First Aid for Aggressive Behaviours

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Facts On Aggressive Behaviours

The majority of individuals with mental illnesses do not pose a threat to others. Only a small percentage of violence in society can be attributed to mental illness.

While certain conditions such as substance use disorders, personality disorders or psychosis may have a higher risk of associated with violent behaviour, depression and anxiety do not. Alcohol or drug use is more commonly linked to violent behaviour than mental illness. A significant number of crimes are committed by individuals under the influence.

In cases where violence is committed by someone experiencing psychosis, it is typically driven by a belief that they are acting in self-defence.

How to Assess

Aggression is a complex behaviour that can manifest in different forms, such as verbal aggression (e.g., insults or threats), behavioural aggression (e.g. pounding, throwing things, violating personal space), and emotional aggression (e.g., raised voice, looks angry). Perceptions of aggression can vary among individuals and across cultures. It is essential to take preventive measures and de-escalation actions as soon as aggression is perceived. If you suspect that a person may become aggressive, it is important to take steps to protect yourself and others.

How to Assist

If a person becomes aggressive, it is essential to prioritise your own safety at all times. Try to remain calm and take steps to de-escalate the situation. Take any threats or warnings seriously, particularly if the person believes they are being persecuted. If you feel frightened, seek outside help immediately.

You should never put yourself at risk and always ensure you have access to an exit. If the person’s aggression escalates out of control at any time, you should remove yourself from the situation and call for emergency assistance, such as the mental health crisis team or the police.

If you suspect that the aggression is related to a mental health problem, it may be necessary to call the mental health crisis team. When doing so, it is best to describe the person’s symptoms and behaviours rather than attempting to make a diagnosis on your own. Keep in mind that the crisis team may not attend without a police presence.

If the situation becomes unsafe, involving the police may be necessary. If you suspect that the person’s aggression is related to a mental health problem, inform the police and ask for their help in obtaining medical treatment and controlling the person’s aggressive behaviour.

It is important to note that aggressive behaviour is frequently associated with intoxication with alcohol or another drug. If this is the case, and you decide to call the police, inform them of your belief that the person is intoxicated and what substances you believe have been used. In either case, inform the police if the person is armed or not.

How to De-escalate The Situation

  • Communicate with the individual in a slow and self-assured manner, using a kind and compassionate tone.
  • Avoid responding in a hostile, disciplinary, or confrontational manner.
  • Refrain from engaging in a dispute with the person.
  • Do not intimidate them, as this may heighten fear or provoke aggressive behaviour.
  • Be mindful not to raise your voice or speak too quickly.
  • Be aware that the person may react strongly to negative language; thus, use positive language (e.g., “Remain calm”) instead of negative language (e.g., “Don’t struggle”).
  • Keep a composed attitude and avoid fidgeting or making sudden movements.
  • Do not impede the person’s movement, such as if they wish to walk around the room.
  • Be cognisant that the person’s symptoms or fear may exacerbate their aggression if certain actions are taken, such as involving law enforcement.
  • Consider taking a break from the conversation to give the person time to calm down.
  • Think about inviting the person to sit if they are standing.
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