Assessing when acts of violence and self-harm were likely to occur enabled one clinic to deploy staff more effectively, say Mike Sullivan and Peter Ghroum

Analysis of the distribution and frequency of episodes of violence/aggression and deliberate self-harm in a medium-secure unit shows that there are peak times for such occurrences and destabilising conditions that may precipitate these behaviours. Adjusting staffing levels and shift patterns, and providing individualised observation plans reduces the number of incidents. Flexibility and responsiveness are important at all times.