Managing Violent Patients

Managing Violent Patients – see it on YouTube

A training video for psychiatrists on how to best manage potentially violent patients. It was made by psychiatry residents at the University of Iowa in the spring of 2008.

View Part 1

View Part 2

One of the bright spots in any educator’s career is seeing his students’s own creative and influential productions. Literally, that’s what I am proud to introduce—a professional, very clever, and educational video production dramatizing the principles of what I’ve taught psychiatry residents regarding the management of violent patients. Readers will be able to see the principles in my chapter in the forthcoming book, Introduction to Psychosomatic Medicine.

Dr. David Mair, MD, a former chief resident of psychiatry at the University of Iowa, put the video together in the summer of 2008 along with several other residents who evidently had a talent for acting of which I’d been unaware. It’s a lot like the book, a collaborative effort between teacher and learner to disseminate essential knowledge about how to manage patients with comorbid medical and psychiatric illness in a compact toolkit which just happens to be entertaining as well.

But I give full credit to David and his peers for transforming what could be (and probably was) pretty dry stuff in lecture form into a hysterical hoot of a learning experience that’s much more likely to stick to your ribs as well as tickle them.

Dr. George W. Henry, who is said to have written the very first journal paper on consultation-liaison psychiatry, published in the American Journal of Psychiatry in 1929, wrote of using the psychiatric approach in managing patients with both medical and psychiatric illness:

“Relegating this approach entirely to specialists is futile for it is doubtful whether there will ever be a sufficient number of psychiatrists to respond to all the requests for consultations. There is, therefore, no alternative to educating other physicians in the elements of psychiatric methods.”

I think the video is more than just a step in the right direction. I owe many thanks to Dr. Mair and the rest of the learners, each of whom is a teacher in his or her own right. Enjoy!

James J. Amos is co-editor of Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry.

Early in my training, I didn’t quite know how to react with potentially violent patients.  No amount of knowledge of medicine, physiology, or the DSM provided me the skills to address these situations.  Though we had excellent training during orientation, I really learned by observing skilled clinicians, and through my own encounters, both good and bad.  This was exemplified during my rotation in consultation-liaison psychiatry, when working with Dr. Amos, to learn his logical, step-wise approach, see him in these problematic scenarios, and to practice what I had learned.

In making this educational video, I wanted to give incoming residents a quick way to make these observations, and present it to them in a way that was both useful and entertaining. It helped that I had a cadre of multi-talented peers and a faculty supervisor who recognized the utility of such a project.  Though managing these patients will be an eternal source of anxiety for all psychiatrists, my hope is that with this video, they will feel just a little better prepared.

David Mair MD, Hennepin County ACT Program Psychiatrist


One Response to Managing Violent Patients

  1. Pingback: Delirium as a Cause of Violent Behavior | The Practical Psychosomaticist: James Amos, M.D.

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