Occupational Violence & Aggression (OVA)

What is Occupational Violence & Aggression?

You must understand that OVA is not limited to physical attack. It is a broad spectrum of hazardous behaviors directed at your workers by clients, customers, patients, or members of the public.

Your definition of OVA must encompass the full continuum of aggression. It includes:

• Physical acts: Biting, spitting, scratching, hitting, kicking, pushing, shoving, tripping, grabbing, or throwing objects.
• Verbal and emotional abuse: Yelling, swearing, name-calling, blackmail, and gendered or sexual harassment.
• Intimidation: Standing over a worker, blocking exits, aggressive posturing, or brandishing makeshift weapons.
• Online abuse: Cyberbullying, stalking, or threatening emails/messages related to work duties.

For you as a Person Conducting a Business or Undertaking (PCBU), managing OVA is not optional. It is a core component of your primary duty of care. You cannot dismiss incidents as "part of the job," even in high-risk industries like healthcare or policing.

If your worker is abused while working from home or at a client's site, this is still a workplace incident for which you hold responsibility.

How it works / Key components

OVA rarely occurs in a vacuum; it typically follows a pattern of escalation or arises from specific environmental triggers. Understanding these mechanics helps you design effective interventions.

The Spectrum of Escalation

Violence often begins with low-level behaviors that, if unchecked, escalate to physical assault. You should train your workers to recognize these stages:

1. Distress/Frustration: The person is agitated due to pain, wait times, or confusion.
2. Verbal Aggression: The person becomes personal, shouting or swearing to assert dominance or vent frustration.
3. Physical Intimidation: The person invades personal space, postures, or makes explicit threats.
4. Physical Assault: The person attacks the worker or property.

Risk Factors and Triggers

You need to identify the specific "generators" of violence in your workplace. Common high-risk triggers include:

• Service Denial: Workers enforcing rules, refusing refunds, or denying drugs/alcohol.
• Distressed States: Clients experiencing pain, grief, acute mental health crises, or the effects of substances (common in healthcare and social assistance).
• Cash and Valuables: Workplaces holding cash or restricted drugs (pharmacies) attract predatory violence.
• Isolation: Workers performing duties alone, at night, or in isolated locations (e.g., community nurses, security guards) lack immediate support.

The "Normalization" Mechanism

A critical failure mode for your organization is the "normalization of violence." This occurs when your workers stop reporting incidents because they believe abuse is inevitable or "just part of the role".

Desensitization: Staff in aged care or mental health may tolerate biting or scratching because they attribute it to the patient's condition.

Reporting Fatigue: If your reporting system is cumbersome (e.g., a 10-page form for a verbal threat), workers will not use it.

Data Blindness: When minor incidents go unreported, you lose visibility of the risk. You cannot fix a hazard you do not see.

Why it matters

Failing to manage OVA exposes your organization to severe legal, financial, and operational penalties.

Legal Obligations (WHS Act)

Under the model WHS Act (and equivalent state laws like the Victorian OHS Act), you have a primary duty of care to eliminate risks to health and safety so far as is reasonably practicable.

Psychosocial Regulations: New regulations in jurisdictions like Victoria explicitly require you to identify and control psychosocial risks, including violence.

Officer Due Diligence: If you are an Officer (Director/Executive), you must exercise due diligence to ensure the business has resources and processes to manage OVA. Ignorance of the violence occurring on the "shop floor" is not a legal defense.

The "Right to Cease Work"

You must respect your workers' legal right to cease unsafe work. Under the WHS Act, a worker may cease work if they have a reasonable concern that carrying out the work would expose them to a serious risk to their health or safety from an immediate or imminent exposure to a hazard.

Implication: If your controls fail and a worker is facing an aggressive client without support, they are legally entitled to remove themselves from the situation. You cannot take adverse action against them for exercising this right.

Business and Human Cost

Workers' Compensation: The healthcare and social assistance industry has the highest number of serious claims for OVA. These claims are often long-term due to psychological injury (PTSD).

Staff Retention: High levels of unchecked aggression lead to burnout and turnover. Replacing skilled staff is far more expensive than implementing security controls.

Common challenges

You will face specific hurdles when attempting to control OVA risks. Acknowledging these limitations is essential for realistic risk management.

1. The "Duty to Treat" vs. Staff Safety

In healthcare and social services, you face a tension between clinical care obligations and worker safety. You cannot easily "eject" a violent patient who requires life-saving treatment or has diminished capacity (e.g., dementia or psychosis).

Challenge: Balancing the human rights of the client with the safety rights of the worker.

Response: You must implement clinical controls (e.g., chemical/physical restraint protocols) alongside security controls, rather than relying on standard "refusal of service" policies.

2. Under-Reporting

Your incident data likely under-represents the true scale of the problem. Studies suggest up to 80% of verbal abuse goes unreported.

Challenge: Workers feel that reporting is a waste of time or fear being blamed for "mishandling" the client.

Response: You must streamline reporting (e.g., mobile apps, simple checklists) and ensure feedback is given to reporters so they know their report led to action.

3. Reliance on Administrative Controls

A common failure is relying on "de-escalation training" as your primary control.

Challenge: Training relies on human behavior under stress. It is a "low-level" control. If a worker is tired or the aggressor is intoxicated, training often fails.

Response: You must prioritize Level 1 and 2 controls (Design and Engineering) that work regardless of the worker's state of mind.

Best practices

Effective management requires a systems approach, moving beyond "fixing the worker" to "fixing the workplace." Use the Hierarchy of Controls to structure your response.

1. Design and Environmental Controls (CPTED)

Crime Prevention Through Environmental Design (CPTED) is your most effective strategy. You should audit your workplace against these principles:

2. Emergency Response Systems

You must have a coordinated response plan for when violence occurs. In healthcare, this standard is often defined by color codes:

Code Grey: A clinical response to an unarmed person who is aggressive. The goal is de-escalation and clinical management (e.g., sedation).

Code Black: A security/police response to an armed person or a threat to life. The goal is containment and safety.

Your Duty: Ensure your workers know the difference. Sending a nurse to a "Code Black" situation puts them in mortal danger.

3. Post-Incident Support (Psychological First Aid)

Do not rely on old-school "debriefing" which can retraumatize staff. Adopt Psychological First Aid (PFA).

Immediate: Ensure physical safety and provide practical comfort (water, rest).

Short-term: Help the worker regain a sense of control ("Do you want to call your partner?").

Long-term: Monitor for injury and provide access to EAP or WorkCover support.

4. Data-Driven Prevention

Use your data to predict and prevent.

Flagging Systems: Implement electronic alerts on client files (e.g., "Two-person visit required") to warn staff of known aggressors.

Consultation: Regularly ask your HSRs and workers where they feel unsafe. They know the "hotspots" better than you do.