Part 3: Closing in on causes of violence at OMH
This is the third and final article in a three-part series about the
persistently high level of violence and injuries at state mental health
facilities and how managers and staff are working together to stop it.
In May we reported the scope of the problem. In June, the focus was on efforts
to open the system to fresh approaches.
This month, the series highlights specific insights and ideas for reducing the
violence.
By SHERRY HALBROOK
More than half of the 5,243 on-the-job accidents last year involving state
Office of Mental Health (OMH) employees resulted from patient assaults or from
attempts to restrain patients.
That insight was revealed in March, when approximately 225 managers and union
leaders at OMH met in Saratoga Springs to create a safer and more therapeutic
environment for patients and staff.
Who’s
got the power?
PEF Vice President Pat Baker, the union’s labor-management chair for OMH, cited
the need to get more support from local law enforcement and the courts,
especially in New York city.
“Some police will not take the report (of an assault on staff),” Baker said. “We
need uniformity of enforcement across the board.”
Richard Miraglia, OMH deputy commissioner for forensic services, said his office
would try to improve the agreement with they NYC Police Dept. on prosecuting
assaults.
NO EASY STEPS — Marianne Albamont, left, and PEF VP Pat
Baker, right, lead PEF efforts for greater safety at OMH. Photos by Ken Dischel
Many conferees were surprised to hear Albany County Court Judge Thomas Keefe say
patients charged following an assault are returned the same day to their
psychiatric centers to await trial.
In New York state, Keefe said, the (criminal court) judge can set bail or hold a
defendant without bail only if he or she might flee prosecution, not to protect
the public safety.
“That’s only allowed in federal court. I’d be removed as a judge, if I did it,”
Keefe said. He added that he can order the defendant to stay away from an
assault victim, “but I have no power to order OMH (to enforce it).”
Eye-opening
insights
PEF Division 183 Leader Jo Cecelia Moore said Mohawk Valley Psychiatric Center
“discovered just four patients were responsible for 70 percent of the
incidents.”
She said procedures and policies based on detailed data are helping.
“We already have seen a 21 percent reduction in incidents and an 11 percent
reduction in accidents,” she said.
Patients’ confused or distorted perceptions of what staff are doing was
identified as another common trigger of violent outbursts. But other, less
confused patients may come to the aid of staff.
“I’ve worked 28 years for OMH and I’ve often found patients have intervened to
save people,” said Bob Hogle, PEF Division 310 treasurer at Hutchings PC.
The collection and review of patients’ comments at Buffalo Psychiatric Center
revealed “the injury rate was directly tied to restraint and seclusion (of
patients who were out of control),” said Celia Spacone, deputy director for
operations there.
One patient said he reacted violently to being restrained because he feared a
fire might break out and he would be unable to escape.
“If you take away a patient’s hope,” Spacone said, “you can create a very
violent and dangerous person with nothing to lose.”
But eliminating restraints and seclusion also poses risks.
Debbie
Lee, PEF Division 235 leader at Rockland PC, warned going restraint-free should
not mean going intervention-free. The need for effective interventions when
patients become upset is greater than ever when physical restraint is not an
option.
“A heavily rule-based environment may not serve well,” said John Allen, OMH
director of recipient affairs. “Our goal should be to make the environment
violence and coercion free.”
“If people are getting upset about a rule,” said Dr. Beatrice Kovasznay of
Capital District PC, “think about why you have it. Do you really need it? Avoid
getting into a power struggle for an arbitrary reason.”
Spacone urged having “a coach who can go on any unit to
help staff learn how to prevent and manage potentially dangerous situations.”
Get the facts
Maureen Cox, who heads the state Labor Department’s Division of Safety and
Health, said accurately and comprehensively assessing all of the possible risk
factors at your worksite is key to preventing violence.
When
asked how to get results at facilities that are seriously and chronically
understaffed, Cox urged people to get the facts and make their case for how
better staffing could reduce violence.
“If staffing is the root cause,” Cox said, “we’ll deal with it. The truth is the
truth. ... But I didn’t say you would get more staff.
The Communicator
July/August 07
Features
Nurses'
power rally
works
PEF
nurse saves child
Contract team
gives GOER list
Saving
School for the Blind
DOCS conference productive
Departments
President's
Message
Legislative
Action
You
Said It: Letters To The Editor
Health
and Safety
Retirees
In Action
Getting
To Know PEF
Member
Mobilization
Health
Notes
Member
Highlights
Membership
Benefits &Travel
Union
Matters
Convention
delegate list
Bronx
PC: Stopping violent attacks
Scacalossi
winners
Unions,
DMV renew Quality license
Executive
Board news
PEF runs in Corporate
Challenge
Other Links
Professional
Directory
Members'
Classified
Communicator
Feedback
Prefer
The Online Edition?
How
To Advertise with PEF
The Communicator
Staff
Website
questions ?
Communicator
Webmaster