Risk management of aggressive behaviors in mental health units for adolescents: a scoping review

Introduction: Research on aggressive behaviors (ABs) in adolescent mental healthcare settings remains limited and underexplored. Such behaviors significantly affect staff, patients, and the therapeutic environment, necessitating nursing interventions for effective risk management to reduce their adverse impact on safety and quality of care. Objective: This review aimed to map the existing evidence on nursing interventions for the risk management of AB in adolescent mental health units. Methods: A search strategy was used to identify relevant studies in databases, respecting the Participant/Concept/Context (PCC) question formulation structure. This review covers studies describing nursing risk management strategies for adolescents (10 to 19 years old) with aggression problems and admitted to mental healthcare units. Results: From the 499 records initially identified, 9 articles met the inclusion criteria and were selected for review, in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses extension for scoping reviews (PRISMA-ScR) and its associated flow diagram. The nursing interventions identified for managing AB in adolescent healthcare settings included risk assessment tools, targeted risk management strategies, evidence-based interventions but also various forms of coercive measures. Conclusions: This review integrates current knowledge on nursing interventions for the risk management of AB in adolescent mental health units. The focus of these interventions is prevention, by early intervention strategies but also intervention programs with improved outcomes for the patient, staff and therapeutic milieu, promoting less coercive interventions and increased care quality and safety.