Assaults on hospital staff are on the rise in Northland, with the highest number of assaults ever recorded in 2017.
The majority of the assaults happened in the Northland District Health Board (NDHB) mental health units each year.
In 2017, 74 of the 143 assaults took place in mental health - more than 51 per cent of the total assaults from last year. There were 40 assaults in 2012 and 22 in 2013.
The injuries suffered by staff range from bruises, to strains, to blood noses and concussions.
Weapons were used in some cases; one staff member was assaulted with an IV pole in 2013. Other weapons included a rolling pin, a coffee table, chairs and a shoe.
General manager planning, integration, people & performance at NDHB John Wansbone said the DHB recognised that increasing workplace violence was causing concern across the organisation.
"Keeping staff, patients and visitors safe is a key responsibility of Northland DHB.
All staff, patients and visitors should reasonably be able to expect that they will be safe in the clinical and work setting and that where the situation is not safe that appropriate response systems can be activated," Wansbone said.
The Public Service Association (PSA) is one of the unions that represent mental health workers in New Zealand.
PSA organiser for Whangarei Mark Furey says its members working in mental health acknowledge their work involves volatile situations, and that sometimes this can spill over into violent behaviour.
"However, the PSA believes NDHB can do more to support its mental health workers," Furey said.
"The PSA has had concerns about the DHB's support for staff safety, particularly, risk minimisation and how injured staff are treated following an assault."
General manager of mental health and addiction services at Northland DHB, Ian McKenzie listed a number of initiatives the DHB has enacted to improve staff safety.
"Approximately 80 per cent of clinical staff have completed Safe Practice Effective Communication [SPEC] training, with ongoing training being provided to ensure all staff are fully trained."
He said refresher training commenced in 2017 and was ongoing. NDHB has also made a significant investment in a de-escalation training programme which is rolling out across the region.
"The purpose of this training is to provide staff with the skills, techniques and confidence to reduce the risk of duress or confrontational client-staff situations from developing into situations of assault," Mr McKenzie said.
Staff are supported to keep themselves safe by encouraging a low threshold for withdrawing from home visits if workers are uneasy about the environment, he said.
NDHB chief executive Nick Chamberlain said one of the reasons behind the increase in assaults on staff was the DHB's new incident reporting system.
"Feedback from staff noted that the new system was easier to use and we noted an increase in reporting across the organisation after its introduction," Dr Chamberlain said.
Mr Furey said while it was good that a stricter reporting system has been put in place, this needed to be accompanied by a compassionate and worker-focused approach to convalescence and recovery.
New Zealand Nurses Organisation (NZNO) organiser Julie Governer said patients presenting under the influence of methamphetamine was becoming more prevalent.
Ms Governer said this was changing the way nurses did their jobs and they were often spending a lot of time de-escalating situations. She said the reasons behind the increase in assaults were a combination of poverty, drugs and alcohol.
Assaults to staff in Northland DHB since 2012