Violence and aggression

Work-related violence and aggression is any incident where a person is threatened, attacked or physically assaulted in circumstances relating to their work.

Work-related violence and aggression covers a broad range of actions and behaviours that create a risk to health and safety of workers. These are actions or behaviours that may physically or psychologically harm another person. Examples include:

abusive behaviour, including insults and name-calling intimidating behaviour that creates a fear of violence, such as stalking or threatening to cause physical harm
any form of assault, such as biting, spitting, scratching, hitting, kicking, punching, pushing, shoving, tripping, grabbing or throwing objects.

Violence and aggression can be:

physical, psychological, verbal or written
one off or repeated incidents
minor behaviours through to more serious acts, including criminal offences, which require the intervention of public authorities
in person or can include threats by correspondence, electronic means or by social media.

Whether the violence or aggression was intended or not, or whether the perpetrator has the capacity to recognise that their actions could cause harm, does not reduce the risk of harm from the violence.

All workers and other people at workplaces are potentially at risk of experiencing some form of violence or aggression. Workers most at risk are those who have regular contact with the general public or provide direct services to clients. Higher risk industries and occupations include:
- health care and social assistance – this includes nurses, doctors, paramedics, allied health workers, child protection workers, and residential and home carers
- public administration and safety – such as police officers, protective service officers, security officers, prison guards, welfare support workers and frontline service workers in large government agencies
- retail and hospitality – particularly for new and young workers, including workers at grocery outlets, pharmacies, petrol stations, restaurants, bars and takeaway food service
- education and training – including teachers and education assistants.
Violence and aggression may cause physical and psychological injury or harm can lead to:
- feelings of isolation, social isolation or family dislocation
- loss of confidence and withdrawal
- physical injuries as a result of assault
- stress, depression, anxiety, post-traumatic stress disorder (PTSD)
- illness such as cardiovascular disease, musculoskeletal disorders, immune deficiency and gastrointestinal disorders; e.g. as a result of stress
- suicidal thoughts.
There can also be considerable direct and indirect costs for the organisation, including lost productivity while people are not working, repairing property damage, and medical and legal expenses.

WHS duties

Everyone in the workplace has a duty to manage hazards and risks to worker physical and psychological health and safety. These duties are set out in the WHS Act. A workplace where mental health and wellbeing is a priority benefits everyone.

A PCBU has the primary duty of care under the WHS Act to ensure that workers and other people are not exposed to health and safety risks arising from work carried out. This duty includes:
- providing and maintaining a work environment that is without risks to health and safety
- providing and maintaining safe systems of work
- monitoring the health and safety of workers and the conditions at the workplace to ensure that work related illnesses and injuries are prevented
- providing appropriate information, instruction, training or supervision to workers and other persons at the workplace to allow work to be carried out safely
Workers need to know what the procedures are for managing and responding to violence and aggression in the workplace. This information should be included in induction training for new workers. Information to workers could include:
- the nature and causes of violence and aggression in their organisation or industry sector, including potential triggers
- suggested measures to prevent such problems occurring, and best practices for their reduction and elimination
- the laws and regulations covering violence and aggression, both specifically and generally
- how to report incidents and how they will be investigated
- the services available to assist workers exposed to work-related violence and aggression.
Other people at a workplace, such as visitors and clients, have similar duties to that of a worker and must:
- take reasonable care for their own health and safety
- take reasonable care that their acts or omissions do not adversely affect the health and safety of workers or other persons, and
- comply with any reasonable instruction given by the business.
Finding out what workers are exposed to, the types of behaviour they experience, the frequency and severity of incidents, and what can be done to prevent or mitigate the risk of exposure, needs a systematic and holistic approach. This can take the form of a violence and aggression plan and include:
- measures and procedures for preventing violence and aggression in the workplace
- measures and procedures for dealing with workplace violence and aggression immediately, should it occur or if it is likely to occur, including communicating risks and the need for assistance
- measures and procedures for workers to report incidents of workplace violence and aggression to the PCBU or supervisor
- information about how the PCBU will investigate and deal with incidents or complaints of violence and aggression
The code of practice outlines the steps for developing a violence and aggression prevention plan. Once the prevention plans are established they should be periodically reviewed to ensure it remains relevant.

