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Abstract
The main objective of this study was to identify the factors that differentiate persistently violent patients from less violent patients. Violent incident forms completed between 1980 and 1996 on the Denis Hill Unit, a medium secure unit, at the Bethlem Royal Hospital were analysed. During this period 280 patients were admitted to the unit and of those 165 (59%) had one or more violent incidents recorded against them. Out of a total of 2,180 incidents 1,460 (67%) were accounted for by 18 (6%) of the patients, who each had 25 or more violent incidents during their stay on the Unit. Of these 18 patients, additional background and outcome data were available on 17 patients. The 17 patients were compared with their less violent peers (i.e. those with fewer than 25 violent incidents) using the maximum number of variables that were available for analysis. A stepwise logistic regression revealed three significant variables in the final model. The odds were 5 : 1 against the persistently violent patients having received previous prison sentences, almost 5 : 1 in favour of them being female and 3 : 1 of them having had a history of special education. The findings have important resource and management implications for those persistently violent patients.