Exposure to Aggression and the Impact on Staff in a Child and Adolescent Inpatient Unit Angela J. Dean, Peter Gibbon, Brett M. McDermott, Tim Davidson, and James Scott Aggression is common in mental health services, but little research has exam- ined exposure to aggression and its impact on staff in children and adolescent settings. Staff members within a child and adolescent psychiatric inpatient unit were interviewed to examine exposure to aggression and perceptions about the impact of aggression. Involvement in episodes of physical aggression was common (84.8%, 28/33) and was linked to difficulty attending work and other emotional and professional sequelae. These findings suggest that aggression is an important issue for staff working in child and adolescent settings and that aggression may impair the therapeutic capacity of staff. © 2010 Elsevier Inc. All rights reserved. O VERT AGGRESSIVE BEHAVIORS are one of the most common reasons for referral to child and adolescent mental health services (Connor, Melloni, & Harrison, 1998; Dean, Duke, George, & Scott, 2007; Garrison et al., 1990). Episodes of aggression are also common during admission to child and adolescent psychiatric inpatient units (Connor et al., 1998; Garrison et al., 1990; Sukhodolsky, Cardona, & Martin, 2005; Vivona et al., 1995). Research conducted in largely adult services suggests that a large proportion of psychiatric nurses are exposed to aggression at work and that aggression during admission can threaten staff safety and impair professional functioning (Baxter, Hafner, & Holme, 1992; Inoue, Tsukano, Muraoka, Kaneko, & Okamura, 2006; Nijman, Bowers, Oud, & Jansen, 2005; Soares, Lawoko, & Nolan, 2000). Little research has examined the impact of exposure to aggression in staff working within child and adolescent inpatient units. We aimed to examine exposure to aggression in staff within a child and adolescent inpatient psychiatric unit and explore staff perceptions about the impact of aggressive behaviors. BACKGROUND Aggression in Children and Adolescents Aggressive behavior is one of the most common symptoms in child and adolescent mental health services and may contribute to poor educational achievement, reduced employment, social isolation, violence, crime, and suicide (Bor, 2004; Connor et al., 1998; Dean et al., 2007; Masters et al., 2002). Aggression is heterogeneous and has been defined as any behavior that is destructive to self, others, or property (Connor et al., 2006). The type of Available online at www.sciencedirect.com From Kids in Mind Research, Mater Child and Youth Mental Health Service, South Brisbane QLD, Australia; Department of Psychiatry, School of Medicine, University of Queensland, Australia; Mater Child and Youth Mental Health Service, South Brisbane QLD, Australia; and Child & Youth Mental Health Service, Royal Children's Hospital, Herston QLD, Australia. Corresponding Author: Angela J. Dean, PhD, Kids in Mind Research, Mater Child and Youth Mental Health Service, South Brisbane QLD 4101, Australia. E-mail address: angela.dean@mater.org.au © 2010 Elsevier Inc. All rights reserved. 0883-9417/1801-0005$34.00/0 doi:10.1016/j.apnu.2009.01.002 Archives of Psychiatric Nursing, Vol. 24, No. 1 (February), 2010: pp 15–26 15