Contributing Factors to Aggressive Incidents in Correctional and Forensic Psychiatric Care: A Rapid Evidence Assessment

Abstract

Purpose: Aggression within secure settings poses considerable concern. This paper aims to offer more recent considerations of factors, such as cultural and environmental, that contribute to the prediction of aggressive security incidents, focusing on a rapid evidence assessment (REA) of available literature since 2018.
Design/methodology/approach: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Moher et al., 2009) guidelines were utilised for this REA, taking guidance from a previous study (Ireland et al, 2019) for the development of search terms.
Findings: Twenty-three final studies were included in the REA. All studies were conducted in either prison (n = 8), psychiatric in-patient facility with involuntary or compulsory treatment (n = 7), and forensic secure services (n = 7), with one study looking at both general in-patient psychiatric hospital and forensic services. Thematic analysis noted 4 main themes that were predictive of aggressive security incidents, these were: (1) Inadequate living facilities and poor physical environment, (2) Institutional security levels predicting aggression, (3) Restricted movement and the lack of meaningful activities, (4) Ward atmosphere and staff factors impacting staff-client relationships and consequent aggression.
Practical implications: This REA adds value to understanding the current interplay between the living facilities, wider forensic environment and interaction of staff in a forensic client’s aggressive behaviours.
Originality/value: This REA offers an updated reflection and understanding on the presentation of aggression in secure forensic environments.