Putting hospital support staff in charge of volatile patients is not fair to either party, according to clinical and forensic psychologist Dr Mitchell Byrne.
Dr Byrne, director of clinical training at the University of Wollongong, agrees with the decision by wardspersons at Wollongong Hospital to refuse to continue to perform the role of "companioning" patients.
The Health Services Union invoked a clause of the Work Health and Safety Act to protect the staff who have complained of verbal and physical abuse while sitting with patients, including many with mental health issues and dementia.
Dr Byrne said staff dealing with such patients needed adequate training and support, while the patients themselves deserved staff with some understanding of their needs and motivations.
"If you give someone a role, they need to be adequately trained to undertake that role, whether that's dispensing medication, dressing a wound or dealing with emotional distress," he said. "If [the wardspersons] haven't received appropriate and adequate training to understand the aetiology of people's behaviour, and to know how to respond to that, then they shouldn't be involved - from a patient care perspective or from their own care perspective."
Where patients had a "disturbed perception of reality", it was important for anyone dealing with them to understand what might be driving their fears or frustrations.
"For example, if a person is paranoid and feels under threat, that might be one reason for them to act out," he said. "Or if a person is feeling frustrated by their limitations, or by not being able to communicate their needs, then that might be another reason.
"But there's many different reasons people act out - they could be related to cognitive processes, like in dementia, or mental health processes like depression, anxiety or even psychosis."
The HSU said companioning was undertaken by trained security and nursing staff at other NSW public hospitals.
"Hospitals can be volatile places," NSW secretary Gerard Hayes said. "The state government needs to ease its budget straitjacket, so that staff get the appropriate training and resources to ensure that their physical and mental health is not jeopardised simply by doing their job."
The union is in discussions with Wollongong Hospital management, which said it had put in "interim measures" to ensure that companioning continued where required.