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Essays About Violence: Top 5 Examples and 7 Prompts

Violence is a broad topic and can be sensitive for many; read our guide for help writing essays about violence.

The world has grown considerably more chaotic in recent decades, and with chaos comes violence. We have heard countless stories of police brutality, mass shootings, and injustices carried out by governments; these repeating occurrences show that the world is only becoming more violent.

Violence refers to the use of physical force so as to injure, abuse, damage, or destroy . From punching a friend due to disagreement to a massacre of innocent civilians, a broad range of actions can be considered violent. Many say that violence is intrinsic to humanity, but others promote peace and believe that we must do better to improve society.

If you are writing essays about violence, go over the essay example, and writing prompts featured below. 

Are you looking for more? Check out our guide packed full of transition words for essays .

1. Videogames, Violence, and Vulgarity by Jared Lovins

2. street culture, schools, and the risk of youth violence by lorine hughes, ekaterina botchkovar, olena antonaccio, and anastasiia timmer, 3. violence in media: no problem or promotes violence in society by albert miles, 4. my experience of domestic violence by ruth stewart, 5. a few thoughts about violence by jason schmidt, writing prompts on essays about violence, 1. what is violence, 2. different types of violence, 3. can social media cause people to be violent, 4. is violence truly intrinsic to humankind, 5. causes of violence, 6. violence among the youth, 7. race-based violence.

“Parents allow themselves to be ignorant of the video games their children are playing. Players allow themselves to act recklessly when they believe that playing video games for ten, twenty, or even thirty hours on end won’t have an adverse effect on their mental and physical health. People allow themselves to act foolishly by blaming video games for much of the violence in the world when in truth they should be blaming themselves.”

Lovins discusses the widespread belief that video games cause violence and ” corrupt our society.” There is conflicting evidence on this issue; some studies prove this statement, while others show that playing violent video games may produce a calming effect. Lovins concludes that it is not the games themselves that make people violent; instead, some people’s mental health issues allow the games to inspire them to commit violence.

“The risk of violence was not higher (or lower) in schools with more pervasive street culture values. Higher concentrations of street culture values within schools did not increase the likelihood of violence above and beyond the effects of the street culture values of individual students. Our results also showed that attending schools with more pervasive street culture values did not magnify the risk of violence among individual students who had internalized these same values.”

In this essay, the authors discuss the results of their study regarding “street culture” and violence. Street culture promotes toughness and dominance by using “physical force and aggression,” so one would think that students who embrace street culture would be more violent; however, the research reveals that there is no higher risk of violent behavior in schools with more “street culture”-following students. 

“We have had a violent society before media was even around, and violence is just in our nature as human beings. Those who happen to stand against this are deceived by society, due to the fact that we live in a dangerous world, which will stay this way due to the inability to create proper reasoning.”

Miles writes about people blaming the media for violence in society. He believes that government media regulations, including age-based ratings, are sufficient. If these restrictions and guidelines are taken seriously, there should be no problem with violence. Miles also states that violence has existed as long as humankind has, so it is unreasonable to blame the media. 

“It was when I was in the bath, and I looked down at my body and there were no bruises on it. None at all. I was shocked; it was the first time I had lived in a non-bruised body in many years. I don’t know if any other women who got out of violent situations felt their moment. The point at which they realised it was over, they could now get on with recovering. I promised myself that I would never stay with a violent partner ever, ever again. I have kept that promise to myself.”

Stewart reflects on her time with an ex-boyfriend who was violent towards her. Even though he kept hitting her, she stayed because she was used to it; her mother and stepfather were both violent during her childhood. Thankfully, she decided to leave and freed herself from the torture. She promises never to get into a similar situation and gives tips on avoiding staying with a violent partner. 

“I went back and replayed the burglar scenario in my head. Suppose I’d had a gun. When would I have pulled it? When he ran out of the apartment? What were the chances I would have killed him in a panic, without ever knowing he was armed? Stupidly high. And for what? Because he tried to steal someone’s TV? No.”

In his essay, Schmidt recalls an instance in which a man pulled a gun on him, threatening him with violence. He chased a burglar down the street, but the burglar pulled a gun on him, leaving him stunned and confused enough to escape. Schmidt was so bothered by the incident that he got his own concealed carry permit; however, after reading statistics regarding gun accidents, he decided to reject violence outright and pursue peace. 

As stated previously, violence is quite a broad topic, so it can be challenging to understand fully. Define the word violence and briefly overview some of its probable causes, how it manifests itself, and its effects. You can also include statistics related to violence and your own opinions on if violence is a good or bad thing. 

Essays About Violence: Different types of violence

There are many types of violence, such as domestic violence, gun violence, and war. List down the commonly occurring forms of violence and explain each of them briefly. How are they connected, if they are? To keep your essay exciting and readable, do not go too in-depth; you can reserve a more detailed discussion for future essays that are specifically about one type of violence.  

Social media is quite explicit and can show viewers almost anything, including violent content. Some sample essays above discuss the media’s effect on violence; based on this, is social media any different? Research this connection, if it exists, and decide whether social media can cause violence. Can social media-based pressure lead to violence? Answer this question in your essay citing data and interview research.

Many argue that humans are innately violent, and each of us has an “inner beast.” In your essay, discuss what makes people violent and whether you believe we have tendencies towards violence. Be sure to support your points with ample evidence; there are many sources you can find online. 

Violence arises from many common problems, whether it be depression, poverty, or greed. Discuss one or more causes of violence and how they are interconnected. Explain how these factors arise and how they manifest violence. With an understanding of the causes of violence, your essay can also propose solutions to help prevent future violence.

Youth violence is becoming a more severe problem. News of school shootings in the U.S. has set public discourse aflame, saying that more should be done to prevent them. For your essay, give a background of youth violence in the U.S. and focus on school shootings. What motivates these school shooters?  Give examples of children whose upbringing led them to commit violent acts in the future

Another issue in the U.S. today is race-based violence, most notably police brutality against African-Americans. Is there a race issue in policing in America? Or do they target offenders regardless of race? Can both be true at the same time? You decide, and make sure to explain your argument in detail. 

If you’d like to learn more, in this guide our writer explains how to write an argumentative essay .Grammarly is one of our top grammar checkers. Find out why in this Grammarly review .

introduction about violence essay

Martin is an avid writer specializing in editing and proofreading. He also enjoys literary analysis and writing about food and travel.

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How To Craft a Top-Tier Violence Essay Easy-Peasy

violence essay

Are you looking forward to a straight A-grade in your violence essay assignment?

Well, use our excellent writing prompts and expert tips below.

Definition of an Essay About Violence

As the name suggests, this is a writing piece that seeks to present an author’s argument on violent activities in society. Such an essay may contain one of the following aspects:

  • Intentional use of physical force
  • Emotional abuse
  • Self-violence

These actions may result in any of the effects mentioned below:

  • Psychological harm
  • Deprivation
  • Mal-development

Now that we are well-informed on the topic let us explore the structure of essays on violence.

Outline of an Essay on Violence

The sensitivity of such a paper requires maximum precision on the part of the student. The diction, format, style, and general outline will play a vital role in the delivery of your essay.

Let’s brush through the main parts of your future essays about violence:

Introduction: Present the issue at hand (force), its importance, and why your reader should pay attention. The thesis statement will appear here to give the focus of the paper. Body: In this section, develop your argument present in the intro with convincing facts and examples. Ensure that the topic sentences of your paragraphs answer the thesis statement. Conclusion: Reiterate the most important evidence supporting the arguments as a reminder to your reader. You can have a call-to-action in this section, which may be a warning against the perpetrators of violence or how to report a case of abuse.

Remember that violence can take different forms. Thus, it would help if you endeavored to address the way you chose in detail to feed the reader’s curiosity as much as possible.

Now, let’s take a look at some violence essay samples.

Violence Against Women Essay To many, it remains remarkable that violence against women persists in modern, Western cultures. Women have achieved a great deal of equality, if mainly legal, which in turn supports shifting social thinking that condemns the violence. In plain terms, it makes little sense that society should still in some way enable the abuses. However, sociological theories help to clarify the issue just as Western logic does little to defy or address the violence. It may in fact be, for example, that the abuse was lesser in a past when women enjoyed fewer freedoms, and because men did not perceive them as threats to masculine authority. Not unexpectedly, any patriarchy enables the violence, just males tend to be increasingly dominant when women seek independence (McDermott, Cowden, 2014, p. 1768). This then reinforces that male resentment is likely an influence in abuse of women. As men feel increasingly challenged, they will then use their generally superior physicality to punish such women, and the patriarchal society adds an exponential effect; more exactly, the more women suffer violence, the more the violence is supported as a norm. Then, given the complex nature of the highly developed patriarchy, other elements impact on the subject. An important factor of the subject is that, in Western and other cultures, violence against women is usually intergenerational. This in turn reinforces the impacts of observational learning; in families or in social arenas, societies often support the violence (Michalski, 2004, p. 658). If it is often challenged or condemned, the greater reality is that male dominance is so deeply embedded in a culture like the American, it essentially exists as an intensely powerful force. Despite advances in women’s movements and activism, it must be remembered that this goes back only a few decades. This equates to men holding great power for long centuries, and a trait in any population holding power is a disinclination to surrender any. These traditions then link to the male’s as having the “right” to abuse women as they choose, just as sexual violence against women is still extremely common. Times have changed but it takes a great deal to reverse ethics and gender values so implanted in the culture. Moreover, such changes, again, rely on a male willingness to alter male perceptions. This is unlikely. In plain terms, American men have traditionally enjoyed the socially supported validation of abusing women, which reality has long existed with marriage and external to it. This may be supported by how, today, campus sexual violence and date rape remain at high levels. Little more may be expected in a society that has so long perceived women property. It may then be wondered why changing laws offer minimal protection for female victims of violence. This, however, suggests a reverse logic. Laws of themselves rarely impact on society unless that society is insisting on the law. The U.S., for example, may enact severe penalties on men who abuse women. As noted, many such laws exist. Nonetheless, the current administration strongly reflects gender value which may easily be described as blatantly sexist, which in turn promotes the male empowerment to abuse. Legislation is then no answer unless the society radically revises its views of gender roles. It is true that women today have opportunities to empower themselves to unprecedented degrees. Even this, however, is relatively meaningless in a patriarchy determined to retain its authority. As long as the society’s control largely rests in male hands, then, it is the tragic reality that violence against women will be ongoing. This also reflect how, generally speaking, males who are violent or abusive so often support one another. As noted, then, the answer is not legal; rather, it lies within the culture’s ability to redefine itself.
Domestic Violence Essay Sample Domestic violence is prevalent throughout the world, including Northern America. While the victims may include men, women are by far the most common targets. There are several types of domestic violence, which in turn often lead to a deadly cycle of violence with other, external factors that often play a large role and greatly influence domestic violence, such as patriarchy and power. Fear is perhaps the most basic element in regards to domestic violence, as it is at the core of how most perpetrators attempt to control their victim(s). Fear can be created either explicitly or implicitly, and can be given off through merely a subtle look or gesture. Additionally, one may possess weapons to create fear, destroy another’s property, or show any type of behavior that would intimidate their victim (Johnson, 2008). Intimidation can include a number of different tactics, such as destroying things, handling weapons, raising one’s voice, or hostile treatment overall towards the victim. A perpetrator may even drive recklessly with the victim in the car, or harass him or her at their workplace. Additionally, they may intimidate through communication, such as texting or emailing. Intimidating communication also extends to verbal abuse, which can cause great damage in the victim (Johnson, 2008). Screaming, putting down the other, swearing, or deriding someone are all part of verbal abuse, and is often a precursor to physical abuse (Johnson, 2008). Physical abuse is often a form of domestic violence, and includes measures such as slapping, hitting, pushing, shoving, strangling, hair pulling, and others. Additionally, physical abuse can also encompass the use of weapons. Physical abuse may also, in a less obvious sense, include threats to destroy the other’s possessions, and thus ranges from lack of consideration, to permanent injury or even death (Wilson, 2009). Emotional abuse is perhaps the most common type of domestic violence. This includes any behavior that purposely undermines another’s confidence, thus leading the victim to believe that they are stupid, useless, a ‘bad person,’ or even that the victim is insane (Wilson, 2009). This type of domestic violence can have long lasting consequences, as it demeans and degrades the victim. The perpetrator can also threaten the victim with harm, along with threatening their family. They may even threaten to commit suicide, or use the silent treatment as a form of emotional abuse (Johnson, 2008). Other forms of domestic violence include sexual abuse and domestic homicide. Sexual abuse includes any unwanted advances or sexual behaviors, such as rape, forcing the other to perform sexual acts that are either painful or humiliating, or even causing injury to the other’s sexual organs (Johnson, 2008). In addition, domestic homicide is not extended to only the partner, but also the children. This is, sadly, often a result of ongoing domestic violence that leads to a culmination of killing the other (Wilson, 2009). Domestic violence often follows a common pattern, or cycle. While every relationship varies, they typically undergo similar events based on three parts: the tension building phase, an acute battering episode, and the honeymoon phase. These can all occur in one day, or they may be spread out over a period of months. In the tension-building phase, tension will rise over common, smaller issues, such as money or jobs. Then the verbal abuse may begin, in which the victim tries to please the abuser, and may even give into a form of abuse (Johnson, 2008). The verbal abuse usually escalates to physical abuse at this point. The second phase is the acute battering episode, in which tension peaks and physical violence ensues. This is most often triggered not by the victim’s behavior, but by the abuser’s own emotional state. The last phase is the honeymoon phase, in which the tension has been released. The abuser will become ashamed of their behavior at this point, and try to make amends or either blame the partner for the abuse. The abuser may also try to be kind and loving at this point, and exhibit uncharacteristic helpfulness (Johnson, 2008). Often, the abuser will try to convince the victim that it will not happen again, and thus the victim will not want to leave the relationship. This cycle of abuse can occur over and over again, as the relief gained and promises made during the honeymoon phase provide the abused victim with the false belief that they and their partner are ‘ok.’ There are other, less obvious factors that also greatly influence domestic violence and aid in analyzing violence against women, such as patriarchy, power, and systemic gender oppression, which are deeply entrenched into societies and cultures worldwide. Systemic gender oppression refers to violence against women, which may be carried out not only by romantic partners, but also within communities, civic, and legal institutions. Perpetrators may unconsciously endorse physical abuse as a result of systemic gender oppression (“Patriarchy,” 2015). This is closely tied to the influence of patriarchy towards domestic violence, which refers to the social relations between women and men. Patriarchy is a means of sustaining gender, racial, or class privileges over another, which may be outright, such as violence, or subtle, like the formation of laws, which perpetuate gender inequality. Patriarchy, in this way, is a structural force that sways the relations between men and women (“Patriarchy,” 2015). Additionally, power often sets the course for patriarchy. Often, abusers will combine their masculinity with entrenched feelings of patriarchy, thus making the cycle of abuse more severe (“Patriarchy,” 2015). As a result, power forms relationships based on only one of the individuals maintaining the authority, while the other is at their mercy. Culture and racial oppression are two other factors that come into play when analyzing domestic violence against women. Culture is often utilized to rationalize gender inequality and, consequently, violence, by integrating cultural beliefs as to how women must or should be treated (“Patriarchy,” 2015). When the defense of a place, particular society or culture, religion, or country are integrated into justifying one’s belief on the maltreatment of women, this is also a defense of the culture of patriarchy within said entity. This is closely related to the factor of racial oppression in domestic violence against women. Studies have shown that men of color typically overemphasize how racial oppression influences violence towards women. Additionally, race and gender often overlap within this realm; however, race is “all too often privileged over gender” (“Patriarchy,” 2015). In summary, domestic violence comes in many shapes and forms, which often form a pattern, or cycle of violence. Domestic violence, in turn, can be greatly influenced by other external factors, such as power, patriarchy, culture, and racial oppression, as discussed. Sadly, domestic violence is not merely a result of an individual’s own behavioral issues, but also an offshoot of the implicit and explicit ways that societies and cultures influence the relationships between men and women.

