Most mentally ill patients are more likely to be the victim of the violence than the perpetrator of it. Most evidence would suggest individuals experiencing mental illness are no more inclined towards violence than the general public.
Yet among Canadian psychiatrists, 50 per cent have reported to have been assaulted by a patient at least once. Whitby’s Ontario Shores Centre for Mental Health Sciences has experienced a rise of incidents of workplace violence in recent years. In the last three months for which we have data (May, June, July 2012), the centre has experienced 90 reported acts of physical violence.
The situation has led to an ongoing exodus from the employer. Many skilled workers choose to quit rather than continue to put their health at jeopardy. Only about a third of employees who were at the Whitby psychiatric hospital in 2006 (when it divested from the Ministry of Health) remain there today. This is an employer that used to be known for excellent retention of staff.
A 2003 paper by Queen’s University faculty Dr. Heather Stuart suggests that aggressive behaviors differ dramatically in treatment units, “indicating that mental illness is not a sufficient cause for the occurrence of violence.”
Stuart writes: “Studies that have examined the antecedents of aggressive incidents in inpatient treatment units reveal that the majority of incidents have important social/structural antecedents such as ward atmosphere, lack of clinical leadership, overcrowding, ward restrictions, lack of activities, or poorly structured activity transitions.”
Cuts to services have had an impact on activities at Ontario Shores, many recreational spaces getting turned into office space for an expanding roster of management.
The Ministry of Labour is presently conducting its own major investigation into the Whitby hospital’s extraordinary rate of violence. Many staff have already been interviewed and more are expected to still meet with the investigator. Given the size of the investigation it is not expected that the Ministry will issue its report for some time.
Many staff members wrongly believe that such incidents are part of the job and fail to report when they do take place. The OPSEU Local estimates the real impact is likely closer to double these reported figures.
Nor do we have any figures on what the impact is on patient-on-patient violence as this is not shared with the union.
Some examples of what workers experience:
• A worker required dental work after she was punched in the mouth while trying to remove dangerous and restricted items from a patient.
• A worker sustained facial injuries after getting head butted and put in a choke hold by a patient he was escorting.
• While performing nursing duties, a worker bent over to listen and make eye contact with a patient. She was told to “shut up” and punched in the nose, resulting in a contusion/fracture.
• Trying to stop a patient from banging her head on a wall, the worker was scratched, hit in the head and kicked in the stomach, resulting in injuries to her abdomen and left arm.
• After attempting to clean up a patient found eating her own feces, the patient became agitated and tossed feces at the worker. The worker was pushed up against the wall and her right arm twisted.
• At the beginning of the night shift a worker was hailed by a patient who said he wanted to show her something. Walking very quickly towards the worker, the patient started making punching motions in the air. The worker retreated to a nursing station where the patient threatened to “smash her face in” the next time he saw her.
While other psychiatric hospitals have made significant progress in reducing such incidents by working with the union, Ontario Shores appears more willing to blame the workers than address what is becoming a pandemic.
If it is the environment, and not the illness, then Ontario Shores has work to do. The question is, will they do so willingly?