Sources of Social Support: Who Provides Effective Support after Patient Assault?

Background

Nearly 70% of staff in psychiatric inpatient settings are physically assaulted on the job, often by the patients for whom they provide care (Service Employees International Union, 2011).  Research shows that social support can mitigate the negative impact of patient assault on staff well-being.  However, social support is not routinely provided after assault, and even when it is offered, its impact may depend upon whether or not it is wanted and perceived to be effective.  In order to guide workplace responses to patient assault, more information is needed about how to best support staff after assault.  This study examines the types of support that are offered to staff after assault, as well as which sources staff perceive as desirable and effective.      

Methods

The study sample consists of 348 clinical staff at a large public mental hospital in California.  Staff completed a survey asking about support after patient assault from 7 sources, including coworkers, supervisors, hospital administrators, security staff, family, friends or other.  For each source of support, staff indicated (yes/no) if the source of support was wanted, offered, and effective following patient assault.  Count variables of the number of sources that were offered, desired and effective were calculated.  Patterns of overlap between sources of support wanted and offered, offered and effective, and then wanted, offered, and effective were examined.     

Results 

Of the 279 staff members who responded about support after assault, 72% wanted support, 65% were offered support, and 73% found effective support.  Coworkers, family, and friends were the sources of support that were most frequently wanted, offered, and effective.  On average, staff wanted significantly more sources of support than they were offered (paired t (278) = 9.39, p <.001) or found effective (paired t (278) = 8.10, p <.001).  Staff wanted support more than it was offered from supervisors, administrators, and security staff.  Coworkers and supervisors were the sources most likely to offer ineffective support.  While hospital administrators rarely offered support, those who sought support from hospital administrators found the support received to be effective. 

Discussion

These results highlight that most staff want, are offered, and find effective social support from at least one source after patient assault.  However, there are also gaps in support that have implications for management.  Increasing provision of support from supervisors may be critical to the well-being of staff since supervisors can directly impact the unit environment.   In addition, training should be provided to supervisors, coworkers, and security staff to improve the support they do provide.

Service Employees International Union 1000 (2011). Violence in California's mental health hospitals: Workers deserve stronger protection [White paper]. Retrieved from: http://seiu1000.org/research/research_white%20paper_dmhviolence.pdf on November 21, 2014.