So, what are some of the writing prompts that you can use for such kind of paper? Read on.

Essay on Violence in Society

The society has become a scary world with recent happenings. Here are some prompts for your inspiration:

  • Causes of violence in society
  • The impact of crime on teenagers
  • Forms of violence between nations
  • Organizational abuse and how to deal with it
  • People don’t just become evildoers in society
  • Violence and genetic inheritance: What is the connection?
  • Development of aggression in a person
  • Age and violence: Which is the most aggressive age?
  • A power fueled society is a violent society. Discuss
  • How the crave for knowledge cause violence

Gun Violence Essay Topics for High School Students

Below are some great ideas that high school students can use for their essay on gun violence assignment:

  • How to reduce school gun violence
  • Traumatic experiences of gunfire and killings in schools
  • Gun violence amongst adolescents in high schools
  • Gang violence groups in schools
  • How teachers can contribute to a reduction in gun violence in school
  • Should gun control be introduced in the high school curriculum?
  • The role of peer provocation
  • Parenting practices to reduce gun violence
  • Schoolyard bullying and gun violence
  • How troubled teens end up with guns

Gun Violence in America Essay

Are you stuck on your essay on gun violence in America? Well, here are some professional ideas to get you jam-started:

  • Political debates and gun control in America
  • Gun violence in poor American urban cities
  • The rise of highly organized mass killings in America
  • Post 9/11 gun control measures
  • Who is to blame for gun violence in America?
  • Victims of gun attacks in the US
  • Gun control policies
  • Social issues in the US lead to gun violence
  • Security measures in the US
  • Justice for victims

General Essays About Gun Violence

  • Mental health
  • Human trafficking
  • Domestic violence
  • Gun control laws
  • Religious violence
  • Gang violence
  • Education on gun control
  • Role of psychiatric services
  • Prediction of gun violence
  • The purpose of the National Rifle Association

From the insights, violence is indeed both an individual and societal issue of concern. Therefore, writing on such a topic needs extensive research and elaborate facts.

Do you still have a question on domestic, mental, school, or gun violence essays? Our professional custom writing help is all you need! Just tell us your writing need, and we will do the rest for you!

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National Academies Press: OpenBook

Preventing Violence Against Women and Children: Workshop Summary (2011)

Chapter: 1 introduction.

1 Introduction

Violence against women and children is a serious public health concern, with costs at multiple levels of society. Although violence is a threat to everyone, women and children are particularly susceptible to victimization because they often have fewer rights or lack appropriate means of protection. In some societies certain types of violence are deemed socially or legally acceptable, thereby contributing further to the risk to women and children.

In the past decade research has documented the growing magnitude of such violence, but gaps in the data still remain. Victims of violence of any type fear stigmatization or societal condemnation and thus often hesitate to report crimes. The issue is compounded by the fact that for women and children the perpetrators are often people they know and because some countries lack laws or regulations protecting victims. Some of the data that have been collected suggest that rates of violence against women range from 15 to 71 percent in some countries and that rates of violence against children top 80 percent (García-Moreno et al., 2005; Pinheiro, 2006). These data demonstrate that violence poses a high burden on global health and that violence against women and children is common and universal.

On January 27-28, 2011, the Institute of Medicine’s Forum on Global Violence Prevention convened its first workshop to explore the prevention of violence against women and children. Part of the forum’s mandate is to engage in multisectoral, multidirectional dialogue that explores crosscutting approaches to violence prevention. To that end, the workshop was designed to examine these approaches from multiple perspectives and at multiple levels of society. In particular, the workshop was focused on

exploring the successes and challenges presented by evidence-based preventive interventions and examining the possibilities of scaling up or translating such work in other settings. Speakers were invited to share the progress and outcomes of their work and to engage in dialogue exploring gaps and opportunities in the field.

The workshop was planned by a formally appointed committee of the Institute of Medicine (IOM), the members of which created an agenda and identified relevant speakers. Because the topic is large and the field is broad, presentations at this event represent only a sample of the research currently being undertaken. Speakers were chosen to present a global, balanced perspective, but by no means a comprehensive one. The agenda for this workshop can be found in Appendix A .

ORGANIZATION OF THE REPORT

This summary provides a factual account of the presentations given at the workshop. Opinions expressed within this summary are not those of the Institute of Medicine, the forum, or its agents, but rather of the presenters themselves. Statements are the views of the speakers and do not reflect conclusions or recommendations of a formally appointed committee. This summary was authored by a designated rapporteur based on the workshop presentations and discussions and does not represent the views of the institution, nor does it constitute a full or exhaustive overview of the field.

The workshop summary is organized thematically, covering the major topics that arose during the two-day workshop, so as to provide a larger context for these issues in a more compelling and comprehensive way. As well, the thematic organization allows the summary to serve as an overview resource of important issues in the field. The themes were chosen as the most frequent, cross-cutting, and essential elements that arose from the workshop, but do not represent the views of the IOM or a formal consensus process.

The summary begins with a brief introduction of the issue, followed by two parts and an appendix. The first part consists of four chapters that provide the summary of the workshop; the second part of the report consists of submitted papers and commentary from speakers regarding the substance of the work they presented at the workshop. These papers were solicited from speakers to provide further information of their work. The appendix contains additional information regarding the agenda and participants.

DEFINITIONS AND CONTEXT

Violence is defined by the World Health Organization as “the intentional use of physical force or power, threatened or actual, against oneself,

another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation” (WHO, 2002). When directed against women or children, this violence can take a number of forms, including, but not limited to, sexual violence, intimate partner violence, child abuse and neglect, bullying, teen dating violence, trafficking, and elder abuse. The majority of violence against women and children is perpetrated by partners, family members, friends, or acquaintances, so that most violence against women and children takes place in the form of intimate partner violence, family violence, or school violence (WHO and LSHTM, 2010).

These three types of violence, which are interconnected, are commonly referred to as being part of a “cycle of violence,” in which victims become perpetrators. The workshop’s scope was narrowed to focus on these elements of the cycle as they relate to interrupting this transmission of violence. Intervention strategies include preventing violence before it starts as well as preventing recurrence, preventing adverse effects (such as trauma or the consequences of trauma), and preventing the spread of violence to the next generation or social level. Successful strategies consider the context of the violence, such as family, school, community, national, or regional settings, in order to determine the best programs. Thus, the workshop operated in a multidimensional framework that integrated ecologic, public health, and trauma-informed paradigms to explore a comprehensive approach to violence prevention.

The next four chapters examine the four major themes that arose from participants’ presentations and discussions: advancing research on co-occurrence of child maltreatment and intimate partner violence ( Chapter 2 ), paradigm shifts and changing social norms ( Chapter 3 ), the state of prevention research in low- and middle-income countries ( Chapter 4 ), and prevention among multiple sectors ( Chapter 5 ). The three chapters in Part 2 include the submitted papers, organized as (1) overviews of evidence, (2) global partnerships and government initiatives, and (3) examples of preventive interventions.

And finally the appendixes consist of the agenda (A), the speakers’ biographies (B), the planning committee members’ biographies (C), and the Forum on Global Violence Prevention members’ biographies (D).

ACKNOWLEDGMENTS

The Forum on Global Violence Prevention was established to address a need to develop multisectoral collaboration amongst stakeholders. Violence prevention is a cross-disciplinary field, which could benefit from increased dialogue between researchers, policy makers, funders, and practitioners. The forum members chose the issue of violence against women and children

as the forum’s first workshop theme because there is a pressing need to coordinate and collate the information in this area. As awareness of the insidious and pervasive nature of these types of violence grows, so too does the imperative to mitigate and prevent.

A number of individuals contributed to the successful development of this workshop and report. These include a number of Institute of Medicine staff: Tessa Burke, Marton Cavani, Rosemary Chalk, Kristen Danforth, Meg Ginivan, Wendy Keenan, Patrick Kelley, Angela Mensah, Elena Nightingale, Kenisha Peters, Lauren Tobias, Julie Wiltshire, and Jordan Wyndelts. The forum staff, including Deepali Patel, Rachel Pittluck, and Rachel Taylor, also put forth considerable effort to ensure this workshop’s success. The staff at the Kaiser Family Foundation’s Barbara Jordan Conference Center and Mind & Media provided excellent support for the live event and its webcast.

