Challenging behaviour strategy

SA Health recognises that consumers, carers, volunteers and workers all want health services in which health care can be both delivered and received without personal threat or risk.

The SA Health Challenging Behaviour Strategy has examined key issues and identified priorities relevant to the prevention and response to challenging behaviour during health care, so as to minimise the potential harm to workers and harm or self-harm to consumers.

SA Health has developed a comprehensive strategy that includes a policy directive, policy guideline, toolkit which will support health services to focus action on prevention and response to challenging behaviour in a systematic way. 

What is challenging behaviour?

Challenging behaviour is any behaviour with the potential to physically or psychologically harm another person, self or property. It can be deliberate or unintentional and ranges from verbal abuse through to threats or acts of physical violence. Challenging behaviour or actions result in a person or people feeling unsafe or threatened, or feeling that intervention or withdrawal is warranted to avoid harm to someone.

Ultimately, regardless of its extremity, challenging behaviour is a barrier to the delivery of care in a way that is safe for the consumer and health staff.

See the following fact sheets for information on the following:

Research and experience has shown that challenging behaviour from consumers can be triggered or caused by:

  • intrinsic factors – relate to the consumer's thoughts, feelings, emotions or their physical or mental health status
  • extrinsic factors – come from the individual's environment, including people around them

Where challenging behaviour commonly presents across health care settings

A health care setting can be considered 'high risk' if challenging behaviour is more commonly encountered because care is frequently provided:

  • to consumers with particular clinical conditions, including:
    • cognitive impairment
    • mental illness
    • substance abuse
  • in emergency, traumatic, stressful or emotional situations, including:
    • emergency presentation
    • intensive care
    • surgery
    • childbirth
  • in situations where there is limited access to assistance for workers, including:
    • ambulance services
    • community mental health
    • home visits.

Challenging behaviour toolkit

As part of the comprehensive strategy, SA Health has produced a toolkit which will support health services to focus action on prevention and response to challenging behaviour in a systematic way.  These include:

  • quick guides
  • hazard identification and risk assessment
  • reporting and reviewing incidents
  • support options


Michele Sutherland
Safety and Quality Unit
(08) 8226 6539

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