Repetitively assaultive psychiatric patients: fifteen-year analysis of the Assaulted Staff Action Program (ASAP) with implications for emergency services.

Research has demonstrated that psychiatric patient's assaults on emergency services personnel providing onsite, prehospital care represent a serious and ongoing nationwide concern. Embedded within these patient assailants is a small group of repeat offenders who present a serious increased risk for assault. This study examined the demographic and clinical variables of repeat offenders over a 15-year period. Included in the sample were patients who were transferred from correctional facilities to mental health facilities and then to the community. The results indicated that older male patients with schizophrenia and younger patients with personality disorders were the more likely to re-offend. The risk of assault was greatly increased if these patients had histories of violence toward others, personal victimization, and substance use disorder. Correction patients did not appear to present any additional risk per se. The significance of the findings and the implications for emergency services personnel are presented.