The planning committee contributed several hours of service to develop and execute the agenda, with the guidance of the forum membership. Reviewers also provided thoughtful remarks in the reading of the draft manuscript.

These efforts would not be possible without the work of the forum membership itself, an esteemed body of individuals dedicated to the concept that violence is preventable. Their names and biographies can be found in Appendix D .

And finally, the overall successful functioning of the forum and its activities rests on the foundation of its sponsorship. Financial support for the Forum on Global Violence Prevention is provided by the U.S. Department of Health and Human Services: Administration on Aging, Office of Women’s Health; Anheuser-Busch InBev; Avon Foundation for Women; BD (Becton Dickinson, and Company); Catholic Health Initiatives; Centers for Disease Control and Prevention; Department of Education: Office of Safe and Drug-Free Schools; Department of Justice: National Institute of Justice; Fetzer Foundation; F. Felix Foundation; Foundation to Promote Open Society; Kaiser Permanente; National Institutes of Health: National Institute on Alcoholism and Alcohol Abuse, National Institute on Drug Abuse, Office of Research on Women’s Health, John E. Fogarty International Center; Robert Wood Johnson Foundation; and the Substance Abuse and Mental Health Services Administration.

García-Moreno, C., C. Watts, M. Ellsberg, L. Heise, and H. A. F. M. Jansen. 2005. WHO Multi-country Study on Women’s Health and Domestic Violence against Women. Geneva, Switzerland: World Health Organization.

Pinheiro, P. S. 2006. Report of the independent expert for the United Nations study on violence against children. New York: United Nations.

WHO (World Health Organization). 2002. World report on violence and health. Geneva, Switzerland: World Health Organization.

WHO and LSHTM (London School of Hygiene and Tropical Medicine). 2010. Preventing intimate partner and sexual violence against women: Taking action and generating evidence. Geneva, Switzerland: World Health Organization.

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Violence against women and children is a serious public health concern, with costs at multiple levels of society. Although violence is a threat to everyone, women and children are particularly susceptible to victimization because they often have fewer rights or lack appropriate means of protection. In some societies certain types of violence are deemed socially or legally acceptable, thereby contributing further to the risk to women and children. In the past decade research has documented the growing magnitude of such violence, but gaps in the data still remain. Victims of violence of any type fear stigmatization or societal condemnation and thus often hesitate to report crimes. The issue is compounded by the fact that for women and children the perpetrators are often people they know and because some countries lack laws or regulations protecting victims. Some of the data that have been collected suggest that rates of violence against women range from 15 to 71 percent in some countries and that rates of violence against children top 80 percent. These data demonstrate that violence poses a high burden on global health and that violence against women and children is common and universal.

Preventing Violence Against Women and Children focuses on these elements of the cycle as they relate to interrupting this transmission of violence. Intervention strategies include preventing violence before it starts as well as preventing recurrence, preventing adverse effects (such as trauma or the consequences of trauma), and preventing the spread of violence to the next generation or social level. Successful strategies consider the context of the violence, such as family, school, community, national, or regional settings, in order to determine the best programs.

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National Collaborating Centre for Mental Health (UK). Violence and Aggression: Short-Term Management in Mental Health, Health and Community Settings: Updated edition. London: British Psychological Society (UK); 2015. (NICE Guideline, No. 10.)

Cover of Violence and Aggression

Violence and Aggression: Short-Term Management in Mental Health, Health and Community Settings: Updated edition.

2 introduction, 2.1. the need for a violence and aggression guideline.

The need for a guideline focused on the short-term management of violence and aggression in mental health, health and community settings arises because violence and aggression are relatively common and have serious consequences in such settings ( Bourn et al., 2003 ; Flood et al., 2008 ). The prevention and management of violence and aggression are complex tasks, because their manifestation will depend on a combination of intrinsic and extrinsic factors as well as the setting and context in which it occurs.

The intrinsic factors are a combination of personality characteristics, current intense mental distress and problems in dealing with anger. The extrinsic factors are more varied, including the physical and social settings where violence and aggression occur, the attitudes of those whose behaviour is violent or aggressive, characteristics of the victims, the experience and training of health and social professionals, and the perceived risk of danger to others. Understanding how such variable contextual factors interact with historical behaviour in the aetiology of violence and aggression is important in informing evidence-based approaches to the prevention of violence and aggression that would otherwise emerge, and also in the management of violence and aggression that has already occurred or is still in progress ( Dack et al., 2013 ). In preparing this guideline, the GDG was also aware of a number of preconceptions regarding the perceived relative and absolute dangerousness of certain groups of service users, particularly those with severe mental illness such as psychotic disorders ( Walsh et al., 2002 ). It is therefore particularly important to distinguish from the outset between the ‘problem’ of violence and aggression, and the care of those often-distressed individuals who may exhibit violent or aggressive behaviour.

In the NHS there are currently several general policies that are difficult to integrate because of variability in the contexts within which violence and aggression may emerge. While the management of violence and aggression is a core component of criminal justice systems, it has not generally been at the heart of systems for health and social care, which have instead tended to emphasise ‘zero tolerance’ approaches ( Bourn et al., 2003 ). This approach is anomalous because the impact of violence and aggression in mental health, health and community settings is significant and diverse, adversely affecting the health and safety of service users, carers and staff ( NICE, 2005 ). Critically, the management of violence and aggression may itself be hazardous to those exhibiting violent or aggressive behaviour and accentuate risks to their health and safety ( Nissen et al., 2013 ).

The consequences of violence and aggression in mental health, health and community settings are not confined to the immediate environment, but have an impact on the wider health and social care economy (for example, costs of secure care for service users), and the economy in general (for example, sickness absence for staff) ( Flood et al., 2008 ). Incidences of violence and aggression may also affect the perception by staff of services and service users in a manner that has a strong negative impact on the overall experience of care ( De Benedictis et al., 2011 ).

If imminent violence is anticipated, its overt manifestations maybe avoided and non-restrictive interventions suffice. However, complete avoidance of violence is impossible and so a graded set of preferably evidence-based interventions is needed to prevent minor violence from escalating into major violence. For recommendations about interventions, NICE guidelines rely primarily on the results of randomised controlled trials (RCTs) in providing the underpinning evidence. However, because of the risks associated with severe violence, it is often not possible to carry out RCTs and, although there have been significant developments in this field since the previous guideline was published in 2005, it is likely that many recommendations will be based on expert opinion of the GDG.

2.2. DEFINITIONS OF VIOLENCE AND AGGRESSION

For the purposes of this guideline, violence and aggression refer to a range of behaviours or actions that can result in harm, hurt or injury to another person, regardless of whether the violence or aggression is behaviourally or verbally expressed, physical harm is sustained or the intention is clear.

Definitions of violence and aggression usually include some combination of the following elements: an expression of energy that may be goal directed; an immoral, repulsive and inappropriate behaviour; the intention to harm, damage or hurt another person physically or psychologically; the intention to dominate others; the experience and expression of anger; defensive and protective behaviour; verbal abuse, derogatory talk, threats or non-verbal gestures expressing the same; the instrumental use of such threats to acquire some desired goal; damage to objects or the environment, from vandalism through to smashing of windows, furniture and so on; attempting to or successfully physically injuring or killing another person with or without the use of weapons, or forcing another to capitulate to or acquiesce in undesirable actions or situations through the use of force; and inappropriate, unwanted or rejected sexual display or contact.

The number of definitions in circulation are so great that they have been combined into a rating scale to measure the Perception of Aggression ( Jansen et al., 1997 ) as held by different people. Factor analysis of this scale, based on 32 definitions of aggression, shows that the concept comprises 2 fundamental elements: a positive perception emphasising healthy, normal protective aggression; and a negative perception of aggression as undesirable and dysfunctional.

Another way to approach the definition is to inspect the contents of the most well-used research instruments and scales that have been used to measure these behaviours. The Overt Aggression Scale (OAS) ( Yudofsky et al., 1986 ) and its derivatives ( Sorgi et al., 1991 ) are used to record aggressive incidents, and include: verbal aggression ranging from angry, loud shouts and noises through to clear threats; physical aggression against objects, ranging from door slamming and making a mess through to fire setting and throwing objects dangerously; and physical aggression against other people, from threatening gestures through to attacking another person causing severe physical injury. However, the OAS and many other such scales include self-harm and suicide attempts as aggressive behaviours against the self. The Social Dysfunction and Aggression Scale ( Wistedt et al., 1990 ) is used to assess the total level of aggression retrospectively, and while including verbal aggression, aggression towards objects and others, it also incorporates irritability, lack of cooperation, discontentment, provocative behaviour and self-harm. Because there is a separate guideline on self-harm ( NICE, 2004 ), this is excluded from the definition of violence and aggression used in this guideline.

2.3. INCIDENCE AND PREVALENCE OF VIOLENCE AND AGGRESSION IN DIFFERENT SETTINGS

Violence and aggression present a serious problem within the NHS to both service users and staff. Exposure to aggression in the healthcare workplace is common, constituting 25% of all workplace violence ( Iennaco et al., 2013 ). In 2014, 14% of NHS staff reported having experienced physical violence from service users, their relatives or other members of the public in the previous 12 months, reduced from 15% in 2013. This figure was higher in staff in ambulance trusts (31%) and mental health trusts (17%) ( NHS England, 2014 ).

More than 60,000 physical assaults were annually reported against NHS staff across the UK ( NHS Protect, 2013 ), with the absolute rate steadily increasing since 2010– 2011 (57,830) and 2011–2012 (59,744). Of these assaults, 43,699 were in mental health or learning disability settings, 1628 involved primary care staff and 16,475 were targeted at acute hospital staff. More than 25% occurred in hospitals managed by acute trusts, including emergency departments ( NHS Protect, 2013 ).

While some figures are collected and national audits conducted across different settings, the main focus has tended to be on inpatient psychiatric settings and emergency departments. Information from primary care settings, for example, is relatively scarce; 1 review found only 14 of 113 studies referred to violence in community settings.

In terms of the inpatient literature, 1 review ( Bowers et al., 2011b ) of 424 international studies reported that the overall incidence of violence by service users in inpatient psychiatric hospitals was 32.4%. Violent incidents across forensic settings were found to be consistently higher. The review team concluded that forensic inpatients were responsible for a higher proportion of violent incidents; but, given that acute wards admit a far higher number of people over time, on balance the risk of violence is actually greater in acute environments.

With regard to forensic settings, 2137 incidents involving 42.9% of service users were reported by a recent survey of a large independent secure care facility; this rate was greater in medium-secure as opposed to low-secure services ( Dickens et al., 2013 ) Staff were the victim of assaults over twice as frequently compared with service users; however, if service users were the target, incidents were more likely to result in an actual injury. In a high-secure setting, Uppal and McMurran (2009) reported 3565 violent incidents over a 16-month period in just under 400 service users. Staff and service users were equally likely to be the target. In both surveys, a small proportion of service users was responsible for a disproportionate number of incidents.

Emergency department staff were also reported to have experienced a high exposure to aggression, particularly verbal aggression ( Gates et al., 2006 ; Winstanley & Whittington, 2004 ). In long-term and older people's settings the figures for aggression were also found to be higher than general medical and surgical wards ( Chapman et al., 2009 ).

Stathopoulou (2007) suggests that workplace violence affects every country and every healthcare setting. According to international data, nearly 4% of the total employee population has reported that they have experienced physical violence. The possibility of nurses being exposed to violence is 3 times higher than that of any other professional group ( International Labor Office, 2002 ). This was reflected in a National Audit of Violence in the UK, which reported that 44% of clinical staff overall and 72% of nursing staff had been, or experienced feeling, unsafe at work ( Royal College of Psychiatrists, 2007 ). The rates of psychiatrists being or feeling unsafe are reportedly lower than for nurses ( Bowers et al., 2011c ).

In light of these figures it is important to identify the causative factors that may contribute to these including care failures. This guideline aims to reduce such figures by suggesting best practice and preventative measures.

