Introduction
In high-risk workplaces, violence and threats aren’t abstract hazards—they’re daily realities. HR and safety leaders face mounting pressure to mitigate occupational violence and aggression (OVA), yet many solutions lean heavily on policy. The real question is: are we focusing on the right lever for change?
This longitudinal study by Gadegaard, Andersen, and Hogh (2018) provides compelling evidence that violence prevention is driven not just by what’s written into policy—but by how people at every organisational level behave.
Problem
Despite the existence of policies, many workers continue to face physical and verbal violence at work—particularly in sectors like psychiatry, eldercare, corrections, and special education. Prior research has highlighted “safety climate” as a predictor of workplace incidents, but there’s limited understanding of how prevention behaviors themselves reduce exposure—and whether they work equally across different sectors.
Methodology
- Design: Longitudinal survey with a 1-year follow-up
- Sample: 3,016 employees from four high-risk sectors in Denmark—psychiatry, eldercare, corrections, and special schools
- Focus: Employee perceptions of violence prevention behaviors from:
- Top management (e.g., investment in training, staffing decisions)
- Supervisors (e.g., encouraging reporting, providing support)
- Coworkers (e.g., informal support, peer responses after incidents)
- Measures: Self-reported exposure to threats and violence, stratified by sector; adjusted for gender, seniority, and baseline exposure
- Statistical Tool: Logistic regression
Discussion
The study confirms that prevention behaviors—especially those that are enacted, not just espoused—can significantly reduce exposure to workplace violence and threats. But not all behaviors carry equal weight across settings.
- In psychiatry, frequent exposure made top management behavior critical. Their investment and systemic decision-making influenced whether threats declined.
- In eldercare and corrections, where violence was moderate, supervisors and coworkers played a more influential role—suggesting that relational proximity matters.
- In special schools, surprisingly, no prevention behavior had significant impact. The researchers suggest cultural norms and role identities may cause violence to be reframed as “part of the job.”
These findings reinforce the importance of tailoring safety strategies to both the organisational level and the violence exposure profile of the workplace.
Key Findings
- Top management behavior reduced exposure only in settings with high-frequency threats, such as psychiatry (OR = 0.58).
- Supervisors and coworkers were effective in reducing moderate levels of violence and threats in eldercare and corrections (ORs ranging from 0.53–0.78).
- Special education settings showed no significant reduction, despite high exposure—pointing to a potential desensitisation or structural gap.
- Social support after incidents from peers and supervisors is a vital element that enhances prevention effectiveness.
Key Takeaways for HR and OHS Leaders
- Violence prevention behaviors must be visible and consistent
Employees benefit most when supervisors and peers actively engage in prevention—not just when policies exist. - Strategise by sector and exposure level
High-frequency environments need top-level structural shifts (e.g. staffing); moderate-risk settings benefit more from supervisor-led support and peer engagement. - Embed social support into your systems
Follow-up care and informal peer support can mitigate trauma, reduce risk of recurrence, and boost safety participation. - Challenge informal cultures that normalise aggression
In education and caregiving sectors, staff may downplay incidents. Use training and messaging to reframe violence as unacceptable—not inevitable. - Think behavior, not bureaucracy
Written policies are only as strong as the behaviors backing them. Audit, train, and reinforce prevention behaviors across the org chart.