International precipitants to psychiatric patient assaults in community settings: review of published findings, 2000-2012.

In studying psychiatric patient assaults, assessing the person × event × environment interaction is important in enhancing safety and ensuring quality care. Precipitants to patient assaults have traditionally received less attention than the characteristics of such assaults. A recent review of inpatient precipitants noted acute psychosis, denial of services, and substance abuse as common precipitants in these settings. Even though health care systems are moving toward community-based services, no community studies were included in this inpatient review. The present study reviewed the precipitants reported in community studies internationally from 2000-2012. A variety of community precipitants, including acute psychosis and substance abuse, were obtained. How these community precipitants differ from the inpatient preciptiants and a detailed methodological inquiry are presented.