2.4. THE RELATIONSHIP BETWEEN MENTAL HEALTH PROBLEMS AND VIOLENCE AND AGGRESSION

Despite public perception that mental health problems (in particular, severe mental illness such as bipolar disorder and schizophrenia) and violence are associated (see section 2.5 ) the research evidence to support such a relationship is mixed, and most people with a mental health problem are not only never violent but are also more likely to be victims rather than perpetrators of crime ( Pettit et al., 2013 ). However, a small proportion are and consensus has emerged among researchers that there is a consistent, albeit modest, positive association between mental health problems and violence. The extent to which mental health problems contribute to violent behaviour and the relative importance of psychiatric morbidity compared with other risk factors and service-related failings remain areas of controversial ongoing research.

To address the question of whether there is a link between mental health problems and violence, different research designs have been employed, including cross-sectional studies that investigate the prevalence of violence in those with mental health problems and, conversely, rates of mental health problems in those who have committed acts of violence (for example, offenders). While such studies have described a link between mental health problems and violence ( Shaw et al., 2006 ), they are prone to selection bias as they tend to sample individuals detained in criminal justice or psychiatric settings. Some studies have been flawed by their lack of attention to potential confounding factors, such as psychosocial factors, comorbidity, substance misuse and so on. Prospective epidemiological studies of community samples following individuals for extended periods of time to identify those who will become violent and/or develop a mental health problem avoid some of these issues. However, other challenges in the interpretation of findings remain, for example the use of different methods to assess rates of violence, such as self-report, official criminal records and so on, each posing risks of misrepresenting the true prevalence of violence.

Until the 1980s, there was a general view that mental health problems and violence were unrelated; that is, that those with a mental health problem are no more likely to be violent than healthy individuals, and that the criminogenic factors relevant to violence risk are the same in people with a mental health problem as in healthy individuals ( Häfner & Böker, 1973 ). Several large-scale studies in the 1980s and 1990s have resulted in a reappraisal and modification of this view.

The Epidemiological Catchment Area study ( Swanson, 1994 ) comprised a community sample of over 17,000 participants in 5 large US cities, though only about 7000 subjects contributed to the data on violence. Individuals were asked to report any acts of violence they had committed within the previous year and in their lifetime. The study found a lifetime prevalence of violence in the non-psychiatric population of 7.3%. In those with schizophrenia or major affective disorders this rate was more than doubled at 16.1%, but in those with substance-use disorders it rose further to 35%, and those with a substance-use disorder and comorbid mental health problem had a lifetime prevalence of violence of 43.6%. Several early Scandinavian birth cohort studies ( Hodgins, 1992 ) have identified a higher likelihood of having committed a violent crime in those with severe mental illness compared with those with no such diagnosis. A recent longitudinal Swedish study linking national registers of hospital admissions and criminal convictions over 33 years found that individuals with schizophrenia and bipolar disorder were more likely to commit violent acts than matched controls. In the period 1973–2006, 8.5% of individuals with schizophrenia without a substance-use disorder and 5.1% of the matched control group were convicted of at least 1 violent crime; for bipolar disorder these figures were 4.9% and 3.4%, respectively. However, those with dual diagnoses showed rates of 27.6% and 21.3% of violent offending for people with schizophrenia and bipolar disorder, respectively.

One of the most influential studies to disentangle some of the complex relationships between mental health problems and other risk factors for violence, in particular substance misuse, has been the MacArthur Violence Risk Assessment Study ( Steadman et al., 1998 ). This follow-up study of over 1000 people discharged from psychiatric care used self-report triangulated with information from carers and criminal records to assess violence rates. The study found no significant difference between the prevalence of violence in patients and others living in the same neighbourhood when only taking those with no substance misuse into account. Substance misuse raised the rates of violence in people with mental health problems as well as healthy individuals, but disproportionately so in the patient group. Elbogen and Johnson (2009) also argued that a mental health problem on its own does not increase violence risk. They evaluated data on about 35,000 individuals who were part of the US National Epidemiological Survey on Alcohol and Related Conditions. Participants were interviewed in 2 waves in 2001–2003 and 2004–2005 to identify factors that predicted violence in the time between interviews. The researchers found that the incidence of violence was slightly higher in those with a mental health problem but significant only in those with a comorbid substance-use disorder. The researchers concluded that historical, dispositional and contextual factors were more important in determining the risk of future violence than a mental health problem. However, a later re-analysis of these data ( van Dorn et al., 2012 ), using different statistical methods and diagnostic categories found that those with severe mental illness were significantly more likely to be violent than those with no illness, regardless of substance misuse.

More recently a number of meta-analyses have been conducted in an attempt to systematically re-assess the evidence and explore the reasons for variations in findings ( Douglas et al., 2009 ; Fazel et al., 2009 ; Fazel et al., 2010 ). These studies, drawing on a large number of primary studies (204 and 20 for schizophrenia, and 9 for bipolar disorder, respectively), concluded that schizophrenia, other psychoses and bipolar disorder are associated with violence. However, large variations were identified with odds ratios between 1 and 7 for schizophrenia in males and between 4 and 27 for females. For bipolar disorder the odds ratio estimates ranged from 2 to 9. However, for both disorders a comorbid substance-use disorder increased odds ratios up to 3-fold. For bipolar disorder the significant relationship with violence disappeared when controlling for substance misuse whereas for schizophrenia the relationship weakened but remained, although in those with a history of substance misuse, schizophrenia did not contribute any additional risk compared with substance misuse alone.

Determining which symptoms of mental health problems drive the increased risk of violence requires further exploration. In the early 1990s, researchers first identified a set of symptoms called threat/control-override symptoms, which seemed to be linked to this risk ( Link & Stueve, 1994 ). Threat/control-override symptoms are delusional symptoms that cause the person to feel severely threatened and believe that external forces override their self-control. Further studies of the relationship between threat/control-override symptoms and violence revealed conflicted findings with some but not all studies confirming a relationship. In an attempt to disentangle this issue further, Stompe and colleagues (2006) examined a sample of 119 offenders with schizophrenia found to be not guilty by reason of insanity and a matched sample of non-offending service users with schizophrenia (n = 105). While they found no significant difference in the prevalence of threat/control-override symptoms between the 2 groups overall, when only taking severe violence into account threat/control-override symptoms were found to be associated with this form of violence. It seems, therefore, that the relationship between threat/control-override symptoms and violence is not straightforward and that more research is needed to explore the concept further. In the meantime, clinicians are advised to conduct a comprehensive mental state examination as part of their risk assessment, including threat/control-override symptoms.

In summary, a mental health problem on its own appears to be only a modest predictive factor for violence while other factors, most significantly substance misuse, are more relevant in predicting risk. Because of the low base rates of mental health problems, its actual contribution to violence in the general population is small and the vast majority of violence is carried out by those without a mental health problem.

2.5. SOCIAL ATTITUDES TOWARDS VIOLENCE AND AGGRESSION

There has long been an association in the mind of the public between mental health problems and violence (Monahan, 1992), often bound up with moral and judgmental attitudes, whereby people who have a mental health problem are viewed as being irrational, unpredictable and dangerous and presenting with an increased risk of violence ( Blumenthal & Lavender, 2000 ; Butler & Drakeford, 2003 ; Petch, 2001 ).

While there may be certain characteristics of some people with a mental health problem that may increase the risk of violence or indeed self-harm, as has been outlined in Section 2.4 the association between mental health problems and violent or aggressive behaviour is not established. One key issue for the public debate is whether violence generated by people with a mental health problem is increasing, but according to the Avoidable Deaths report from the National Confidential Inquiry, homicides by current or recent service users peaked in 2006, and has fallen since that year ( Appleby et al., 2006 ).

However, a perceived association between mental health problems and violence is nevertheless often reinforced by images in the media and other cultural representations. As an example, in September 2013 a leading UK supermarket chain advertised a Halloween ‘mental patient fancy dress costume’ with an image of a person in a bloodied suit holding a meat cleaver. Negative media attention caused the supermarket to withdraw this item. The key point from this example is how such an image could have been brought to mind by those creating and marketing such products. While there are a number of theories about this, ‘labelling’ and the ‘availability heuristic’ (the process whereby people assess the frequency or probability of an event by the ease with which instances or occurrences can be brought to mind ( Tversky & Kahneman, 1974 ) are 2 mechanisms that can influence negative attitudes and responses towards people with a mental health problem.

Labelling theory in sociology proposes that labelling occurs when certain members of society interpret certain behaviours as deviant and then attach this label to individuals ( Becker, 1963 ) as a means to identify and control such behaviour. Labelling theory examines who applies what label to whom, why it is applied and what the effects are. The consequences of someone being labelled as having a propensity to violence just because they have a mental health problem can be negative and far-reaching. Labelling results in people having fears engendered by their attributions towards a person, leading them to conclude that the person is highly likely to be violent with no other knowledge of them other than the diagnosis. This in turn will affect their attitudes to, and communications with, people with mental health problems.

The ‘availability heuristic’ ( Middleton et al., 1999 ) affects our attributions towards a particular idea or group of people; in this case, reporting in the media that draws attention to violence and murders carried out by people with mental health problems (often in a gory and sensationalist way) results in the attribution of violent behaviour to those with a mental health problem. This discourse was played out in the case of Philip Simelane, who murdered a 16-year-old female stranger, Christina Edkins, on a bus. The headline in the Daily Mail on the 3 October 2013 was: ‘Why was schizophrenic who stabbed this girl to death on a bus not having treatment?’ The focus, as here, tends to be on the fact that the person had a mental health problem, implying the murder occurred because of the person's mental health problem; other factors that might have been considered if the person had committed the same offence without having a mental health problem do not appear relevant. The more dramatic and easy to visualise the reported event, the more likely it will be contained within such a heuristic, with menacing photographs of ‘perpetrators’ and ‘horror stories’ of what they have done. Because of this, for many people, the first thing that often comes to mind about those with a mental health problem is that they are highly likely to be violent. There is much less reporting of other aspects of having a mental health problem, or of people with a mental health problem being more likely to be a victim of violence than a perpetrator, as found by 1 large-scale study in the US ( Choe et al., 2008 ).

What is necessary instead is for the reality of the risks to be recognised and taken into account by both the public and professionals in a considered and fair manner, for the sake of all involved.

2.6. PERSONAL CONSEQUENCES OF VIOLENCE AND AGGRESSION FOR THE INDIVIDUAL AND FOR OTHERS

The under-reporting of violence and aggression ( Gates et al., 2006 ; Holmes et al., 2012 ; McLean et al., 1999 ), and the varied effects it may have on those subjected to violence and aggression, limits our understanding of the consequences for the individual. Research into the effects of violence at the individual level has largely been focused on staff. While this is not surprising (because, by and large, staff have conducted the research and published the findings), other areas are less well covered. Other consequences of violence are only spelt out obliquely by research, resulting in limited understanding of the consequences for the individual who is prone to behaving in a violent manner.

The earliest work concerning the effects on staff and others of violence from people with mental health problems was produced by the Department of Health and Social Security (1976) and the Confederation of Health Service Employees (1977) . The issues raised were in relation to physical violence in inpatient psychiatric units, and the concerns of the Confederation of Health Service Employees were about how their members needed greater recognition for, and protection from, such violence. In social care work in the community, the effects of violence to staff came later in the 1980s ( Brown et al., 1986 ).

Holmes and colleagues (2012) concluded that the consequences of workplace violence for individuals were far-reaching and included absenteeism related to illness, injury and disability, staff turnover, decreased productivity, decreased satisfaction at work, and decreased staff commitment to work.

Physical injury as a result of assault by a service user can be serious, including injuries such as head, back, facial and eye injuries, broken bones, sprains, cuts, grazes and scratches. A review of multiple previous research studies estimated that 26% of violent incidents resulted in mild, 11% in moderate and 6% in serious injuries ( Bowers et al., 2011b ). A similar review of the psychological impact of violence found by previous research reported that the 3 most common responses to injury were anger, fear and guilt (self-blame and shame) ( Needham et al., 2005 ). The fear can generalise into avoidance of the service user who has been violent or aggressive ( Needham et al., 2005 ), or all service users, and some victims report persistent ruminations and intrusive thoughts about the incident, with symptoms severe enough to be classified as post-traumatic stress disorder.

