In recent days, a repeated case of violence, to which one of the employees of the Ljubljana Health Center was exposed, has echoed. Although it is one of the incidents with the most media coverage, it is far from the only one. Not because the media does not want to report on other cases, but because the vast majority of cases do not come to the public at all.

This is not about a conspiracy, the deliberate placement of news, or the hiding of real data, but the fact that even the management of medical institutions often do not have an overview of cases of violence against employees.

In the last two years, the colleagues of the Institute for Security and Strategic Research have implemented projects in the field of preventing violence against employees in more than ten different medical institutions. Analysis of the incidence of violence against employees is always part of our projects. And the fact that always surprises us? Victims of violence are mostly not reported - neither to management nor to the police.

From the data we have collected in the last two years, we can understand:

• That an average of 49 % employees in healthcare are exposed to psychological violence on an annual basis, and 19 % report a case of psychological violence to the institution's management or the police, i.e. every fifth victim of psychological violence.
• That on average 5 % employees in healthcare are exposed to physical violence on an annual level, and 26 % report a case of physical violence to the institution's management or the police, i.e. every fourth victim of physical violence.

Changing legislation

The Medical Chamber of Slovenia recently prepared a proposal to amend the Criminal Code, which provides for the introduction of a new criminal act Assault on a healthcare worker. The purpose of the proposed amendment is primarily to punish bullies more severely. And although we believe that such a change in the legislation would bring with it certain positive consequences, in order to ensure safe jobs in the long term, merely punishing the perpetrators more severely will not be enough.

When proposing changes to the legislation, there is only talk of stricter punishment, but no one proposes better measures in the areas of reporting, detecting and investigating cases of violence. Why is this important? Because scientific research in the field of crime prevention teaches us that the likelihood of committing a crime is significantly more influenced by the likelihood that the perpetrator will be discovered and punished than the severity of the punishment. In practice, this means that (potential) perpetrators do not see a significant difference between six and twelve months in prison, but they understand the difference between freedom and prison.

Therefore, it is imperative that in health institutions, attention is also paid to measures that will improve the situation in the area of detection and reporting of cases of violence against employees. A higher prison sentence will not improve the situation as long as only one in four victims report physical violence. Why don't victims decide to report violence more often? In the course of cooperation with health institutions, we most often receive the following answers:

• Unclear reporting routes, poor communication with management and lack of knowledge of the persons responsible for receiving reports of violence.
• Unclear procedures for dealing with violence, non-transparent and "ad-hoc" handling of cases of violence.
• "But what will we achieve by applying?"
• Low trust in the work of law enforcement agencies and courts.
• Fear of reprisals from perpetrators.

At least some of the listed reasons could be solved by health institutions by:

• Education and awareness of employees.
• Updating reporting routes and clearly addressing violence reporting procedures.
• Regular cooperation with the local police station and the head of the police district.
• Implementation of technical solutions for easier detection of bullies.

And if we're talking about changing the legislation. The Labor Relations Act stipulates that the employer is obliged to ensure safe working conditions, but in the context of the prevention of violence, most health institutions understand it only as the prevention of mistreatment at the workplace. The law requires the employer to take measures to prevent ill-treatment, but not other forms of violence against employees. As a result, most health institutions adequately regulate the field of mistreatment at the workplace, while preventive measures to prevent other forms of violence are most often lacking.

How to approach the prevention of violence?

And how to prevent violence in the organization? First of all, it is important to familiarize ourselves with the real situation within the organization. This allows management to take targeted actions that address the most pressing risks. This includes, among others:

• Adoption of relevant internal acts, instructions and protocols that define the procedures for preventing, identifying and dealing with individual cases of violence.
• Establishment of a system of education, training and awareness of employees.
• Taking measures to maintain a good working climate and interpersonal conditions.
• Providing secure infrastructure and working tools.
• Providing adequate technical and physical security solutions.

For more information about our approach to violence prevention, you can see https://ivsr.si/varnost-na-kljuc/preprecevanje-nasilja-in-amok-situacij/ or write to us at info@ivsr.si.