NHS Wellbeing Week: Aggression and de-escalation

Aggression is a common human behaviour that can manifest in various forms, ranging from verbal threats to physical violence. As NHS employees, you are often exposed to situations that can trigger aggression in our patients or clients.

These situations can include long waiting times, difficult diagnoses, or simply a lack of understanding about the treatment process. Therefore, it is essential for us to understand the nature of aggression and develop effective de-escalation strategies to ensure the safety of both you and your patients. 

The causes of aggression

Aggression can stem from various factors, including fear, frustration, or a perceived threat to one's autonomy or dignity. It can also be a result of underlying mental health issues such as anxiety, depression, or personality disorders. It is important to recognize that aggression is not always a deliberate act of violence but rather a response to a perceived threat or challenge.

De-escalation is the process of reducing the intensity of an aggressive situation or behaviour. It involves a range of techniques that aim to defuse the situation and prevent it from escalating further. De-escalation is a crucial skill for NHS employees as it can prevent harm to patients, staff, and property. The following are some effective de-escalation strategies that can be used by NHS employees:

How an EAP helps employees with mental health

Stay calm and composed

It is important to remain calm and composed when dealing with an aggressive individual. The person may be feeling overwhelmed, and responding with aggression can escalate the situation further. It is important to maintain a non-threatening posture and tone of voice.

Listen actively

Listening actively is a crucial aspect of de-escalation. It shows the person that their concerns are being heard and acknowledged. It is essential to maintain eye contact and focus on the person's body language to understand their emotions better.

Empathise

Empathy is the ability to understand and share the feelings of another person. It is important to empathize with the person and acknowledge their feelings. Using phrases such as "I understand how you feel" or "I can see that this is upsetting for you" can help the person feel heard and understood.

Use non-threatening language

It is essential to use non-threatening language when communicating with an aggressive person. Avoid using aggressive or accusatory language, and instead, use neutral and non-judgmental language. This will help to de-escalate the situation and prevent further aggression.

Offer choices

Offering choices can help the person feel a sense of control in the situation. It can also help to redirect their attention away from the source of their aggression. For example, offering a choice between two treatment options or two waiting areas can help the person feel empowered.

Provide a safe environment

Creating a safe environment is crucial when dealing with an aggressive person. If the person is in a public area, it may be necessary to move them to a private area. It is also essential to have a clear escape route in case the situation escalates.

Involve others

If the situation is escalating, it may be necessary to involve other staff members or security personnel. It is important to have a clear protocol in place for when to involve others and how to communicate effectively in a crisis.

Follow up

After the situation has been de-escalated, it is essential to follow up with the person. This can involve checking in on their well-being, providing additional support, or following up on any concerns or complaints they may have. Following up can help to build trust and prevent future incidents.

In conclusion, aggression can be a challenging behaviour to deal with, but effective de-escalation strategies can prevent harm to individuals and property. As NHS employees, we must understand the nature of aggression and develop effective de-escalation skills. This involves staying calm, active listening, empathizing, using non-threatening language, offering choices, creating a safe environment, involving others, and following up. By implementing these strategies, we can ensure the safety and well-being of our patients and ourselves, and provide high-quality care in a compassionate and respectful manner.