Violence on the rise in mental health wards


In June 2020, the Doctors Union (ASMOF) was contacted by our members at Nepean Hospital Mental Health after two Registrar doctors were assaulted by patients in a short space of time. Not long after, a nurse was also assaulted by a patient. Doctors in training at the site reported that they felt unsafe working in the ward and wanted immediate changes on site to protect them.

Action taken by ASMOF

In response to members’ concerns, ASMOF immediately wrote to management and asked them to formally respond to what actions had been taken to minimise the risk to safety on site. ASMOF received a response from management however it was not clear if specific action had been taken in response to these critical incidents and management proposed a meeting in over one months’ time.

Less than one day after receiving that response, another registrar was assaulted on site.

ASMOF believed that there was a sense of urgency and an imminent risk of violence on site and concrete action was needed. We made a Request for Service (RFS) to SafeWork, the health and safety regulator. In addition, ASMOF also attended the site to conduct a site inspection and with input of staff, ASMOF developed a list of recommendations to improve the safety of the site. The key recommendations included:

  1. Permanent security to be stationed on site
  2. Reconfiguring furniture to ensure that an escape route is not blocked between the patient and the staff member
  3. All JMOs on orientation should be informed of the location of the duress alarms in consult rooms and how to operate them
  4. The duress alarms need to be regularly services and audited to ensure they are working appropriately and remain charged at all times
  5. Extra personal duress alarms should be purchased to ensure that there is never a shortage
  6. Changes to the layout of the facility to ensure to avoid thoroughfare through common rooms where patients can become aggressive
  7. Removal of all equipment etc cluttering consult rooms so that a quick exit can occur if required.

ASMOF has provided a full list of our recommendations to both SafeWork and Nepean management.

Management’s response

In late July 2020, Management committed to assign a security officer to the reception area on a temporary basis and assured the health unions that an audit of the existing security unit would be undertaken to determine:

  • the number of alarms,
  • the battery capacity and;
  • whether there were any spots in the clinical areas that did not have adequate coverage.

In response, ASMOF again called on management to ensure that security was ongoing not just on a temporary basis.

We initially received an extremely inadequate response from the District that additional security would not be made available at the site on an ongoing basis and would only be available during the review of the duress alarms.

Health Unions collectively respond

The concerns around permanent security at this site are shared by ASMOF, NSWNMA and the HSU. Accordingly, the health unions have been meeting regularly to discuss our common concerns and we requested that a meeting be arranged with management of Nepean to address these ongoing safety issues with the three unions.

That meeting was held on 27 August 2020 and in a positive step forward management has indicated that it would consider whether security will be deployed on an ongoing basis - ASMOF will continue to advocate for permanent security given the high levels of violence at this site. It was also discussed whether there may be options for security to wear plainer attire rather than their security uniform (as the uniform may aggravate certain patients). The health unions are also calling for management to ensure that all staff have time to undertake their VPN training in paid work time. Management have now agreed to review the scheduling of the VPN training including for JMOs. Critically, management are also reviewing the alarm system currently in place and have identified concerns regarding response delays which require corrective action. Another meeting will be scheduled to continue these discussions.


Violence in the workplace should never be accepted or considered the norm. It is abundantly clear that more needs to be done at the local level as well as by NSW Health in driving an improved safety culture across hospitals in NSW.

We thank our courageous members and the members of the NSWNMA and HSU for bringing these issues to our attention so that they can be addressed to minimise the risk of violence at this site.

If you experience violence in the workplace, please contact ASMOF so we can address these issues for our members.