Do workplaces at increased risk for customer – related violence have an increased risk of co-worker conflict and bullying?

We conducted a large cross sectional survey of 12,546 public sector employees (response rate was 72%) who worked in four large state agencies that provide a range of public services. We measured coworker conflict by a six-question modified version of Einarson's Negative Act Questionnaire and with a standard definition for bullying. At the request of one agency, we included a set of questions on Type II violence, in this case violence perpetrated by the “driving public or a client”. We also conducted a large focus group with MH facility employees to discuss and interpret survey data. Respondents from the agency providing mental health services and those working in transportation reported a significantly higher prevalence of workplace conflict compared with workers employed in the other two state agencies. When we examined the Type II and Type III data from the transportation workers who had contact with the driving public, we found a significant dose response relationship between Type II outcomes and coworker conflict. Among workers employed by the MH agency, those who work on in-patient units reported significantly higher prevalence of conflict than MH workers in the outpatient and administrative units. Findings from the focus group with MH staff provided important insight into the high prevalence of coworker conflict in the MH work setting. Staff reported that staffing reductions, constraints around the use of restraint and seclusion (R/S) and the potential consequences to staff when R/S are used are highly stressful and may lead to staff “lashing out” at other staff.