Mental health centres must reduce risk to staff and patients

Local 500 President Nancy Pridham during a 2008 press conference addressing assaults at the Toronto hospital. Six years later the same problems persist with the union calling on the Ministry of Labour to charge the employer under the Occupational Health and Safety Act.

Local 500 President Nancy Pridham during an October 2008 press conference addressing assaults at the Centre for Addiction and Mental Health. Six years later the same problems persist with the union calling on the Ministry of Labour to charge the employer under the Occupational Health and Safety Act.

Client Empowerment Council at Ottawa’s psychiatric hospital say they became advocates for the safety of the care team because a “safe place for staff members increased patient safety as well.”

In a statement issued by The Royal November 26, mental health advocate Claude Lurette spoke about his own regret at lashing out at others while a patient at the hospital. “It wasn’t until I became solid in my own recovery of living with bi-polar disorder that I came to understand that the best thing I can do is to own my behaviour and learn what I need to learn in order to minimize the chances of it happening again,” he writes. “It is hard to find the words to express how much I appreciate the nurses and other staff who took care of me even when my behaviour was unpredictable.”

The Royal was publicly responding to the court proceedings following charges laid against the hospital under the Occupational Health and Safety Act. In the alleged incident a patient choked and assaulted two nurses and a support worker in the Royal’s Recovery Unit.

The Royal faces numerous charges around failing to take reasonable precautions to protect worker safety.

Their woes may not be entirely over with these court proceedings. In October, a nurse at the Royal’s Brockville site was allegedly stabbed multiple times in the neck, narrowly missing her carotid artery. She survived the encounter, but the hospital has received an extraordinary interim order by the Ontario Labour Relations Board to provide formal security in the nurse’s unit 24-7.

Stories about patient assaults are always very difficult because of the risk of further stigmatizing persons with mental illness. The truth is that a person with mental illness is more likely to be the victim of violence than the perpetrator of it. With so few beds left in Ontario’s psychiatric hospitals, there is a filtering process that takes place so that patients finding their way into one of these beds are more likely to be a risk to themselves or to others. That should be a call to administrators to step up their efforts to keep everyone safe.

On Friday OPSEU and the Ontario Nurses’ Association issued a joint release calling on the Ministry of Labour to lay charges at the Centre for Addiction and Mental Health around another alleged assault resulting in serious worker injuries. Both the RN and RPN involved in the incident have not been back to work since January 12, 2014.

It’s not like this is a new issue for CAMH. In 2009 CAMH was fined $70,000 plus a 25 per cent victim surcharge after two assaults the previous year. Yet despite this track record, the Ministry appears reluctant to go from issuing orders to actually laying charges.

“It is unacceptable for a nurse to go to work healthy and not come home because she’s in the ER,” said ONA’s President Linda Haslam Stroud. “If a worker at a construction site or on an assembly line was beaten in this manner, there’s no doubt this would be treated differently. Employees in male-dominated workplaces do not put up with violence and neither will our predominantly female profession.”

“There have been 400 incidents of violence against workers at CAMH this year alone,” said OPSEU President Warren (Smokey) Thomas. “It’s time for the CEO, directors, and managers of a hospital to be held accountable for showing disregard for the health and safety of their employees.”

When patients are too difficult to handle at places like CAMH and the Royal, they often end up at Waypoint Centre for Mental Health Care in Penetanguishene.

Waypoint transferred high security patients from its former Oak Ridge site to its new $474 million Atrium building in May. Any new building usually requires a period of adjustment for staff and patients, but in Waypoint’s situation, staff and patients have faced situations far more serious than usual. They include  significant risks from safety code malfunctions, magnetic locks that fail, and materials in the rooms that are turned into lethal weapons. There was also a high-profile elopement, the first in about 40 years at the hospital.

Prior to the move, the Ministry of Labour had already issued 10 orders under the Occupational Health and Safety Act.

OPSEU’s President Warren (Smokey) Thomas has been asking to tour the building since late August in hopes of seeing for himself the issues it has been presenting. While one date was established for the tour in October, it was cancelled due to personal circumstances on the part of Waypoint’s senior leadership. We have been given no dates since.

On Saturday OPSEU placed an ad in the Barrie Examiner challenging Waypoint to work together to address these issues. (See 2014-12 en_Local 329-Waypoint_Barrie Examiner_b)

It’s not like there aren’t workable models out there. During a meeting with us last June, Toronto East General Hospital highlighted the success of their work to reduce the risk of workplace violence. While not a tertiary care psychiatric hospital, TEGH does provide emergency crisis intervention as well as inpatient, outpatient and community based mental health services.

We are pleased that the Client Empowerment Council at The Royal has recognized what’s at stake. Having individuals like Lurette publicly come forward will make it not only possible to improve safety, but also deal with related issues of stigma.

As staff in these hospitals, we cannot resolve this issue on our own.

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