Joy Duxbury Palmstierna Tom Henk Nijman Nico Oud Patrick Callaghan Patrick Callaghan - Nico Oud - Henk Nijman Tom Palmstierna - Joy Duxbury VIOLENCE Proceedings of the 10th European Congress on VIOLENCE IN CLINICAL IN CLINICAL PSYCHIA PSYCHIATRY TRY Violence in Clinical Psychiatry Design and production: DM Creatieve Communicatie. The Netherlands. www.dmcreatief.nl Prof. Dr Patrick Callaghan Mr Nico Oud, MNSc Prof. Dr. Henk Nijman Prof. Dr. Tom Palmstierna Prof. Dr. Joy Duxbury Editors Violence in Clinical Psychiatry Proceedings of the 10th European Congress on Violence in Clinical Psychiatry 26 – 28 October 2017 Crowne Plaza Dublin Airport Northwood Park Santry Demesne Santry - Dublin - 9, Ireland 4 © 2017 Oud Consultancy, Amsterdam Publisher: Oud Consultancy Oud Consultancy & Conference Management Hakfort 621 1102 LA Amsterdam The Netherlands Telephone: +31 20 409 0368 Telefax: +31 20 409 0550 [email protected] [email protected] www.oudconsultancy.nl ISBN 978-90-827096-0-5 NUR 895 All Rights Reserved. No part of this publication may be produced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, without the permission in writing of the copyright owner (Oud Consultancy) and the concerned author. 5 Preface Invitation and historical background A thousand welcomes to Dublin and the 10th European Congress on Violence in Clinical Psychiatry, 26-28 October 2017. In this, our silver jubilee year, the Congress is co-organized by the European Violence in Psychiatry Research Group (EViPRG), the European Network for Training in the Management of Aggression (ENTMA08), and is a World Psychiatric Association (WPA) co-sponsored meeting. This year’s Congress will focus strongly on clinically relevant and practically useful interdisciplinary scientific and practical knowledge on interventions aimed at treating and reducing violence and aggression. The overall congress theme: “Creating collaborative care: a multi-partnership approach” reflects our commitment to partnership working between clinicians, agencies, researchers, educators, service users and carers from across the globe. The first congress, held in 1992 in Stockholm – Sweden, was an initiative by Prof. Börje Wistedt, the head of one of the larger psychiatric clinics in Stockholm at Danderyd Hospital / Karolinska Institute. He and his staff organized the congress with him as chairman and Prof.Tom Palmstierna as his scientific secretary. The Congress was held at the Swedish Medical Association and attracted 120 delegates who attended a series of lectures and seminars. The second congress in 2001 was organized by the Addiction Center in Stockholm and its head Prof. Stefan Borg, and attracted 200 delegates. For the first time the Congress was a joint initiative with the European Violence in Psychiatry Research Group (EViPRG) founded in 1997 by Prof. Len Bowers and Prof. Richard Whittington. Following the success of this partnership all subsequent Congresses were co-organised with EVIPRG with the aim of bringing the latest science on violence and aggression to clinicians, researchers and managers. London in the Summer of 2003 was the venue for the third Congress organized by Prof. Tom Palmstierna and Dr. Gerd Nyman, supported by the Addiction Center and Prof. Stefan Borg, and attracted 185 delegates. From 2005 the Congresses have been organized by Oud Consultancy & Conference Management, chaired by Professors Henk Nijman & Tom Palmstierna in close collaboration with EVIPRG. Since 2011 the World Psychiatric Association (WPA) has co-sponsored the meeting. Since 2015 the European Network for Training in the Management of Aggression (ENTMA08) has been a collaborator in the organisation and delivery of the Congress. 6 Since the first European Congress on Violence in Clinical Psychiatry the meeting has expanded rapidly in terms of the number of scientific contributions and participants; the previous congress in Copenhagen in 2015 was attended by more than 600 participants from 36 countries, Dublin will be similar. In line with previous congresses in Vienna (2005), Amsterdam (2007), Stockholm (2009), Prague (2011), Ghent (2013) and Copenhagen (2015) all contributions to the 10th European Congress on Violence in Clinical Psychiatry are published in this “book of proceedings” reflecting the current state of knowledge about, and research into the prevention and management of violence and aggression in mental health and intellectual disability settings and the training and education of staff. The broad multi- and interdisciplinary scope of the 10th Congress is reflected in our varied programme encapsulating epidemiology and nature of inpatient violence against staff and patients, violence prevention and treatment, trauma informed