| Themec | Paradigmatic Examples | Psychiatric Emergency Room, n (%) | Inpatient Units, n (%) |
|---|---|---|---|
| Psychosis | 36 (60) | 71 (57) | |
| Disorganization | Incident is unprovoked and accompanied by other nonsensical behavior | 25 (42) | 56 (45) |
| Paranoia | Patient complains that a person is talking about him or her, then strikes that person | 13 (22) | 20 (16) |
| Perceptual disturbance | Patient has command auditory hallucinations to hurt others | 4 (7) | 10 (8) |
| Conflicts with peers | 8 (13) | 34 (27) | |
| Taunting | One patient calls another patient a derogatory name | 3 (5) | 17 (14) |
| Dispute over limited resource | Two patients want to use the same computer at the same time | 0 (0) | 7 (6) |
| Annoyed by behavior on the unit | A patient is talking loudly and constantly, which is bothering many on the floor and ultimately triggers an incident | 1 (2) | 7 (6) |
| Dispute over personal space or property | A patient enters the wrong room, or roommates disagree on whether the door should be open or closed | 1 (2) | 4 (3) |
| Direct challenge to fight | One patient challenges another patient to fight | 2 (3) | 2 (2) |
| Retaliation | Incident is a response to an argument that started the previous day | 0 (0) | 7 (6) |
| Defending others | Patient thinks someone else is about to be attacked | 1 (2) | 3 (2) |
| Phenomenological escalation | Patients are shadow boxing, then start real boxing | 0 (0) | 2 (2) |
| Conflicts with staff | 20 (33) | 32 (26) | |
| Objection to unit rules or structure | Patient is asked not to stand next to the door | 4 (7) | 18 (15) |
| Admission or discharge dispute | The patient wants immediate discharge | 12 (20) | 12 (10) |
| Perceived needs are not being met | Patient demands opioids for pain | 4 (7) | 4 (3) |
| Other themes | 16 (27) | 37 (30) | |
| Accidental assault | Person is flailing arms without targeting anyone in particular, or a staff member gets pushed while keeping two patients apart | 1 (2) | 3 (2) |
| Dispute involving food | Staff threw away food a patient was intending to eat | 0 (0) | 6 (5) |
| Themes related to sexuality | Patient feels a romantic connection with a staff member and touches the staff member inappropriately, or targets a perceived rival, or feels insulted on the basis of sexuality | 3 (5) | 11 (9) |
| Family involvement | Incident happens after a family visit | 6 (10) | 13 (10) |
| Bodily integrity | Patient thinks he or she is about to be attacked | 2 (3) | 4 (3) |
| No identifiable narrative | Patient is not described as disorganized, but no clear narrative is mentioned | 4 (7) | 1 (1) |
↵a The full code book, with definitions for each code or theme, is available in the supplemental materials.
↵b There were n = 60 total incidents in the psychiatric emergency room and n = 124 incidents on the inpatient units.
↵c Category counts (e.g., psychosis) may differ from theme count sums (e.g., disorganization, paranoia, perceptual disturbance) because some incidents involved multiple themes within a category.