Staff in the hospital

On any psychiatric ward a proportion of the staff's time is taken up with protecting service users from each other via the identification and protection of the vulnerable, general supervision of the environment and rapid response to any noise or cry for help, among other strategies. In addition, service users may also become involved in trying to defuse and deal with violence and aggression between service users, and between service users and staff. A proportion of the injuries that occur in staff happen during the breaking up of fights between service users, for example, but staff may also be assaulted unpredictably as service users respond to the symptoms they experience, or as a consequence of confrontations about leaving the ward, medical treatment or other issues ( Nicholls et al., 2009 ). Staff also have to physically intervene to stop service users injuring themselves or trying to leave the ward, sometimes eliciting an aggressive response. Most assaults and aggression against staff – and by service users on other service users – are thankfully minor, but they can occasionally be severe. Every year several hundred injuries on staff are officially reported to the Health and Safety Executive by psychiatric hospitals as resulting in periods of sickness lasting 5 or more days. As a consequence of physical and/or psychological injuries, staff may leave psychiatry to work elsewhere. Verbal aggression to staff is extremely common and takes the form of abuse, shouting, threats, racism and generalised anger ( Stewart & Bowers, 2013 ). Verbal aggression can have a profound psychological impact ( Stone et al., 2010 ), affect performance and functioning ( Uzun, 2003 ) and is the particular form of aggression that is associated with low staff morale ( Bowers et al., 2009 ; Sprigg et al., 2007 ).

Staff in the community

Violence and aggression to staff in the community is less well documented and reported. While rates among NHS community teams are lower than those experienced by staff in hospital, the consequences are the same when assaults do occur. In England, since the early 1980s, 9 social work and social care staff have died as a result of violence from service users. The majority of those killed worked in mental health or child protection. Rates of assault experienced by staff working in supported accommodation run by a range of charities and private companies are unknown.

Personal consequences

Violent behaviour associated with a mental health problem is a criterion for admission to hospital, compulsory admission under the Mental Health Act ( 1983 , amended 1995 and 2007 ) ( HMSO, 1983 ; HMSO, 1995 ; HMSO, 2007 ), transfer or admission into more secure settings such as psychiatric intensive care or forensic services, and the use of severe containment methods such as manual restraint, rapid tranquillisation and seclusion. All things being equal, service users who exhibit violent behaviour will therefore experience more frequent admissions, more compulsory admissions, to greater security settings, for longer lengths of stay, with more restrictions on their liberty, greater coercion and higher doses of medication. Because violent behaviour is a criterion for exclusion from shared accommodation and social activities, service users who behave violently are likely to experience more accommodation instability and change, reduced social networks, social support and be more isolated. They may also have impaired access to mental health services in the community and, for safety reasons, home visits may be avoided and all appointments offered at clinics where the backup of other staff is available. Violent behaviour is therefore problematic for the person concerned and is likely to have a negative impact on their quality of life.

Relatives, carers and social networks

Where the risk of violence does exist, family members, carers and those in close contact with the individual concerned are most likely to be injured. Major injuries and deaths are rare, but the number of minor assaults is unknown as they may never be reported to the police or to anyone else. Living with a potentially violent person can lead to the family member or carer becoming severely stressed or developing a mental health problem. Alternatively, if the person concerned is living independently, relatives may withdraw, cease support or stop visiting if they are regularly faced with abusive and aggressive behaviour.

Other service users

People who share a ward with a potentially violent service user are also at risk of physical and psychological harm. Most aggression is directed at staff who are in positions of power, control access to desirable resources and discharge from the ward, and who may impose unwanted treatment. However, living in close proximity with others whose violence is unpredictable coupled with the service user's own psychiatric symptoms does place them at risk. Very occasionally that risk is severe and deaths have been reported. Minor assaults and injuries are regrettably more common, and approximately 20% of violent incidents on psychiatric wards are between service users ( Daffern et al., 2006 ; Foster et al., 2007 ). The research literature tends to focus on consequences for staff in terms of physical injury and psychological distress, with service user outcomes seldom mentioned or studied. However, the consequences of an assault on people who already have a mental health problem may be considered to be negative, possibly hindering their recovery. It is known that inpatients are at times fearful and frightened of each other, leading to a range of avoidant behaviours that are employed to maintain distance from other service users who are regarded as having violent propensities ( Quirk et al., 2004 ). Bullying between service users has also been reported ( Ireland, 2006 ) as has sexual aggression. The move to single sex wards in UK psychiatry in recent years has been largely in response to a desire to protect female service users from unwanted or aggressive sexual advances from male service users ( Department of Health, 2003 ). The consequences of unwanted sexual advances, harassment, bullying or assault are acknowledged as impeding the treatment and recovery of service users subjected to such behaviours, besides such incidents being extremely unpleasant in their own right.

Violent behaviour by people with a mental health problem is rare and only carried out by a small minority. However, it looms large in the public estimation ( Bowen & Lovell, 2013 ; Thornicroft et al., 2007 ), adding to the stigma, fear and exclusion faced by this population. As such, the impact of violent behaviours is far bigger than the actual scope of the problem because it corrodes trust between people and makes it more difficult for the mentally ill to reveal their situation and to seek or obtain social support from others.

Dealing with the consequences

From the above discussion, it can be seen that violence and aggression have consequences for staff, service users and their families, carers and significant others, and the relationships between these people.

The consequences of violence and aggression cannot be dealt with unless incidents are reported and unless those reporting them feel they will benefit from doing so. Staff working in health and social care may not report incidents because they believe that they will not be dealt with sympathetically and are worried that they will be viewed negatively by colleagues and managers ( Holmes et al., 2012 ).

Harris and Leather (2011) found in their research with social work and social care staff that as exposure to service user violence increased, so did reporting of stress symptoms and reduction in job satisfaction. Harris and Leather also found that fear or feeling vulnerable was an important consequence of exposure to violence and aggression; the same consequences of fear and feeling vulnerable can also occur in service users.

Ilkiw-Lavalle and Grenyer (2003) , in a study on differences between service user and staff perceptions of aggression in mental health units, found that staff often perceived service users' illness as the cause of aggression, while service users perceived illness, interpersonal and environmental factors as having equal responsibility for their aggression. Such attributions from staff are important in how they will respond to incidents, and this will therefore affect their need for support post-incident in order for them to deal effectively and fairly with the consequences for themselves, service users, staff and others ( Paterson et al., 2014 ).

Shapland and colleagues (1985) found that there were special considerations for victims of violence at work. Where staff could depend on supportive work colleagues and managers, and were employed by an organisation that proactively offered support, staff were more able to overcome the negative effects of violence at work.

The need for support depends on several factors:

  • The nature of the emotional and/or physical effects on the individual victim.
  • The effects on professional and/or personal life for the individual victim (see Holmes and colleagues, 2012 ).
  • How the victim's views about the nature and causes of the violence might affect their approaches to that service user, and possibly other service users.
  • The individuals' experiences of support in dealing with the consequences.
  • Service users also have a need for agencies and staff groups to recognise that they, too, are affected and take measures to make them be and feel safe ( Holmes et al 2012 ).

2.7. CURRENT MANAGEMENT OF VIOLENCE AND AGGRESSION IN THE NHS

Given the risks posed by violent behaviour in mental health, health and community settings, all trusts have policies for its prevention and management. These policies can be wide ranging and are often directed at other primary goals, but also have secondary beneficial impacts on reduction of violent incident rates, reductions in their severity when they do occur and amelioration of their outcomes. For example, prompt and effective psychiatric treatment resolves acute symptoms and, because symptoms can be linked to violent behaviour, this constitutes one way that incidents are reduced. Within forensic settings, specific psychotherapies may be available to help people reduce their own capacity to act in a violent way. Buildings and wards are sometimes designed with the possibility of violent behaviour in mind, so in many areas, and especially in forensic or psychiatric intensive care settings, buildings are made out of stronger materials. Doors and furniture may be more robustly constructed, windows are fitted with stronger or safety glass, and living areas are designed in a way to maximise observation and supervision so that violent incidents can be quickly identified and responded to. Service users are searched for weapons on admission to hospital, and a number of items that could be used as weapons are banned from being brought onto the wards. As an aid to observation, closed-circuit television (CCTV) may be fitted in public areas and a variety of alarm systems may be fitted, from wall-mounted buttons to personal alarms for staff that quickly identify where an incident is taking place. These measures are accompanied by policies dictating their use and procedures as to who responds and takes control. In most psychiatric hospitals, if weapons are involved or the situation is beyond the capacity of staff to manage, the police may be called to manage the situation.

Within psychiatric hospitals, the main professional group that manages violent incidents (and who are most likely to be victims) are mental health nurses and healthcare assistants. The basic training of mental health nurses includes instruction on the causes of aggression, good communication skills and non-confrontational practice. During their training, nurses learn how to quickly establish and strengthen good relationships with service users, and these act as a safeguard against violence to staff, or aid in the de-escalation and management of agitated and violent behaviour. De-escalation or defusion refers to talking with an angry or agitated service user in such a way that violence is averted and the person regains a sense of calm and self-control. Most potential occurrences of violence are averted in this way, especially when there is some warning that they are about to occur, such as raised voices and abusive language. Of course some instances of violent attack occur suddenly and apparently ‘out of the blue’, and these are more difficult to prevent. All NHS psychiatric services provide additional training to their staff, especially those working in inpatient areas, in the prevention and management of violence. Such training typically (but not always) consists of 5 days with subsequent annual refresher courses, contains instruction on de-escalation, breakaway techniques and manual restraint, and is provided by an in-house training team. Where such training is commissioned from external private providers, a plethora of courses exists with different content. In-house courses are often linked to private providers via ‘train the trainer’ schemes. There are no detailed national guidelines on the content of violence management courses or on the specific physical techniques that are taught, and there are no standards, quality control processes or accreditation procedures for the courses concerned, whether provided in house or by external providers.

If an actively violent service user cannot be verbally calmed and is judged likely to imminently assault another, they will be manually restrained by suitably trained nurses and healthcare assistants. Such manual restraint is aimed at securely holding the person so that they cannot strike out or hurt others, so that they are not injured themselves and so that attempts to verbally engage with them can continue. Such holds can be slowly released when the person is emotionally calmed and can negotiate about their behaviour. If a state of calm cannot be immediately achieved, sedating medication may be offered by mouth or given by injection without the person's consent (rapid tranquillisation). If these efforts fail, the service user may be secluded in a specially constructed room, although not all hospitals have these. Additionally or alternatively, as the person becomes calmer, they may be asked to stay away from other service users by remaining in their own bedroom or other area (but without the door being locked), or be placed on some form of special psychiatric observation to facilitate early intervention if the violent behaviour seems likely to recur. Further changes to the person's regular medication regime may occur following a violent incident in an effort to prevent recurrence. Debriefing of the staff team and service user involved may also occur in an effort to learn from the incident and plan, so as to prevent the chance of a repetition. All these procedures are variously guided by a trust's policies and training provision for staff.

It is important to note that the nature and extent to which violence and aggression is experienced in the NHS varies greatly with the setting. The experience and hence the management of such incidents will differ between community and hospital environments. The interface with non-NHS agencies (such as the police, the courts and social services) has a role to play, and these links are well developed in some settings. Within the NHS hospital setting, there are particular areas that are better developed (by virtue of their philosophy of care, skills mix and clinical experience) to therapeutically manage acute or sustained risk of violence and aggression in the context of mental or physical health problem. These include emergency departments linked to general medical hospitals, psychiatric intensive care units within the acute inpatient psychiatric care pathway and forensic psychiatric inpatient facilities.

2.8. PREDICTING THE RISK OF VIOLENCE AND AGGRESSION AND THE CULTURE OF THE NHS

The prediction of the risk of violence and aggression by service users in mental health, heath and community settings is challenging in a number of ways. The key challenges include the lack of definition of what is being predicted, over what time-frame and in which context. Intuitively, the clinical tools required to predict imminent or short-term violence and aggression would be different by some degree to those utilised in the prediction of medium to longer-term violence or aggression. Furthermore, the heterogeneity in clinical populations where violence and aggression is exhibited seriously hinders the reliability and validity of specific clinical tools; there is no broad clinical assessment tool that can be applied in all circumstances where violence and aggression needs to be predicted.

