The prosecution of psychiatric patients for assaults on staff: a preliminary empirical study.

A survey of five public hospitals yielded nine cases in which staff pressed charges against patients who assaulted them. Examining the effects of prosecution on the patients, the legal system, and the staff, the authors found that two patients benefited, three showed little or no change, and four were lost to follow-up. The legal system was responsive to the request to prosecute, although sometimes reluctantly, in six cases, but uncooperative in the rest. In five of the cases, staff were satisfied with the outcome of the legal intervention, even though it benefited only two of those patients. Among the authors' recommendations for dealing with assaults are to use appropriate clinical measures first, address any systems problems that an assault suggests, and, because prosecution may alienate patients from the treatment system, obtain consultation from a psychiatrist outside the patient's care system before proceeding.