Video recording in the assessment of violent incidents in psychiatric hospitals.

Research into causes and management of aggressive behavior in mental illness has been hampered by difficulties related to the accurate detection, description, and classification of aggression. Much aggressive behavior, particularly verbal aggression, is unreported or reported inaccurately. We describe the use of video surveillance to study aggression in psychiatric inpatients. The videos supplement or correct eyewitness accounts, accurately identifying aggressors and victims, as well as specific aggressive behaviors. Video has provided a tool for studying behavioral precursors and environmental catalysts of assaults. These observations have contributed to our efforts to create a typology of aggression based on underlying causes. Furthermore, video has played a direct role in clinical care, documenting or revealing medication side effects, as well as feigned or self-induced injuries. The ethical and responsible use of video surveillance of psychiatric inpatients has the potential to enhance our understanding and treatment of aggression.