Manage risks

It is a requirement under the WHS legislation to manage risks to worker health and safety, including psychological health and safety. Risk management is a continual process that involves the following steps:

The first step in the risk management process is to identify the hazard. In this context, the hazard is violent and/or aggressive behaviour from a client, customer or other person who is not a worker in that workplace. Some of the ways to identify situations include:
- consulting with the workforce about violence and aggression risks in their work area
- checking accident reports, injury records or client histories to find out about previous incidents
- conducting workplace inspections to identify risks of exposure
- reviewing means of access to and exit for workers before/after working hours
- reviewing working arrangements
- analysing feedback from clients to identify problems areas
The third step is to implement control measures to eliminate or reduce the risk of the violence or aggression occurring. Some controls for the management of violence and aggression risks are more effective than others and are ranked from the highest level of protection and reliability to the lowest.

Elimination

Elimination controls are the most effective and reliable form of control. Examples include:
- Banning people with a history of violence and aggression
- Refusing service to clients who expose workers to violence and aggression
- Providing alternative methods of customer service to eliminate face-to-face interactions
Substitution

Use a safer alternative. Examples include:
- Use EFTPOS machines instead of cash
- Minimise discomfort in waiting rooms and use signs to advise current waiting times
- Use way-finding volunteers at hospitals to reduce customer frustration
Isolation

Separate workers from the hazard

Physical barrier examples:
- Controlled-access doors where access is via a security card or code
- Screens to reduce the risk of attack from clients; e.g. on buses, at counters.
- Interview rooms in hospitals, community health clinics and mental health clinics designed with controlled access and separate emergency egress to isolate aggressive clients.
Administrative barrier examples:
- Service agreements that outline acceptable behaviour and consequences when clients or members of public are violent or aggressive
- Posters outlining acceptable behaviours and consequences of unacceptable behaviours
- Signs warning that cameras are in use
Administrative controls

Examples include:
- Training workers in appropriate systems of work, dealing with difficult clients and conflict management skills
- Implementing job rotation to reduce the amount of time workers are in stressful situations or working with high-risk clients
- Implementing customer feedback procedures
Personal protective clothing and equipment (PPE)

Examples:
- PPE for protection from contact with body fluids
- Protective body gear or riot gear in prisons or high security detention centres
- Personal duress alarms.
Case study examples are provided in the Violence and Aggression at Work Code of Practice.
The last step is to review the effectiveness of the implemented control measures to check they are working as planned. The PCBU needs to consult with workers to review the effectiveness of the control strategies put in place. Questions to be asked include:
- Have incidents of violence and aggression decreased?
- Have any new risks been introduced following implementation of the risk control?
- Are there other controls which may be more effective?
After an incident occurs, it is important to look at whether or not controls were applied, their effectiveness, and whether they need altering, amending or replacing. There should be ongoing analysis of reported incidents to work out whether additional measures should be provided to workers.

Responding to incidents

How PCBUs respond to incidents is a critical part of the overall prevention plan. Information from the risk management process will guide the response. There are three key areas:

It is essential that there are clear procedures to be followed for an effective immediate response that controls and defuses the situation, and provides avenues for retreat should de-escalation and prevention fail.

Establishing effective communication systems to be used in an emergency is an essential part of emergency planning. This is especially important for people who work alone and those requiring rapid assistance.
There are two components to post-incident response. One is investigating the incident and how it can be prevented from reoccurring; the other is supporting worker recovery, including injury management, counselling and return to work, where required.

When investigating an incident, it is important to:
- consult with workers and interview witnesses to investigate the incident
- review the controls to assess their effectiveness and whether they can be improved, replaced or new controls introduced
- inform all workers about what action will be taken to reduce the risk of harm or injury in the future
- keep records of incident reports, investigations and actions taken so that trends can be established and reviewed as part of the ongoing risk management.

Further support

High risk industries

Other WorkSafe publications

- Aggression in the workplace - Toolkits and information resources
- Sample presentation: Preventing and managing aggression in the workplace for employees
- Sample: Aggression in the workplace prevention policy
- Sample: Aggression in the workplace risk management toolkit

Other publications

- Preventing workplace violence and aggression guide 
- Workplace violence and aggression – advice for workers
- Community Safety. Business Security Audit: Crime Prevention Tips for You and Your Business
- Preventing Client-Initiated Violence: A Practical Handbook