Is a No-Restraint Policy Associated with Increased Aggression Towards Healthcare Professionals Among Inpatient Psychiatric Units? A 16-Year Retrospective Observational Study Conducted in Italy.

The aim of this study was to investigate aggression-related work accidents in an inpatient psychiatric unit before and after implementing a no-restraint policy in Italy. Results revealed that, over the study period (2007-2022), 113 accidents occurred, mostly related to physical aggression (81.4%), with healthcare assistants and psychiatric nurses being the most affected and more accidents occurring during the morning shift (49.6%). A transitory peak of accidents occurred during the policy transition (χ = 16.0, < 0.001; V = 1.000), falling rapidly in the subsequent years. In conclusion, adopting a no-restraint policy is not associated with increased aggression toward staff in psychiatric healthcare in the longer term, although greater support is needed during the transition phase to minimize risks.