<p>The challenges of caring can cause severe stress to all concerned in ways that must be recognised, acknowledged and managed. This is important to prevent stressors, particularly the vicious circle of controlling aggression by aggression, becoming chronic. If this happens an organisation can become dysfunctional and ultimately toxic to those who work in it and those it seeks to support.</p> <p>In a corrupted culture, the needs of the service user become secondary to the needs of staff, who have become demoralised without adequate training and support. Leadership is seen as critical in the reduction of coercive interventions, but effective staff training can bring about positive changes.</p>