care & practice, assessment of risk, prevention and protective factors, humane safe and caring approaches in and reduction of restrictive practices and the understanding of violence in specific populations. The training and education of (interdisciplinary) staff has featured consistently in all congresses. Despite twenty-five years of progress, throughout this time, we have remained true to our vision that the Congress will gather the best evidence and use this to transform care. We are delighted that this year Congress is supported by the Department of Transport, Tourism and Sport, Fáilte Ireland (the National Tourism Development Authority), the Lord Mayor of Dublin, the Dublin Convention Bureau and the Irish industry suppliers. Prof. Dr Patrick Callaghan Mr Nico Oud, MNSc Prof. Dr. Henk Nijman Prof. Dr.Tom Palmstierna Prof. Dr. Joy Duxbury 7 Supporting Organisations • European Violence in Psychiatry Research Group (EViPRG) • ENTMA08 • World Psychiatric Association (WPA) Section on Art and Psychiatry Section on Psychiatry and Intellectual Disability Section on Stigma and Mental Illness • Oud Consultancy & Conference Management • Altrecht Aventurijn • British Institute for Learning Disabilities (BILD) • The College of Psychiatrists of Ireland • CONNECTING, partnership for consult & training • Dundalk Institute of Technology (DkIT) • Health and Safety Authority Ireland • Irish Medical Organisation (IMO) • Karolinska Institute • Mental Health Commision (MHC) • National Institute for the Prevention of Workplace Violence, Inc • NGO Forum for Health • Pflegenetz • St. Olavs Hospital, Trondheim University Hospital • The University of Nottingham • The Mandt System • The Psycho-Fysical Consultants The Scientific Committee Prof. Tom Palmstierna (Sweden) (chair) Prof. Henk Nijman (Netherlands) (chair) Dr. Hulya Bilgin (Turkey) Prof. Tilman Steinert (Germany) Prof. Richard Whittington (UK) Prof. Dirk Richter (Switzerland) Dr. Mojca Dernovsek (Slovenia) Dr. Brodie Paterson (UK) Mr. Bart Thomas (Belgium) Prof. Joy Duxbury (UK) Prof. Stål Bjørkly (Norway) Dr. Kevin McKenna (Ireland) Prof. Seamus Cowman (Ireland) Prof. Sabine Hahn (Switzerland) Dr. Mary E. Johnson (USA) Prof. Patrick Callaghan (UK) Dr. Roger Almvik (Norway) Ass. Prof. Lars Kjellin (Sweden) Dr. Liselotte Pedersen (Denmark) Dr. Marie Trešlová (Czech Republic) Ass. Prof. Frans Fluttert (Netherlands) 8 The Organisation Committee Henk Nijman (Netherlands) (chair) Tom Palmstierna (Sweden) (chair) Joy Duxbury (UK)(chair on behalf of the EViPRG) Brodie Paterson (UK)(chair on behalf of ENTMA08) Patrick Callaghan (UK) (main editor of the proceedings) Nico Oud (Oud Consultancy – Congress Organiser) Kevin McKenna (Ireland) Local Organisation Committee Kevin McKenna (chair) (Dundalk Institute of Technology (DkIT)) William Flannery (College of Psychiatrists of Ireland) Aisling Culhane (Psychiatric Nurses Association of Ireland) Rosemary Smyth (Irish Mental Health Commission) Anne Maria O’Connor (Health and Safety Authority of Ireland) Vanessa Hetherington (Irish Medical Organization) General scientific remark Occasionally the congress organization receives queries, especially from academic Institutions, regarding the procedure for the selection of abstracts to be presented at the congress. Each abstract is submitted for peer review to members of the International Scientific Committee. Each abstract is anonymously adjudicated by at least three members of the committee. Abstracts are evaluated according to the following criteria: • relevance to the conference theme, • interest to an international audience, • scientific and/or professional merit, • contribution to knowledge, practice, and policies, and • clarity of the abstract Following the evaluation of each submission, the Organization Committee assesses the merit of each individual abstract and deliberates on the acceptance, the rejection or – occasionally – on provisional acceptance pending amelioration of the abstract. On applying this procedure, the Organization Committee endeavors to do justice to all submitters and to the Congress participants, who are entitled to receive state of the art knowledge at the Congress. In total we did receive 208 abstracts from 34 different countries worldwide, of which 21 (10%) were rejected, 16 (8%) were withdrawn mainly due to financial reasons or not getting funding in time, and 20 (10%) were not included in the program and the proceedings due to not registering after all or not paying the fees in time. Together with the special workshops, special presentations and the keynotes in total 172 presentations from 30 different countries worldwide were presented. 9 ENTMA08 Reception & Meeting ENTMA08 addresses issues related to training