This Partnership for Workplace Mental Health article is based on Dr. Schouten’s chapter, Violence in the Workplace, published in Mental Health and Productivity in the Workplace: A Handbook for Organizations and Clinicians; extra material was added here to update the data and give additional context.

The combination of media attention and the catastrophic nature of workplace homicides have resulted in the impression that there is an epidemic of workplace violence. The published literature is replete with references to this so-called epidemic. However, examination of the data gathered by the Bureau of Labor Statistics of the U.S. Department of Labor reveals the epidemic, and several other commonly held beliefs, to be inaccurate.

Commonly Held Beliefs About Workplace Homicides

Belief: Workplace homicides are on the rise.

Fact: There was a 44% drop in workplace homicides between the peak number in 1994 and 2002.

Belief: Workplace homicide is the leading cause of death at work.

Fact: Workplace homicide is the number three cause of death in the workplace, behind highway accidents and falls from high places.

Belief: When workplace homicides do occur, the perpetrators are primarily disgruntled co-workers or former co-workers.

Fact: The vast majority of workplace homicides are committed by outsiders in the course of robbery or attempts at other crimes. From 1994 to 2002, co-workers or former co-workers committed a minority (between 5% and 11%) of workplace homicides.

Assessing the Risk of Violence

Analysis of any threat situation requires an acknowledgment that violence is not the product of a single factor. Rather, it is the product of the interaction between a number of variables, including the individual’s traits, the environment in which he or she is functioning, and situation factors or triggers. Even a person with a high propensity for violence is not violent all the time. The challenge lies in determining what factors are likely to incite such a person to act and to intervene so that those factors are diminished or eliminated.

The degree of concern about workplace violence has resulted in a demand for information and certainty that has not yet been filled by scientific research. The most widely used technique for violence risk assessment in the workplace is the behavioral profile. The popularity of profiles is understandable: they answer the public’s desire for a simple, understandable, and apparently accurate method of identifying employees and co-workers who are likely to be violent, but the profiles themselves have never been demonstrated to have any predictive value.

The empirical research on workplace violence is limited, and no empirical studies of workplace homicides could be found in a literature review conducted in 2002. That review did find studies, however, that support a number of individual risk factors for workplace aggression.

Common risk factors for workplace aggression:

• History of antisocial behavior
• Unsatisfied by treatment from supervisor
• Male gender
• Being laid off
• History of alcohol use
• A belief that revenge is justified
• Trait anger
• Younger age
• Blaming others for own problems
• Previous exposure to aggressive cultures
• History of criminal behavior

Surprisingly, many of the most commonly cited individual risk factors have not been validated. These include:

• Fascination with the military and weapons
• Inability to accept criticism or authority
• Irrational beliefs or ideas
• Length of job tenure
• Paranoid personality traits
• Mismanaged stress
• Marital and financial problems
• Rude remarks to others, harassment, and bigoted beliefs
• Being older than 35 years
• Substance abuse other than alcohol

That does not mean, however, that these and other risk factors are not relevant, have been disproved, or might not be validated in the future—merely that they may not have been fully validated yet.

Beware Ineffective Workplace Violence Resources

Being prepared to prevent and/or address workplace violence is key to the resolution of these types of conflict. Dr. Schouten warned an audience of the pitfalls of utilizing inefficient and ineffective programs for preventing violent incidents at the workplace at the Carter Center/American Psychiatric Association Symposium on “The Business Case for Mental Health Care,” (June 2001, Atlanta, GA):

“People are out there trying to sell [employers] profiles of perpetrators of workplace violence. The information on which these profiles are based is anecdotal, coming either from newspaper accounts or court records."

