Workplace violence against healthcare workers: a narrative review of evidence to inform policy and legislation in India

Abstract

Workplace violence (WPV) is a global issue affecting healthcare workers’ (HCWs) safety, mental health, and the delivery of healthcare. WPV against HCWs has dramatically increased in India and is now a priority concern. We conducted a narrative review of WPV in Indian setting to address the burden of WPV against HCW, risk factors, and mitigation strategies by using the socio-ecological framework model. Four databases–PubMed, Scopus, Epistemonikos, and Embase, were searched using the search strategy. The initial search was conducted in October 2024, and the final search was again done in June 2025. All types of articles, including original articles, review articles, commentary, editorials, viewpoints, etc., were considered. A total of 80 articles were deemed eligible. Overall, WPV varied between 34.5% and 87% among HCWs, with 0.9–58% physical violence across different studies. WPV ranged from verbal abuse to physical violence like slapping, beating, thrashing, vandalism, assaults with weapons, and instances of sexual violence. Violence was predominantly observed in emergency departments, psychiatric wards, and intensive care units. The key contributing factors include poor security, overwork, staff shortages, service dissatisfaction, communication failures, and negative media portrayals. Financial burdens, inadequate infrastructure, and distrust further escalate conflicts in healthcare settings. WPV severely impacts HCWs’ well-being, mental health, and family life, increasing suicidal ideation. WPV in the healthcare sector is increasing due to power conflict, gender violence, and inadequate infrastructure. Findings suggest potential benefits from enhanced security, complaint redressal systems, and enhanced workplace training. Healthcare facilities must report their outcomes, and accreditation processes should assess the safety measures in place.