Violations and Abusive Events as Experienced by Staff Within Adult Psychiatric Care: A National Cross-Sectional Survey

Background
Previous research has emphasized the high prevalence and far-reaching consequences of violations of ethical principles in patient care.

Aim
To study the extent of violations perceived by healthcare professionals in Swedish adult psychiatric care.

Methods
Online survey among 2,538 mental health professionals. A revised version of Transgressions of Ethical Principles in Health Care Questionnaire was used.

Results
Events that could be perceived as abusive occur to a large extent. Respondents reported 96% observation and 84% self-involvement in at least one abusive event during the past 12 months and were considered unethical by 43% upon observation and by 34% upon self-involvement. Respondents who work in inpatient care report both more observations and more of their own involvement in abusive events compared to outpatient care.

Conclusions
The findings indicate the importance of actively working with and preventing violations and abusive events, and could motivate healthcare professionals to talk about alternative ways of acting in certain situations.