
The role of these three clinical variables in association with subsequent assaults, the role
of trauma in female assailants, and the consistency of the fundamental characteristics of
assaultive patients during several service system initiatives were examined. Implications for
research and intervention are discussed.
Keywords Assaulted staff action program (ASAP)
Physical assaults on employees are a serious form of nonfatal violence in the workplace
and assaults by psychiatric patients on health care staff constitute a sizeable proportion
of these assaults . No less than fourteen review articles of databased research studies
have documented this unacceptable patient violence worldwide for over a thirty-year period
[2–15]. No type of health care setting has been exempt [2–15]. Assaults have occurred in
public and private inpatient, outpatient, and emergency services as well as other common
R. B. Flannery, Jr., Ph.D. (
Department of Psychology, Worcester State Hospital,
305 Belmont Street, Worcester, MA 01604, USA
J. Juliano, L.I.C.S.W. · S. Cronin, R.N.
Department of Mental Health
A. P. Walker, B.A.
Massachusetts Department of Mental Health,