Estimating the costs of conflict and containment on adult acute inpatient psychiatric wards

Researchers sought to estimate the costs of different types of conflict and containment in the United Kingdom using events from 136 adult acute inpatient psychiatric wards in the United Kingdom and unit costs from a sample of 15 wards. Researchers study sought to obtain and observe actual staff time managing conflict and containment by means of a new method of estimating costs arising from the development of an interview schedule to use with key staff. The estimated mean annual cost for conflict is £145,177, and for containment £212,316. The total estimated annual costs in England for all conflict is £72.5 million and for containment is £106 million (see Table 1). The most expensive conflict behavior to manage was verbal abuse with a mean cost per ward of £21.2k and a total of £10.5 million nationally. Self-harm had a mean cost of £8.2k per ward and £4 million nationally in England. Intermittent and special observation cost £45 million and £35 million respectively (see Table 1). This study also suggests that approximately half of all nursing resources are expended in managing conflict and deploying containment.