The aim of the study was to examine individual staff experience and management of threats and violence in the acute psychiatric department for children and teenagers in Uppsala. Previous research shows that the experience of threats and/or violence is individual, and that it is difficult to distinguish between these concepts. Research shows that it is particularly vulnerable to work in psychiatry when mental illness is a cause when threats and violence occurs. Threats and violence can result in different consequences for the individual. The study is based on qualitative interviews and the material was collected in the autumn of 2012 at Akademiska sjukhuset. The qualitative interviews was transcribed and carefully analyzed. The result had an outcome in four different themes: The diffuse definition between threats and violence that showed how difficult it is to define threats and violence. Causes and staff reaction showed that mental illness, how you treat someone and compulsive cares are contributing factors to threats and violence occurs. This theme also shows ambivalence within the staff, that the behavior is unacceptable meanwhile he or she is mentally ill. Management and reporting showed that the staff has different coping strategies when they deal with threats and violence and that it is different how functional the reporting is. The theme working environment showed that it is a vulnerable environment to work in. Therefore, it is important to get support from colleagues and managers but the staff has different opinions whether they feel supported from managers. There is a need to develop routines for incidents when threats and/or violence have occurred. Keywords: Threats, Violence, Staffs experience, Child and adolescent psychiatry, Causes

The aim of the study was to examine individual staff experience and management of threats and violence in the acute psychiatric department for children and teenagers in Uppsala. Previous research shows that the experience of threats and/or violence is individual, and that it is difficult to distinguish between these concepts. Research shows that it is particularly vulnerable to work in psychiatry when mental illness is a cause when threats and violence occurs. Threats and violence can result in different consequences for the individual. The study is based on qualitative interviews and the material was collected in the autumn of 2012 at Akademiska sjukhuset. The qualitative interviews was transcribed and carefully analyzed. The result had an outcome in four different themes: The diffuse definition between threats and violence that showed how difficult it is to define threats and violence. Causes and staff reaction showed that mental illness, how you treat someone and compulsive cares are contributing factors to threats and violence occurs. This theme also shows ambivalence within the staff, that the behavior is unacceptable meanwhile he or she is mentally ill. Management and reporting showed that the staff has different coping strategies when they deal with threats and violence and that it is different how functional the reporting is. The theme working environment showed that it is a vulnerable environment to work in. Therefore, it is important to get support from colleagues and managers but the staff has different opinions whether they feel supported from managers. There is a need to develop routines for incidents when threats and/or violence have occurred. / Syftet med studien var att undersöka personalens enskilda upplevelse och hantering av hot och våld på Barn- och ungdomspsykiatrins (BUP) akutmottagning i Uppsala. Tidigare forskning visar att det är individuellt hur man upplever hot och våld samt att det är svårt att hålla isär dessa begrepp. Forskning visar även att det innebär en särskilt utsatthet att arbeta inom psykiatrin, då psykiska sjukdomar är en bakomliggande faktor till att hot och våld uppstår. Att bli utsatt för hot och våld kan resultera i olika konsekvenser för den enskilde. Studien baseras på kvalitativa intervjuer och materialet samlades in hösten 2012 på BUP på Akademiska sjukhuset. De kvalitativa intervjuerna transkriberades och analyserades noggrant. Resultatet utmynnade i fyra teman: Den diffusa gränsen mellan hot och våld som visade hur svårdefinierat hot och våld är samt var gränsen mellan dessa går. Orsaker och personalens reaktion tog upp att psykiska sjukdomar, bemötande och tvångsvård är bidragande faktorer till att hot och våld uppstår. I en hot- och/eller våldshändelse uppstår en reaktion hos personal, en ambivalens mellan att personen är psykiskt labil och att beteendet är oacceptabelt.  BUP akutens hantering och rapportering visade att personalen har olika copingstrategier när de ska hantera en hot och/eller våldssituation samt att det är olika hur rapporteringen av dessa situationer fungerar. Det sista temat Arbetsmiljön visade att det är en utsatt miljö att arbeta i och att det är viktigt att få stöd i arbetet, men huruvida personalen upplever att de får stöd ser olika ut. Det finns ett behov för att utveckla rutiner kring samtal efter en hot- och/eller våldshändelse.