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Although not widely known, public works employees in the United States were designated as emergency providers during critical incidents in 2003 and have provided these public works services, when activated. These public works employees may be either employees of a specific government entity or, more recently, privately contracted employees who provide similar services for a government entity. First responders working critical incidents are at risk for psychological trauma and posttraumatic stress disorder (PTSD). It is less clear, however, whether government/contracted public works employees working the same critical incidents are subject to the same risk of onset. This paper reviewed 24 empirical studies assessing this possible association from 1980 to 2020. These studies included 94,302 government/contracted employees. Psychological trauma/PTSD was reported in all 24 manuscripts assessing PTSD. Three of these studies additionally reporting serious somatic health problems. Public works employees are at risk for onset and this is a worldwide issue. Study findings and treatment implications are presented.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in medical injury, human suffering, and dollar cost expense. International research through 2000–2017 documented the continued frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five-year period of 2017–2022. There were 39,034 assaults on 34,679 employee victims. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s and that nursing personnel continued to be at greater risk. Aggression management approaches, post-incident interventions, and an updated methodological inquiry are presented.

Since the 1960s, empirical research has focused on a better understanding of the characteristics of assaultive psychiatric patients. International research from 1960 to 2017 indicated that male and female patients with schizophrenia and substance use disorder presented the greatest risk for assault with nursing personnel being at higher risk. This present review of studies sought to assess the latest research findings on assaultive patients for the most recent five-year period, 2017–2022. It was hypothesized that patients with schizophrenia and substance use disorders would present the greatest assault risk for nursing personnel. The studies in this review supported this hypothesis. Assaults by patients with schizophrenia and substance abuse has been a consistent finding worldwide for 62 years of published research. Explanations for these findings, the possible role of posttraumatic stress disorder (PTSD) in assaultive patients, and an updated methodological review are presented.

Since the 1960s, empirical research has worked toward a better understanding of the characteristics of assaultive psychiatric patients. International research through 2012 indicated that male and female patients with schizophrenia and other diagnoses presented the greatest risk for assault. This present review of studies that presented raw assault sought to assess the latest research findings on assaultive patients for the most recent 5 year period, 2013–2017. It was hypothesized that male patients with schizophrenia would present the greatest risk. The findings indicated a sharp increase in the total number of reported assault incidents over the proceeding decade. These assaults were committed largely by male patients with a diagnosis of schizophrenia. Explanations for these findings and an updated methodological inquiry are presented.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in human suffering and dollar cost expense. International research through 2012 documented the frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five year period of 2013–2017. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s, even with new policy initiatives in place meant to reduce such violence. Nursing personnel continued to be at greater risk. The findings by continents and an updated methodological inquiry are presented.

In studying psychiatric patient assaults, assessing the person x event x environment interaction is important in enhancing safety and ensuring quality care. Precipitants to patient assaults have traditionally received less attention than the patient characteristics of such assaults. Reviews of inpatient precipitants from 1960 to 2012 noted acute psychosis, denial of services, and substance abuse as commonly occurring precipitants. The present study reviewed the literature on precipitants from 2013 to 2017. A variety of precipitants, including acute psychosis, substance abuse, and denial of services were observed. The literature in this review broke new ground in subjects, methodologies, and precipitants. These new findings and a detailed methodological inquiry are presented.

In international reviews of psychiatric inpatient violence, one study of all types of patient violence found hostility, involuntary admission, and longer hospital stays associated with violence. A second study of comparison-group papers of patient assaults found younger males with schizophrenia, past violence, and substance abuse assaultive. The present review of raw assault data studies assessed characteristics of assaultive patients worldwide. It was hypothesized that patients with schizophrenia would present greatest assault risk. There were three analyses: International/no American studies (reviewed earlier), European studies, and merged International/American studies. Results revealed that male and female patients with schizophrenia, affective disorders, personality disorders, and other diagnoses presented greatest worldwide risk. Results partially support earlier findings. Given that individual institutional studies in this review reported significant assailant characteristics, a second finding is the absence of most of these institutional characteristics in this international review. Possible explanations for findings and a detailed methodological review are presented.

Psychiatric patient assaults on staff are a worldwide occupational hazard that results in human suffering and dollar cost expense. International research in the 1990s documented the frequent occurrence of these assaults. This present paper reviewed the published, international literature on staff victim assaults during the first decade of the new century. The findings indicate assaults on staff remain a serious worldwide issue as it was in the 1990s, even with new policy initiatives in place meant to reduce such violence. The findings by continents and a detailed methodological inquiry are presented.

Previous reviews of the literature from 1976 to 2000 documented two categories of assaultive psychiatric patients: (1) male patients with schizophrenic illness and histories of violence toward others and substance use disorder and (2) male/female patients with personality disorders and histories of violence toward others, personal victimization, and substance use. The present study reviewed the published findings on American assaultive patients from 2000 to 2012. The present findings partially supported the earlier findings in that patients with schizophrenic illness continued to present the greatest risk for assault. However, personality disordered patients were not equal in assault risk to patients with affective disorders. Possible explanations for these findings and a detailed methodological review are presented.

In studying psychiatric patient assaults, assessing the person × event × environment interaction is important in enhancing safety and ensuring quality care. Precipitants to patient assaults have traditionally received less attention than the characteristics of such assaults. A recent review of inpatient precipitants noted acute psychosis, denial of services, and substance abuse as common precipitants in these settings. Even though health care systems are moving toward community-based services, no community studies were included in this inpatient review. The present study reviewed the precipitants reported in community studies internationally from 2000–2012. A variety of community precipitants, including acute psychosis and substance abuse, were obtained. How these community precipitants differ from the inpatient preciptiants and a detailed methodological inquiry are presented.