Contextualizing Violence Prevention – How Contextual Aspects Influence the Implementation of a Violence Prevention Initiative in Prisons and Psychiatry

The aim of this study was to investigate which contextual aspects and mechanisms are decisive in the implementation of an integrated, tailored intervention to prevent violence and threats of violence from patients or inmates towards employees in psychiatric units and in prisons and detention centers. Based on a standardized implementation degree assessment of fidelity, reach and dose delivered, we selected two workplace cases from each sector, one with a high and one with a low implementation degree. Using a realist evaluation framework, we conducted a thematic analysis of the four selected workplace cases to identify prevalent contextual aspects and mechanisms underlying the implementation degree. We found that prioritization, synergy with parallel change processes, and intervention fit, were decisive mechanisms for the successful implementation of the intervention. We also found that lack of resources (staff instability, insufficient time, poor mental resources) and resource-demanding parallel change processes, were contextual aspects that “blocked” all mechanisms. That is, when resources were not available, none of the mechanisms for implementing the intervention was activated. Our findings point to the importance of investigating the role of contextual aspects when assessing the effectiveness of organizational interventions

Negative Acts as Risk Factor for Work-Related Violence and Threats from Clients towards Employees: A Follow-Up Study

Background: Work-related violence and threats are major problems in many occupations, especially within the human service sector, with consequences at multiple levels, including reduced physical and mental health, increased absenteeism, and reduced organizational commitment. It is, therefore, crucial to identify risk factors for work-related violence and threats. However, only a few studies have examined whether negative acts at work increase the risk of work-related violence and threats from clients toward employees. Objective: To examine the associations between exposure to negative acts towards employees from colleagues, clients, or a combination of both, and the risk of work-related violence and threats perpetrated by clients towards employees in a longitudinal study. Methods: Questionnaire data were collected in 2010, 2011, and 2015. In total, 5333 employees from special schools, psychiatric wards, eldercare, and the Prison and Probation Services participated in the first round of data collection in 2010. Negative acts were measured in 2010 using the Short Negative Acts Questionnaire, while work-related threats and violence were measured at all three-time points. The analyses were performed using multilevel logistic regression. Results: Negative acts from clients and the combination of negative acts from both clients and colleagues were associated with later exposure to work-related violence and threats. The associations were observed after one year, and work-related threats were still present after four years. Conclusion and implications: Negative acts are associated with an increased risk of work-related violence and threats perpetrated by clients toward employees. Organizations may reduce the risk of work-related violence and threats by preventing negative acts

Psychoeducation: perspectives from individuals on sick leave who are at risk of having a mental disorder

The large number of people on sickness and disability benefits due to mental disorders in Denmark has increased the need for improved rehabilitative services to facilitate their return to work. The aim of the present study was to explore the use of psychoeducation in relation to the standard services of a Danish job centre for individuals on sick leave with regard to relevance, elements contributing to recovery, and improvements of psychoeducation as an intervention. Semi-structured interviews were conducted with 16 individuals on sick leave who were at risk of having a mental disorder. The interviews were analysed using systematic text condensation inspired by Giorgi’s phenomenological analysis. The resulting core themes describing psychoeducation with respect to the standard services of the job centre included access and relevance of psychoeducation in relation to the job centre’s standard services, social support, self-care, and psychoeducation intervention. This study concludes that the informants consider psychoeducation a relevant offer to individuals on sick leave who are at risk of having a mental disorder. The relevance of the standard services of the job-centre services was considered to be low. Furthermore, psychoeducation reinforces peer support and inclusion of relatives as elements to aid recovery to a much larger extent than do the standard services of the job centre. In general, the results support the use of psychoeducation in a municipal job-centre setting as a targeted and beneficial offer to individuals on sick leave who are at risk of having a mental disorder