“Nothing’s changed,” – 18 months on and violence in emergency departments across Australia is still too common

As the results of the largest survey of alcohol harm in Australasian emergency departments (EDs) is published today in the Medical Journal of Australia, the Australasian College for Emergency Medicine (ACEM) has indicated that the levels of alcohol-fuelled violence remain unacceptable high, imposing a substantial burden on hospital resources and staff.

The survey, which was undertaken by ACEM over 18 months ago and involved 2002 ED clinical staff, revealed the devastating toll of alcohol-related harm on emergency department clinicians and patients. In the year preceding the survey, more than 90% of ED clinicians had experienced physical aggression from a patient affected by alcohol, with 42% experiencing this aggression weekly or monthly. Verbal aggression from patients affected by alcohol was also an ever-present part of clinical life for ED staff. This violence and aggression has wide-ranging impacts, affecting the care of other patients and the wellbeing of clinicians. Clinicians reported that frequent violence and aggression had a negative effect on their wellbeing, affecting staff retention and recruitment. Such violence and aggression also had adverse impacts on other patients and the effective operation of the ED, diverting hospital resources into the management of alcohol-affected patients, and disrupting or delaying care for other patients. Effects on the welfare of and care for other patients, particularly vulnerable groups, are further exacerbated by the disruptive and antisocial behaviours of alcohol-affected people in EDs.

Since the survey was undertaken, the introduction of lockout laws and other trading restrictions have resulted in improvements in some jurisdictions. However, much more needed to be done, with ACEM expressing concern today that alcohol-related violence and aggression continues to be a pervasive feature of emergency departments.

“The legislative action taken in New South Wales and recently in Queensland is commendable and it’s important to acknowledge that progress,” said ACEM President, Associate Professor Anthony Lawler. “But too many EDs in Australia and New Zealand are still suffering from the blight of alcohol. Since this work was done 18 months ago ACEM has completed further research – including an Australia Day survey, a 7-Day survey and a snapshot survey – and the data is clear: alcohol is still having a disproportionately severe impact on our EDs.”

The release of the MJA survey follows on from the recent visit by Ms Katherine Brown from the UK, who reported on a major survey of emergency workers in the UK. This report echoes the findings of the ACEM report and the experiences of other front-line services in Australia, with up to half of police, paramedic, ED and fire services time spent dealing with alcohol-related incidents. The UK report surveyed approximately 5,000 front-line service staff and found that police spent 53% of their time dealing with alcohol-related incidents, ambulance staff 37% and emergency department personnel 25%. The responses revealed a culture of fear and systematic abuse, with three quarters of police respondents and one in two ambulance crews injured in alcohol-related incidents. Between a third and half of all emergency service personnel reported they had suffered sexual harassment or abuse at the hands of intoxicated members of the public. Reflecting on the report and the parallels with Australia, Ms Brown argued that it is crucial that alcohol is not allowed to continue diverting public resources and to threaten community safety.


For further information on the MJA article and ACEM statement on the impact of alcohol-affected patients in emergency departments in Australia and New Zealand:

For further information about the UK Report on alcohol’s impact on emergency services:

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