article · South African Journal of Psychiatry
Aggression and violence present significant challenges in healthcare facilities, especially within emergency and psychiatric departments. Hospital security staff act as frontline responders during these incidents, yet they often do not receive formal instruction in de-escalation. To address this, an interactive psychoeducational programme incorporating role-play, discussions, and scenario-based exercises was delivered to security personnel at a regional academic hospital in South Africa. Participant attitudes were evaluated before and after the training across key domains related to aggression causes and management. Following the programme, security personnel demonstrated statistically significant improvements in their attitudes across all assessed domains. Female participants experienced greater shifts regarding environmental and interpersonal factors of aggression, while greater job experience correlated with increased recognition of patient-related causes. Overall, structured de-escalation training effectively reshapes security staff perspectives, potentially enhancing hospital safety and multidisciplinary teamwork.
Hospital security officers frequently confront volatile situations in emergency and psychiatric settings without formal preparation, which raises the risk of physical harm. Providing these frontline workers with structured de-escalation training improves their understanding of aggression causes and management. This approach can foster safer clinical environments, lower injury risks, and promote better collaboration between security staff and healthcare professionals.
The findings demonstrate an applied and tested training intervention tailored for hospital security staff. Healthcare providers, public hospital networks, and private security contractors operating in clinical settings could adopt or license similar structured de-escalation curricula. Because the intervention has already undergone evaluation within a public regional hospital, it is positioned close to practical deployment, offering a ready framework for specialised workforce training modules in healthcare security.
AI-generated from the published abstract. Always read the original work before citing.
Background: Aggression and violence remain persistent challenges in healthcare settings, particularly in psychiatric and emergency units. Security personnel serve as frontline responders but frequently lack structured training in de-escalation techniques, increasing the risk of harm. Aim: This study aimed to assess and improve security personnel’s attitudes towards the causes and management of aggression through a structured de-escalation training programme. Setting: The study was conducted at Cecilia Makiwane Hospital, a regional academic facility in the Eastern Cape province of South Africa, housing the only public-sector mental health unit in Buffalo City Municipality. Methods: A quasi-experimental single-group pre-test–post-test design was used. Security personnel completed an interactive educational programme incorporating discussions, role-play, and scenario-based exercises. The Management of Aggression and Violence Attitude Scale (MAVAS) was administered before and after the intervention. Data were analysed using paired-samples t-tests and multiple regression at a 5% significance level. Results: Baseline MAVAS domain scores indicated moderate agreement with all four domains. Following the intervention, significant improvements were observed across all MAVAS domains (p ≤ 0.01), reflecting more positive attitudes towards aggression management. Female participants showed greater changes in environmental and interpersonal causes of aggression (B = −0.259, p = 0.003), while longer work experience predicted increased recognition of patient-related causes. Job rank and age were not significant predictors. Conclusion: Structured de-escalation training effectively improved security personnel’s attitudes towards managing aggression and violence in a hospital setting. Contribution: This study provides empirical evidence that context-specific de-escalation training for security personnel may support workplace safety and strengthen multidisciplinary collaboration in the South African setting.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.4102/sajpsychiatry.v32i0.2648
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
