Should patients who assault staff be prosecuted?

This article discusses the issue of prosecution of mentally disordered patients particularly in relation to assaults or acts of violence in health care settings. The arguments for prosecuting those responsible for committing acts of dangerous behaviour are discussed, as are the arguments against prosecution and some of the possible reasons why this is a contentious area of discussion. There are significant risks to the integrity of mental health services if the consideration of prosecution as a strategy to reduce risk of violence in hospitals does not become an area of meaningful discussion at all levels. The risk of violence is real, but the risks of accepting it without taking measures to reduce the frequency or severity of violence is no less acceptable than accepting that burglary is inevitable and leaving one's front door ajar every day. Health care professionals may wish to consider that in the absence of a clinically based solution or ownership of the problem, the risk of an organizational response to this sensitive area, perhaps guided or driven by political concerns is likely, as has happened in areas such as risk assessment, treatability and compliance with treatment.