Clinicians in the healthcare system have a duty to protect service users (both as potential perpetrators of violence and aggression, and as the victims of such acts), to protect healthcare and other professionals (which includes the attending clinician's personal safety), and to protect the wider public. Such duties are explicit in most professional codes of practice and are most apparent in the codes that regulate the practice of medical doctors and nursing staff.

In this guidance, the prediction of violence and aggression relates to that which is felt to be imminent or occurring in the very short-term; that is, within minutes or up to 72 hours. The fundamentals of predicting the risk of violence and aggression are driven by the best available psychiatric assessment of the person. Comprehensive assessment, which includes a psychiatric history, a mental state examination and an assessment of physical health, leading to clinical and risk formulations, will usually be difficult to achieve in acute clinical scenarios, and much of the clinical and risk information may not be readily available at the outset.

The assessment is an iterative and dynamic process that should lead to responsive changes in the clinical and risk management plan. Particular significance is attached to a past history of violence and aggression because past behaviour is a guide to future presentation. The impact of mental health problems, physical health problems, personality disorders, substance-use disorders, social impairment and cultural factors should be considered within the health or social care framework so as to understand the aetiology of the person's violent or aggressive presentation.

The approach described in the preceding paragraph is essentially that of unstructured clinical assessment. Although it suffers with low reliability, it is operator dependent and the reliability and validity are likely to be improved when it is used by more experienced and skilled clinicians. There is some evidence to support the notion that in the case of predicting inpatient aggression in acutely unwell service users, short-term clinical assessment can be useful ( McNiel & Binder, 1991 ; McNiel & Binder, 1995 ).

There are 2 other types of violence-related risk assessment: actuarial risk assessments and structured clinical judgements.

Actuarial risk assessments use quantifiable predictor variables based on empirical research (often derived of an actual patient dataset, which ultimately limits their generalisability); they aim to provide a quantifiable value to the outcome in question. For the purposes of this discussion, the outcome in question would be the probability of violence or aggression occurring in the short-term.

Structured clinical judgements are an amalgam of the clinical assessment approach and the actuarial approach. Risk factors derived from a broad literature review are rated by the assessor using multiple sources of clinical information.

A number of violence-related risk assessment tools are currently available and some are in general use in specified clinical settings. These include:

  • Brøset Violence Checklist (BVC) ( Almvik et al., 2000 )
  • Classification of Violence Risk (COVR) ( Monahan et al., 2006 )
  • Dynamic Appraisal of Situational Aggression (DASA) ( Ogloff & Daffern, 2006 )
  • Historical Clinical and Risk Management – 20 items (HCR-20) ( Douglas et al., 2013 )
  • Iterative Classification Tree ( Monahan et al., 2000 )
  • Modified OAS ( Sorgi et al., 1991 )
  • Nurse Observed Illness Intensity Scale ( Bowers et al., 2011a )
  • OAS – Modified ( Coccaro et al., 1991 )
  • OAS ( Yudofsky et al., 1986 )
  • Psychopathy Checklist – Revised ( Hare, 2003 )
  • Short-Term Assessment of Risk and Treatability ( Nicholls et al., 2006 ; Webster et al., 2009 ; Webster et al., 2006 )
  • Staff Observation Aggression Rating Scale – Revised (SOAS-R) ( Nijman et al., 1999 )
  • Violence Risk – 10 items ( Roaldset et al., 2011 )
  • Violence Risk Appraisal Guide ( Quinsey et al., 2005 )
  • Violence Screening Checklist ( McNiel & Binder, 1994 ).

Current clinical wisdom is that many of the available risk assessment instruments that predict future violence are broadly similar in their somewhat moderate predictive efficacies ( Yang et al., 2010 ). The risk assessment tools listed above cover a wide variety of clinical settings, and most progress has probably been made in the area of forensic psychiatry. The majority of the risk assessment tools focus on medium- to long-term risk. A few have some emerging evidence base for their applicability to the prediction of violence and aggression in the short term and in non-forensic settings.

Any method that is to predict violence and aggression in the healthcare setting needs to look further than just patient-related factors. Patient-related factors are often well covered in clinical assessments and in violence-related risk assessment tools. Other areas requiring consideration include: staff-related factors (staff experience and training, role clarity); service-related factors (staff-patient ratios; the physical fabric of the ward, the philosophy of care and the ‘atmosphere’ of the clinical setting, multidisciplinary and multiagency input); and organisational factors (the culture of the organisation shaping the engagement philosophy between service users and staff). These non-patient-related factors are just a few examples, but they serve to illustrate the multitude of factors that can potentially shape the expression of violence and aggression. The knowledge and understanding of such factors by staff in more secure settings, such as PICU or forensic psychiatric services, is well described by the model of relational security ( Department of Health, 2010 ). In terms of prediction, with its aim to better manage and reduce violence and aggression, these areas are probably of equal relevance to the direct patient-related factors.

The problem of aggression and violence seems to be endemic in the healthcare sector. The background literature is equivocal and the prediction of violence and aggression is an area of ongoing debate and research. Good clinical teams will make ongoing clinical and risk assessments (with or without the benefit of a violence-related risk assessment tool), and have quite a low threshold when considering a service user to be at high risk of violence or aggression. The low threshold usually leads to the use of clinical measures to prevent or manage the behaviour in the least restrictive and most therapeutic manner possible. Therefore, one argument is that good clinical management should lead to false positive predictions of violence and aggression, where it is predicted that violent and aggressive behaviour will occur but it does not ( Steinert, 2006 ). With this in mind, the very purpose of risk assessment can be brought into question: is the purpose to predict violence or to intervene to prevent violence? The 2 outcomes would seem to require different instruments; the latter would be based in more of a formulation approach to identify relevant factors that may incite violence in a particular service user, rather than estimate how likely that person is to be violent in the future. Clinicians may be well advised to consider a formulation-based approach that facilitates the prevention and management of aggression and violence, as opposed to an over-reliance on purely predictive methods.

2.9. ECONOMIC COSTS OF VIOLENCE AND AGGRESSION TO THE NHS

Due to the complex determinants and broad manifestations of violence and aggression, its full economic impact is difficult to measure and, to date, no formal attempt has been made to quantify this for the UK.

Violence and aggression in the context of mental health issues is associated with a range of negative consequences, which may be broadly grouped into costs to individuals and costs to the UK health service. Incidents of violence and aggression may result in physical pain, stress, loss of confidence and other psychological problems. These personal costs accrue to the individuals at the centre of the episode, to other staff and fellow service users.

The wider health and social care system incurs the costs associated with secure care for service users, staff absence, legal services, extra training costs, NHS trust liabilities, compensation, ill-health retirements, staff replacement costs, counselling, and a myriad of retention and recruitment issues.

Combining data from the NHS protect physical assault statistics with health body declarations of staff, NHS Protect ( NHS Protect, 2009 ; NHS Protect, 2010 ; NHS Protect, 2011 ; NHS Protect, 2012 ; NHS Protect, 2013 ) reported that there were an average of 188 assaults per 1000 staff per year in mental health/learning disability trusts. There was a wide variation between the numbers of reported incidents in the different sectors with an average of 36 assaults per 1000 staff reported in the ambulance sector, 19 per 1000 staff reported in the acute sector and 16 per 1000 in the community care sector.

Furthermore, the same report suggested that incidents of assaults across all sectors may be increasing with 44.4 incidents per 1000 staff in 2008/09 rising to 53 incidents per 1000 in 2012/13. This trend has the opposite direction in mental health and learning disabilities trusts with incidents falling from 193.9 per 1000 to 188 per 1000 between the same periods. Apparent trends in this data should be interpreted with caution because changes in populations, service provision health body amalgamations and reporting culture may all affect published figures.

Another report from the Wales Audit Office ( Colman et al., 2005 ) supports the finding of increased incidents of violence and aggression in mental health services. In 2003–04 in Wales, most ‘generic’ incidents of violence took place in mental health settings, with 1790 such incidents representing 22% of all violent incidents in the country during that period. Incidents of violence and aggression also varied according to service area within mental health services. Violent and aggressive incidents are the third biggest cause of workplace injuries in the health and social care sector, as reported to the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations .

To estimate the healthcare costs associated with incidents of violence, Flood and colleagues (2008) collected 6 months' of incident data from a sample of 136 acute psychiatric wards in England and combined these with end-of-shift reports from nurses in 15 wards to estimate the resource use per violent event. The cost calculation only accounted for the payment of identified staff and medication costs and as such does not observe fixed costs such as specialised facilities. The outputs of this analysis are estimates for the mean cost of violent incidents for individual psychiatric wards and for England as a whole. According to these authors, the annual cost in England of physical assaults is £5.3 million (2013/2014 prices), of aggression to objects is £3.7 million and of verbal abuse is £11.5 million. The analysis also estimated the costs associated with various containment strategies. In dealing with incidents, the use of general ‘as required’ medication was estimated to cost £8.6 million annually, with intramuscular (IM) medication in particular costing a further £3.9 million. Furthermore, transferring care to psychiatric intensive care services was estimated to cost £1.1 million and seclusion £2.2 million per year. Intermittent observation was estimated to cost £49.3 million and constant special observation £38.5 million per year. Manual restraint was estimated to cost £6.1 million and time out £1.3 million per year.

In terms of individual psychiatric wards, the work of Flood and colleagues (2008) estimates that approximately £270,000 of nursing cost per ward per year is associated with the management of violence and aggression. That is, more than one-third of the estimated total nursing cost (£736,000) per ward per year is connected with managing violence and aggression.

Although the currently available estimates of the costs of violence and aggression suggest substantial impact, these estimates remain inherently conservative due to the difficulty of measuring system-wide costs associated with incidents of violence and aggression. That the true costs are likely to be even greater emphasises the need to ensure efficient use of health and social care resources to deal with incidents of violence and aggression in a manner that maximises safety, quality and value for service users, carers and society in general.

All rights reserved. No part of this guideline may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, or in any information storage or retrieval system, without permission in writing from the National Collaborating Centre for Mental Health. Enquiries in this regard should be directed to the Centre Administrator: ku.ca.hcyspcr@nimdAHMCCN

  • Cite this Page National Collaborating Centre for Mental Health (UK). Violence and Aggression: Short-Term Management in Mental Health, Health and Community Settings: Updated edition. London: British Psychological Society (UK); 2015. (NICE Guideline, No. 10.) 2, INTRODUCTION.
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In this Page

  • THE NEED FOR A VIOLENCE AND AGGRESSION GUIDELINE
  • DEFINITIONS OF VIOLENCE AND AGGRESSION
  • INCIDENCE AND PREVALENCE OF VIOLENCE AND AGGRESSION IN DIFFERENT SETTINGS
  • THE RELATIONSHIP BETWEEN MENTAL HEALTH PROBLEMS AND VIOLENCE AND AGGRESSION
  • SOCIAL ATTITUDES TOWARDS VIOLENCE AND AGGRESSION
  • PERSONAL CONSEQUENCES OF VIOLENCE AND AGGRESSION FOR THE INDIVIDUAL AND FOR OTHERS
  • CURRENT MANAGEMENT OF VIOLENCE AND AGGRESSION IN THE NHS
  • PREDICTING THE RISK OF VIOLENCE AND AGGRESSION AND THE CULTURE OF THE NHS
  • ECONOMIC COSTS OF VIOLENCE AND AGGRESSION TO THE NHS

Other titles in this collection

  • National Institute for Health and Care Excellence: Guidelines

Related NICE guidance and evidence

  • Violence: The Short-Term Management of Disturbed/Violent Behaviour in In-Patient Psychiatric Settings and Emergency Departments (NICE guideline CG25)

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Violence: A Very Short Introduction

Violence: A Very Short Introduction

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Violence: A Very Short Introduction examines the physical acts of violence in the modern world, describing it as one of humanity’s most enduring traits and a phenomenon that all cultures and societies share. It also traces the long history of violence and disputes the claim that it is diminishing. This VSI discusses different aspects of violence and diverse attitudes towards violence in the past and present. It talks about violence in cultural, social, economic, and political contexts. However, it also points out that not all groups or individuals are equally violent, nor does violence exist with the same intensity across societies.

