It is estimated that 25% of all healthcare professionals worldwide report currently experiencing or having experienced workplace violence, mainly verbal aggression (Barros et al., 2022). Younger and female nurses (Krut et al., 2021; Barros et al., 2022; Hawkins and El Ghaziri., 2022), as well as black healthcare workers (Hawkins and El Ghaziri, 2022) and nursing students (Hunter et al., 2022) are frequent targets. Inpatients and family members tend to be the most common aggressors (Barros et al., 2022). In the case of nursing students, mentally ill people are the most likely perpetrators (Hartung et al., 2021; Hunter et al., 2022). Common consequences for healthcare professionals include mental disorders, a decrease in productivity, the thought of abandoning their jobs (Contreras Jofre et al., 2020), post-traumatic stress disorder, depression and even homicides and suicides (Braun et al., 2021).

Cases of violence have been connected to individual factors, such as gender, age, professional area and work schedules (Nowrouzi-Kia et al., 2019). The tension in the relationships between health professionals and interns can also be aggravated by organizational factors such as reduced communication competence, unexpected changes in care conditions, lack of personnel (Morphet et al., 2019, Li et al., 2021), authoritarian hierarchical structures, ambiguous tasks, conflicting roles and inefficient conflict management (Barros et al., 2022).

In the past, many mental health facilities tried to control aggression by increasing restrictions. In 2012, the Brazilian Nursing Council highlighted that physical/mechanical restraint should only be applied when all other available means have been exhausted (Capeletto et al., 2021). Then, in some Brazilian institutions, the use of physical restraint is still an option to control episodes of violence. However, physical restraint is widely recognized as a non-therapeutic measure, since it may cause unintentional physical and psychological damage (Ward-Stockham et al., 2022). Physical force should be used only as a last resort and its use implies that the treatment has failed (Haines-Delmont et al., 2022).

Preventing aggression is better when the health team and the users work together to improve services and results (Kylcoine and Angus, 2018). Some intervention methods in mental health facilities have highlighted the participation of these actors.

Considering European studies, three interventions have been highlighted as effective. Care units that resorted to educational interventions based on phenomenography (Maagerø-Bangstad, 2018); participative sessions and integrated shift transfers co-produced with the workers to develop predictive evaluations, incident analyses and a Guide for the Reduction of Restraining Practices (Kylcoine and Angus, 2018); and a working group to develop actions for the admission of cases, the evaluation of personnel and the promotion of dialogue with patients concerning prevention, the management of externalized behavior and learning episodes (Schwartz et al., 2018).

Two studies conducted in Canada were also identified as effective. One union and one administration in a Joint Health and Safety Committee took into consideration safety and the “patient’s voice” to evaluate, implement and revise practices approached systematically (Zahn et al., 2018). The Lean Methodology program was used to organize quality improvement workshops with four interprofessional groups, to identify and deal with opportunities, as well as to implement standard work processes (Carroll et al., 2018).

Beyond the need for the participation of workers and users in violence prevention programs, several studies have indicated the need for a multisectoral approach (Wu et al., 2022), with multiple strategies to deal with potentially violent situations (Goldblatt et al., 2020; Warshawski et al., 2021; Barros et al., 2022) and the implementation of simulation education (Oerther et al., 2021). We also defend that these types of programs should be based on the questioning of the problems and the analysis of the causes.