Healthcare Professionals' Sense-making of Workplace Violence in Psychiatric Inpatient Settings

Violence in mental health inpatient settings affects the safety and psychological well-being of both patients and staff. Research has often focused on incidence and prevention, with less attention to how staff make sense of such experiences. This study explored how healthcare professionals understand and interpret violent incidents within inpatient settings and examined the sense-making processes that shape their emotional responses, coping strategies, and clinical decision-making. In addition, a systematic literature review was conducted to synthesise existing research on how patients, carers, and the public perceive violence in psychiatric inpatient settings, providing important context for the present empirical exploration of staff perspectives. Using a qualitative design, semi-structured interviews were conducted with seven healthcare professionals with experience of violence in mental health inpatient settings. Data were analysed using Interpretative Phenomenological Analysis to explore lived experiences and sense-making. Four key themes were identified: (1) coping, surviving, and the normalisation of violence; (2) navigating organisational failure and institutional betrayal; (3) the emotional and moral weight of violence; and (4) violence as a complex and relational communication. These findings highlight the emotionally and ethically complex processes through which staff attempt to make sense of violence, and suggest potential areas for further inquiry. Participants’ accounts may point to a need to reconsider conventional definitions of violence, to include racial and more subtle forms, and to question models that locate the cause of violence solely within individual psychopathology. The findings tentatively indicate that trauma-informed approaches, reflective practice, and psychologically informed team formulations, may offer valuable avenues for supporting staff. Clinical psychologists, given their roles in leadership and supervision, may be well-placed to contribute. These exploratory findings raise important questions about how inpatient services might begin to address systemic contributors to violence, including staff burnout, institutional culture, and relational breakdowns, to promote safer and more compassionate care environments.