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Essay on Media and Violence

Introduction

Research studies indicate that media causes violence and plays a role in desensitization, aggressive behavior, fear of harm, and nightmares. Examples of media platforms include movies, video games, television, and music. Violence in media has also been associated with health concerns. The youth have been the most common victims of media exposure and thus stand higher chances of exposure to violence (Anderson, 2016). In the contemporary world, violence in media platforms has been growing, reaching heightened levels, which is dangerous for society. When you turn on the television, there is violence, social media platforms; there is violence when you go to the movies; there is violence. Studies indicate that an average person in the United States watches videos for nearly five hours in a day. In addition, three-quarters of television content contain some form of violence, and the games being played today have elements of violence. This paper intends to evaluate the concept of media messages and their influence on violent and deviant behaviors. Television networks and video games will be considered.

The Netflix effect involves the behavior of staying home all day, ordering food, and relaxing the couch to watch Netflix programs (McDonald & Smith-Rowsey, 2016). Netflix and binge-watching have become popular among the younger generation and thus are exposed to different kinds of content being aired. Studies indicate that continuous exposure to violent materials has a negative effect on the aggressive behavior of individuals. Netflix is a global platform in the entertainment industry (Lobato, 2019). Although, the company does not have the rights to air in major countries such as China, India, and Japan, it has wide audience. One of the reasons for sanctions is the issues of content being aired by the platform, which may influence the behaviors of the young generation. The primary goal of Netflix is entertainment; it’s only the viewers who have developed specific effects that affect their violent behaviors through imitation of the content.

Television Networks

Television networks focus on feeding viewers with the latest updates on different happenings across the globe. In other instances, they focus on bringing up advertisements and entertainment programs. There is little room for violent messages and content in the networks unless they are airing movie programs, which also are intended for entertainment. However, there has been evidence in the violence effect witnessed in television networks. Studies called the “Marilyn Monroe effect” established that following the airing of many suicidal cases, there has been a growth in suicides among the population (Anderson, Bushman, Donnerstein, Hummer, & Warburton, 2015). Actual suicide cases increased by 2.5%, which is linked to news coverage regarding suicide. Additionally, some coverages are filled with violence descriptions, and their aftermath with may necessitate violent behaviors in the society. For instance, if televisions are covering mass demonstrations where several people have been killed, the news may trigger other protests in other parts of the country.

Communications scholars, however, dispute these effects and link the violent behaviors to the individuals’ perception. They argue that the proportion of witnessing violent content in television networks is minimal. Some acts of violence are associated with what the individual perceives and other psychological factors that are classified into social and non-social instigators (Anderson et al., 2015). Social instigators consist of social rejection, provocation, and unjust treatment. Nonsocial instigators are physical objects present, which include weapons or guns. Also, there are environmental factors that include loud noises, overcrowding, and heat. Therefore, there is more explanation of the causes of aggressive behaviors that are not initiated by television networks but rather a combination of biological and environmental factors.

Video games

Researchers have paid more attention to television networks and less on video games. Children spend more time playing video games. According to research, more than 52% of children play video games and spend about 49 minutes per day playing. Some of the games contain violent behaviors. Playing violent games among youth can cause aggressive behaviors. The acts of kicking, hitting, and pinching in the games have influenced physical aggression. However, communication scholars argue that there is no association between aggression and video games (Krahé & Busching, 2015). Researchers have used tools such as “Competition Reaction Time Test,” and “Hot Sauce Paradigm” to assess the aggression level. The “Hot Sauce Paradigm” participants were required to make hot sauce tor tasting. They were required to taste tester must finish the cup of the hot sauce in which the tester detests spicy products. It was concluded that the more the hot sauce testers added in the cup, the more aggressive they were deemed to be.

The “Competition Reaction Time Test” required individuals to compete with another in the next room. It was required to press a button fast as soon as the flashlight appeared. Whoever won was to discipline the opponent with loud noises. They could turn up the volume as high as they wanted. However, in reality, there was no person in the room; the game was to let individuals win half of the test. Researchers intended to test how far individuals would hold the dial. In theory, individuals who punish their opponents in cruel ways are perceived to be more aggressive. Another way to test violent behaviors for gamer was done by letting participants finish some words. For instance, “M_ _ _ ER,” if an individual completes the word as “Murder” rather than “Mother,” the character was considered to possess violent behavior (Allen & Anderson, 2017). In this regard, video games have been termed as entertainment ideologies, and the determination of the players is to win, no matter how brutal the game might be.

In this paper, fixed assumptions were used to correlate violent behaviors and media objects. But that was not the case with regards to the findings. A fixed model may not be appropriate in the examination of time-sensitive causes of dependent variables. Although the model is applicable for assessing specific entities in a given industry, the results may not be precise.

Conclusion .

Based on the findings of the paper, there is no relationship between violent behaviors and media. Netflix effect does not influence the behavior of individuals. The perceptions of the viewers and players is what matters, and how they understand the message being conveyed. Individuals usually play video games and watch televisions for entertainment purposes. The same case applies to the use of social media platforms and sports competitions. Even though there is violent content, individuals focus on the primary objective of their needs.

Analysis of sources

The sources have been thoroughly researched, and they provide essential information regarding the relationship between violent behaviors and media messages. Studies conducted by various authors like Krahé & Busching did not establish any relationship between the two variables. Allen & Anderson (2017) argue that the models for testing the two variables are unreliable and invalid. The fixed assumptions effect model was utilized, and its limitations have been discussed above. Therefore, the authors of these references have not been able to conclude whether there is a connection between violence and media messages.

Allen, J. J., & Anderson, C. A. (2017). General aggression model.  The International Encyclopedia of Media Effects , 1-15.

Anderson, C. A. (2016). Media violence effects on children, adolescents and young adults.  Health Progress ,  97 (4), 59-62.

Anderson, C. A., Bushman, B. J., Donnerstein, E., Hummer, T. A., & Warburton, W. (2015). SPSSI research summary on media violence.  Analyses of Social Issues and Public Policy ,  15 (1), 4-19.

Krahé, B., & Busching, R. (2015). Breaking the vicious cycle of media violence use and aggression: A test of intervention effects over 30 months.  Psychology of Violence ,  5 (2), 217.

Lobato, R. (2019).  Netflix nations: the geography of digital distribution . NYU Press.

McDonald, K., & Smith-Rowsey, D. (Eds.). (2016).  The Netflix effect: Technology and entertainment in the 21st century . Bloomsbury Publishing USA.

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Essay On Domestic Violence

500 words essay on domestic violence.

Domestic violence refers to the violence and abuse which happens in a domestic setting like cohabitation or marriage. It is important to remember that domestic violence is not just physical but any kind of behaviour that tries to gain power and control over the victim. It can affect people from all walks of life and it basically subjects towards a partner, spouse or intimate family member. Through an essay on domestic violence, we will go through its causes and effects.

essay on domestic violence

Causes of Domestic Violence

Often women and children are the soft targets of domestic violence. Domestic violence is a gruesome crime that also causes a number of deaths. Some of the most common causes of domestic violence are illiteracy and economical dependency on the menfolk.

The male-dominated society plays an important role in this problem. Further, dowry is also one of the leading causes which have the consequence of violence against newly-wed brides. In many parts of the world, physically assaulting women and passing horrendous remarks is common.

Moreover, children also become victims of this inhuman behaviour more than often. It is important to recognize the double standards and hypocrisy of society. A lot of the times, the abuser is either psychotic or requires psychological counselling.

However, in a more general term, domestic violence is the outcome of cumulative irresponsible behaviour which a section of society demonstrates. It is also important to note that solely the abuser is not just responsible but also those who allow this to happen and act as mere mute spectators.

Types of Domestic Violence

Domestic violence has many ill-effects which depend on the kind of domestic violence happening. It ranges from being physical to emotional and sexual to economic. A physical abuser uses physical force which injures the victim or endangers their life.

It includes hitting, punching, choking, slapping, and other kinds of violence. Moreover, the abuser also denies the victim medical care. Further, there is emotional abuse in which the person threatens and intimidates the victim. It also includes undermining their self-worth.

It includes threatening them with harm or public humiliation. Similarly, constant name-calling and criticism also count as emotional abuse. After that, we have sexual abuse in which the perpetrator uses force for unwanted sexual activity.

If your partner does not consent to it, it is forced which makes it sexual abuse. Finally, we have economic abuse where the abuser controls the victim’s money and their economic resources.

They do this to exert control on them and make them dependent solely on them. If your partner has to beg you for money, then it counts as economic abuse. This damages the self-esteem of the victim.

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Conclusion of the Essay on Domestic Violence

To conclude, domestic violence has many forms which include physical aggression like kicking and biting and it can also be sexual or emotional. It is essential to recognize the signs of domestic violence and report the abuser if it is happening around you or to you.

FAQ of Essay on Domestic Violence

Question 1: Why is domestic violence an issue?

Answer 1: Domestic violence has a major impact on the general health and wellbeing of individuals. It is because it causes physical injury, anxiety, depression. Moreover, it also impairs social skills and increases the likelihood that they will participate in practices harmful to their health, like self-harm or substance abuse.

Question 2: How does domestic violence affect a woman?

Answer 2: Domestic violence affects women in terms of ill health. It causes serious consequences on their mental and physical health which includes reproductive and sexual health. It also includes injuries, gynaecological problems, depression, suicide and more.

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Essay on Youth Violence

Students are often asked to write an essay on Youth Violence in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Youth Violence

Understanding youth violence.

Youth violence is a serious issue affecting many societies. It involves young people hurting peers who are unrelated and who they may or may not know well.

Causes of Youth Violence

Violence can stem from various factors like family problems, substance abuse, or exposure to violent media. It is important to understand these causes to prevent such incidents.

Effects of Youth Violence

Youth violence can lead to physical injury, mental health issues, and even death. It also impacts communities, increasing fear and reducing the quality of life.

Preventing Youth Violence

Prevention involves education, building safe environments, and providing youth with the tools they need to resolve conflicts peacefully.

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  • 10 Lines on Youth Violence

250 Words Essay on Youth Violence

Introduction.

Youth violence is a pressing social issue that has profound implications for public health and social stability. It is characterized by various harmful behaviors among young people, typically involving physical harm, threats, or intimidation.

Root Causes

The roots of youth violence are complex and multifaceted, often rooted in socio-economic disparities, family dysfunction, and exposure to violence. In many instances, youth violence is a manifestation of the social, economic, and psychological stresses that young people face.

Implications

The implications of youth violence are far-reaching. It not only affects the physical and mental health of the victims but also impacts their educational attainment and future prospects. Moreover, it contributes to a cycle of violence, perpetuating a culture of aggression and fear.

Prevention Strategies

Preventing youth violence requires a comprehensive approach that addresses its root causes. This includes socio-economic interventions to alleviate poverty and inequality, educational programs to foster empathy and conflict resolution skills, and mental health services to address psychological issues.

In conclusion, youth violence is a complex problem that requires multifaceted solutions. By understanding its root causes and implications, society can develop effective strategies to prevent it and create a safer, more inclusive environment for all young people.

500 Words Essay on Youth Violence

Introduction: the scope of youth violence.

Youth violence is a global public health problem that inflicts heavy social and economic costs on societies. It is a term that encompasses a range of aggressive behaviors including bullying, physical fighting, sexual violence, and gang-related violence. It is an issue that requires immediate attention and intervention due to its potential to disrupt the social fabric and impede the development of young individuals.

The Underlying Causes of Youth Violence

Youth violence is a multifaceted issue with roots in various socio-economic, familial, and individual factors. Socio-economic inequality, for instance, creates an environment where violence can thrive. Youths from disadvantaged backgrounds may resort to violence as a means of survival or as a manifestation of their frustration and anger towards the systemic disparity.

Family dynamics also play a critical role in shaping a young person’s propensity towards violence. Exposure to domestic violence, child abuse, or neglect can normalize aggression, and young individuals may replicate these violent behaviors in their interactions with peers.

