The Effect of Near-Misses on Psychiatric Healthcare Workers’ Risk Perception: An Exploratory Study of the Awareness of Successful and Unsuccessful Responses of Violent Incidences

Abstract

The Norwegian psychiatric healthcare sector has seen a restructuring in the last couple of decades. As the focus has been on treating more patients in the outpatient facilities, fewer beds are available for longer hospitalization. With this change, new trends are emerging that can affect the psychiatric healthcare workers’ perception. There is, however, limited risk research within the health sector. This thesis’ objective is to shed new light on healthcare workers’ perceptions when considering near-misses. More specifically, near-misses involving a successful or an unsuccessful response. The thesis problem statement is “How does awareness of successful or unsuccessful responses to incidents of violence or threats directed towards employees affect psychiatric healthcare workers’ perceived risk of violent incidents?”.'

A mixed research method is utilized to answer our thesis, which consists of a questionnaire and focus group interviews. We developed three scenarios for our participants, a vulnerable near-miss, a resilient near-miss, and a control scenario. Forty participants within ten focus groups were asked to review two of the developed scenarios. The participants would always receive the control scenario while alternating between the two near-misses. This review consists of individual questionnaires before an open discussion session within the focus groups.

Our thesis indicates that near-misses influence healthcare workers’ perception of risk. We observed that the vulnerable scenario was consistently ranked more poorly compared to the other two scenarios. Furthermore, we found strong indications that trust and perceived control are two important factors influencing risk perception among psychiatric healthcare workers. Lastly, we argue that using the term unsuccessful response is unsuitable in the context of psychiatric healthcare as most responses could prove successful under the right circumstances.