"These profiles have no predictive validity," he continues. "I’ve seen one of these profiles designed to be put up in the coffee room. It talks about the ‘three stages of workplace violence.’ The last item of stage 3—which of course is all in red—is ‘uses weapons to harm others.’ I submit that if you’re in the coffee room and there’s an employee out there shooting people, it’s a little late to be using the checklist….One of my favorite collections of profile factors—white, male, 30-50 years old, identity closely tied to the job, difficulty with authority, likes to work alone—describes half the physicians in Massachusetts.&rdquo

Organizational Risk Factors

A number of organizational risk factors for workplace violence have also been proposed.

Risk factors that correlate with occurrence of workplace aggression:

• Pay cuts or pay freezes
• Use of part-time employees
• Changes in management
• Increased diversity of the workforce
• Use of computers to monitor employee performance
• Corporate reengineering
• Budget cuts
• Deteriorating physical environment
• Workplace located in the city
• High unemployment in the industry
• Low work group harmony
• Conducting terminations with more than one employee present
• Conducting terminations on a Monday or a Tuesday

Factors assumed to be protective, but not yet validated in empirical studies to date:

• Installing metal detectors and other hardware solutions
• Training employees to work with workplace bullies
• Creating early intervention plans
• Offering workplace workshops on nonviolent communication and conflict resolution
• Avoiding hiring applicants about whom managers have a bad, instinctual feeling
• Time-of-day of termination

The lack of scientific research supporting or disproving commonly assumed risk and preventive factors is disturbing to those faced with the need to respond to threats and potentially violent situations. Nevertheless, employers and consultants should not adopt a nihilistic approach to workplace violence and assume that nothing is known simply because the research in the area is in its infancy. Instead, they should be aware as decisions are made that there is no certainty in this area and that much work remains to be done.

Tips for Employers

The following recommendations for assessing and managing threats and potential violent incidents are drawn from Dr. Schouten's experience as a consultant in this field, in collaboration with legal and security professionals.

These employer tips include measures that have not been scientifically tested but have helped organizations:

1. Respond to incidents in a timely and efficient fashion
2. Develop confidence in their ability to respond
3. Avoid legal liability
4. Contain the anxiety of individual employees and the organization as a whole

Employer Tips for Preparing for & Addressing Workplace Violence

• Ensure that your organization has a workplace violence policy. Many companies adopt a zero-tolerance policy toward workplace violence. When doing so, a decision must be made as to the exact meaning of zero tolerance.
• Create a crisis management plan that is practical, functional, and rehearsed at least annually.
• Assemble a crisis management team and plan. A team of individuals from different fields should be organized and given responsibility for the crisis management plan, training exercises, coordinating with local law enforcement, and response to incidents. The size, resources, and needs of the organization will determine the size and composition of the team.
• Communicate crisis management team responsibilities. The core team members, or their designees, should be available 24/7 and prepared to respond to reports and concerns immediately. Once one member of the team receives a report, the other core team members should be contacted. After gathering initial information, a decision should be made about immediate next steps. The team should then conduct an investigation of the incident.
• Reconvene with your crisis management team. Once the information has been gathered, the team reconvenes and determines if there has been a violation of the workplace violence policy.
• Follow-up on each incident. Once the incident has concluded, the team should also be responsible for follow-up.

Mental Health Contributions

Mental health professionals can make important contributions to the team in a variety of ways: analysis of behavior patterns and communications from anonymous threateners, treatment recommendations to employees suffering acute or chronic illness resulting in problematic behavior, and advice on managing threats from individuals with personality disorders.

As Dr. Schouten shares, “In my experience, 95% of cases get resolved by asking ‘Gee, Bill, what’s going on?’ You have to reach out to people and help them to deal with those life stresses. If you find that ‘Bill’ is in a terribly debilitated state, then you deal with that appropriately. I think we miss out on a lot of opportunities to intervene.”

Dr. Schouten is Associate Professor of Psychiatry at Harvard Medical School and the Director of Law and Psychiatry Service at Massachusetts General Hospital. He is also the President of KeyPeople Resources, Inc.

Last Updated: October 2003