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Assessing aggression in psychiatric inpatients

BMJ 2000; 321 doi: (Published 09 September 2000) Cite this as: BMJ 2000;321:636

Assessing aggression can be risky

  1. David Yeomans, consultant psychiatrist (
  1. Overthorpe House, Leeds LS16 5AB
  2. Devon and Cornwall Forensic Psychiatric Service, Langdon Hospital, Dawlish, Devon EX7 0NR

    EDITOR—Carrying out a risk assessment can be risky. Doctors should ask patients if they are carrying weapons only if they can safely cope with the immediate production of a weapon. Doctors must consider their own safety and that of the patient, relatives, and colleagues. Sanders et al recommended inquiry into the full range of aggressive ideation but issued no warning about how dangerous this can be.1 They found that one in 20 patients admitted to a psychiatric hospital in Middlesbrough regularly carried weapons. Some patients will produce their weapon on inquiry, and a few may be prepared to use it.

    I have been treated to demonstrations of knives, scissors, a machete, and a (replica) gun. In most cases I had arranged for others to be present before asking about weapons, and …

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