Furthermore, certain individual factors such as mental health issues, substance abuse, and low self-esteem can contribute to violent behaviors. These factors, often intertwined with socio-economic and familial conditions, create a complex web of influences driving youth violence.

The Impact of Youth Violence

The impact of youth violence extends beyond the immediate harm to the victim. It can lead to long-term physical and psychological trauma, affecting a person’s ability to lead a healthy, productive life. For the perpetrators, involvement in violent activities can lead to a cycle of crime and incarceration, limiting their opportunities for education and employment.

At a societal level, youth violence can perpetuate a culture of fear and hostility, hampering community development and social cohesion. The economic costs are also significant, with resources being diverted towards law enforcement, healthcare, and rehabilitation services.

Preventing youth violence necessitates a holistic approach that addresses the root causes. Socio-economic interventions such as improving access to quality education and creating job opportunities can provide a constructive outlet for youths’ energy and aspirations.

Family-focused interventions, including parenting programs and domestic violence prevention initiatives, can help create a nurturing home environment. Mental health services and substance abuse programs can address individual risk factors, while community-based initiatives can foster a culture of non-violence and mutual respect.

Conclusion: A Call to Action

Youth violence is a pressing issue that demands collective action. By understanding its causes and impacts, we can develop comprehensive strategies to prevent it. Investing in our youth is investing in our future. Therefore, it is imperative to provide them with the tools and opportunities they need to grow into responsible, non-violent adults.

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Home — Essay Samples — Social Issues — Gun Violence — Gun Violence In The United States

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Gun Violence in The United States

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Violence Against Women Essay

Introduction, efforts in addressing violence against women at the global level, challenges in addressing violence against women at global level, conclusion and recommendations.

Violence against women is undoubtedly an international concern. Despite the numerous global legislations and policies on violence against women, different states have their own versions of laws that assist them in dealing with violation against women. These versions are in adherence to the international policies and laws that attempt to eradicate this evil. Several policies are in place to augment the global standardized laws.

To some extent, the individual states run advertisements that promote equality and campaign against unhealthy practices that undermine women’s rights at their local and international platforms. The inequality aspect cuts across the economic, social, and economic dynamics. The paper addresses how the violence targeting women in the parameters of ethnicity, nationality, race, and religion among others is quite traversed.

Violence against women is any action of aggression based on gender discrimination that by any account contravenes the rights of women. Such acts may entail threats and intimidations aimed at denying women autonomy in either private or public life.

Often, these actions likely result in physical, psychological, sexual harm, or distress to women. Internationally, people of all ages unanimously acknowledge that it is every person’s right to live free from violence. Yet, women of all ages, ranging from toddlers to old age, suffer excessively from violence both in peaceful regions as well as in war torn areas ( Violence against women , 2014). Notably, these violations could be witnessed at their homes, communities, or at the hands of officers envisioned to protect them.

Empirical research indicates that violence against women is not confined to a particular culture, country, community, region, or even to a specific group within a defined society, but rather is a global phenomenal (Fedorova & Wolf, 2005). Even though the act is prevalent to date, violence against women is a grave violation of human rights that requires an immediate solution.

Despite decades of marshal by women movements, civil societies, state agencies, and other stakeholders to end this nuisance, there are still numerous instances of violence targeting the womenfolk. Some of these cases go unreported to the relevant bodies. For these reasons, there is an effort to address this problem at a global level. According to Rao (2000), women of all ages, races, social status, as well as those women at the forefront in the fight against women violation too are abused.

Both scholars and gender experts alike share a similar estimation that violence against women has copious negative outcomes that vary from instantaneous, gradual, as well as long-term consequences to their lives. They may be of different forms such as sexual, psychological, physical, emotional, or economic, but are all interrelated in one way or another.

Subsequently, the situation impoverishes women and their families, thus affecting the fight against equality among communities, nations, and the world in general. Nevertheless, the challenges faced in addressing this issue globally are numerous, thus it cannot be solved from a sole intervention. Some of the most observed issues in addressing this problem are discussed below.

Creating awareness about violence against women

Even though violence against women has always existed, Newman and White (2006) note that it was until the last decade that the international community started to define systematically and, at the same time, began to draw the public’s attention to this act and its dangers. In this, the international communities designate violence against women as a gender-based violence, as well as an abuse to human rights.

This further helps the international community to demarcate acts that are vile and, therefore, can be used in creation of public awareness. This could be achieved by exposing incidences or individual perpetrators of violation of women’s rights to public shame. Alternatively, in creating awareness, the international communities use instances of negative effects of violence on women’s rights to sway the public to shun violation against women (Fedorova & Wolf, 2005).

In addition, in an effort to expose violence against women globally, some women movement groups have created websites that collect, store, and share information about violence against women. The women movements have received support from international organizations that fight for the rights of women in the society.

This information can help the supposed victims acquire abundant knowledge on avoiding situations or dealing with situations that violate their rights (Fedorova & Wolf, 2005). Consequently, this step of conception of awareness has resulted in creation of several women movements that support gender equality in order to address violations against women.

Legal and policy creations

Until recently, several acts of violence against women were not regarded as crime, especially the acts that were committed within families or close relationship settings. Newman and White (2006) affirm that in most of the states, once a woman had accepted to get married to a man, the husband had the responsibility to modify her behaviors by whichever means available. This was not limited to battering in order to restrain the wife from mischievous behaviors.

Because the husbands had the authority over their families, the law thought it was reasonable for men to give their wives any kind of punishment that would restrain them from impish behaviors. In this dimension, the police and other government law enforcing agencies, including the courts were unwilling to punish such acts ( Violence against women , 2014). However, with the initiation and development of international legal frameworks that handle crimes against women, the situation has drastically changed.

Rao (2000) points out that since the 1993 UN declaration on elimination of violence against women and the subsequent international agreements, such as Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), violence against women has reduced tremendously, except that it has not been eradicated fully.

Additionally, in the fight against global violation of women, the international policymakers have integrated numerous policies with international legislations that tackle this vice. As a result, there are international legal resolutions as well as instruments that handle violation of rights of women at the global level.

Whereas it is obvious that the issue of violence against women is an international threat and should involve international communities to be resolved, the differences in forms, causes, as well as the environments that this menace prevail differ, thus commanding distinct challenges in their resolutions. Some of the unique situations that hinder international resolution of violence against women are discussed bellow.

Long-held assumptions

One of the greatest obstacles in addressing violence against women is long-held cultural assumptions. For instance, in some communities men are naturally respected, and are viewed as the dominant ones in the society. Undoubtedly, men in this situation are at the top of the social ladder while women are at the bottom, hence are seen as properties.

Under this circumstance, such women are not in a position to recognize the actions that are internationally considered violations as crimes, but rather as normal day-to-day practices (Dua & Robertson, 1999).

Alternatively, the women may lack the forums to express their disappointments. Nevertheless, international campaigns and awareness might create realization of such vise, which may eventually help the individuals at risk of violations to recognize their rights. On the other hand, the global legislations and laws that prohibit women violation might not be effective, as the women might not report such cases for fear of the consequences.

Differences in perceptions, culture and beliefs regarding gender equality

This situation is also witnessed in the feminism debate about combating family violence. Newman and White (2006) note that in the past decades, policymakers, law enforcement agencies, and the society viewed homes as sacred. As a result, whatever was done behind closed doors internally was not the business of the outside world. Even though this perception is losing ground, feminism scholars and experts alike admit that it is present to date in some communities.

Therefore, addressing such a community on the issue of violence against women at the international level is likely to bear no fruit. Instead, to eradicate women violations efficiently in this circumstance, there should be local laws and groups that address the specific beliefs and taboos that violate the women’s rights. At the same time, the groups should educate both women and men on the benefits of abandoning such beliefs.

Race is another outstanding obstacle in addressing violence against. Dua and Robertson (1999) note that the situation for non-white immigrants in the white dominated countries is totally different to those who speak the native language. Racism and related intolerances do not affect all members of victim groups with the same intensity or in the same way. Even in racism aspects, women are amongst the vulnerable group in this scenario, thus suffering intersection of discrimination based on both gender and race.

Besides, racism presents a situation of double standards that merge communalization from high-level management and the infringed individuals. This double standard in treatment of individuals in relation to skin color creates a situation of informal apartheid. In essence, the double standards in treatment of individuals based on the color of their skin propel the cultural identities that already exist (Evans & Wekerle, 1997).

At the same time, the culture of apartheid flourishes, rendering greater risks to the endangered community. These complexities of the societal structure offer the problematic nature of dealing with unique situations of violence against women. Subsequently, this group demands a unique solution to violence against women as opposed to the global laws and policies that tend to eliminate the vice.

Social Class

In discussing the issue of violence against women, the social class is an issue that should be given a discrete consideration other than the general address at the global level. Primarily, Rao (2000) asserts that literacy level, exposure, and awareness are issues of concern in addressing violence against women. In relation to the social class, the privileged community has access to revenue; therefore, they are well-informed on all aspects including their rights.

On the other hand, the low class individuals are deprived of the basic amenities including education and access to justice. Therefore, this group is vulnerable to exploitation both with and without intent. In addition, the social class demarcates the boundaries within which the poor and the rich interact. Therefore, the higher social class is characterized by abundant wealth, as opposed to the lower social class that flounders in poverty.

According to Class notes (2014), in cases of violence against women, the lower class exposes women to vulnerable situations. For instance, women seeking for employment may be victims of violence such as trafficking as well as rape. The Global Report on Trafficking in Persons of 2009 noted that women are the highly affected in human trafficking globally; they represent close to 70% of the trafficked population.

Handling state involved perpetrations

A vast literature that analyze violence against individuals by the states indicate that dealing with violation of women rights that involve state agencies is an obstacle in eliminating violence against women. The case of violation against women by government agencies is mostly reported in warring regions where the soldiers perceived liable to protect the vulnerable citizens in turn violate them, and, eventually, go scot-free. In rare situations, the governments are reluctant in addressing issues that violate women’s rights.

Such is witnessed in nations like Canada where the federal government is reluctant in tackling the issue of killings of the aboriginals ( Class notes , 2014). Likewise, in most states the governments are reported to reluctantly address issues of devaluation of women. Subsequently, the prevailing violence against women in such regions is reluctantly resolved. In sum, these situations highlight the need to address the violation against women at the local level other than at the global level.

Clearly, progress has undeniably been made in the global based fight against violation of women’s rights; this may be evident in terms of improving public awareness, as well as giving women who suffer from violence supplementary places for rehabilitation. This is not an exclusive solution to women’s problems across the globe as many women continue to suffer violence at the hands of abusive partners in silence or fear of the consequence.

Probably to address the issue effectively, the international organization should involve the public in challenging the traditional attitudes toward gender perceptions. In order to address this, the campaigns against this vice should possibly be devolved into the grass-root level. Recently, several cases that would have gone undisclosed have been reported and handled legally, thereby reducing the instances of such violations.

However, feminism scholars ascertain that most of the cases that go unreported to date occur when perpetrators of violence use the state and its agents to intimidate the offended. However, there are unique cases in specific regions that require special attention to eradicate violence. This is witnessed in the reluctance by the law enforcing agencies to take firm actions against the perpetrators. Notably, addressing such situations on a global level could possibly bear no fruit.

Therefore, there is a need to initiate local-based actions that are specific and tailored to every unique situation in order to get rid of this menace. Arguably, the introduction of legislation at different levels within regions and states is a clear indication that the issue of violation against women cannot be handled at global level alone, but must rather be supplemented by the local legal frameworks.

Class notes (2014).

Dua, E., & Robertson, A. (1999). Scratching the surface: Canadian, anti-racist, feminist thought . Toronto: Women’s Press.

Evans, P. M., & Wekerle, G. R. (1997). Women and the Canadian welfare state: Challenges and change . Toronto: University of Toronto Press.

Fedorova, M., & Wolf, W. J. (2005). The United Nations and the protection of the rights of women . Nijmegen, The Netherlands: Wolf Legal Publishers.

Newman, J. A., & White, L. A. (2006). Women, politics, and public policy: The political struggles of Canadian women . Toronto: Oxford University Press.

Rao, D. (2000). Status and Advancement of Women. New Delhi: APH Publishing.

Violence against women . (2014). Web.

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