Heading for the courts, CAMH’s Zahn can’t sweep workplace safety under the rug

It’s time CAMH CEO Katherine Zahn addressed the issue of workplace violence rather than sweep it under the rug. Photo: http://www.canstock.com

You have to wonder about Katherine Zahn.

Not much has been going right lately for the CEO of the Centre for Addiction and Mental Health (CAMH). Data shows incidents of workplace violence are dramatically up. The workforce is upset about threats to their personal safety and injuries are starting to become routine fodder for joint press releases between OPSEU and the Ontario Nurses’ Association (ONA). The Ministry of Labour has recently charged the hospital with violations under the Occupational Health and Safety Act (OH&SA) — the second time in five years. The unions representing the injured workers are clamouring for an urgent meeting. And to put the cherry on the top, the Toronto Star is presently on a campaign to tighten the rules around privacy violations, using CAMH as an example where 22 patient records were inappropriately accessed.

So what do you do if you are Zahn?

Instead of agreeing to meet with the unions, Zahn sent out an e-mail to all staff defending a record of workplace safety that is clearly failing and telling everyone how “disappointed” she is by “inflammatory language” of the union’s press releases. She tries to divide the unions from their membership by suggesting they are “diminishing the excellent work that is being done by their local members.”

There were 118 incidents that resulted in harm last year at CAMH and Zahn wants to talk about language in a press release.

If Zahn is getting any advice about her labour relations strategy, it’s really bad advice. This is not language intended to resolve a problem, its language likely to start a new one.

Zahn admits in her e-mail that “we are seeing patients who are acutely ill more than ever before.” The better question is what is she doing about it?

We understand that news of violence is not good for a psychiatric hospital, especially one that has spent much effort at reducing stigma associated with mental illness. That stigma includes a perception about violence that doesn’t necessarily apply to the broader population struggling with mental illness. As we like to repeat, persons with mental illness are more likely to be the victims of violence rather than the instigators of it. That doesn’t mean there aren’t seriously ill individuals who do pose a serious threat to themselves and others at CAMH and at other psychiatric hospitals around the province. There is no question that with fewer beds the level of acuity has dramatically risen in these hospitals.

As much as CAMH would like to sweep this all under the carpet, the recent charges under the OH&SA make this impossible to ignore.

The Ottawa Citizen has been providing coverage of an ongoing trial involving a Ministry of Labour prosecution of the Royal Ottawa Mental Health Centre under the same Act.

The legal community have recognized that such trials will do one of two things – either better define the employer’s obligations under the OH&SA or highlight to government the gaps in existing legislation.

“As today’s workplaces constantly evolve, employers can assume that workplaces should be regularly assessed to ensure policies and programs continue to protect its workers from workplace violence,” writes Phanath Im in Lexology, the BLOG of the Association of Corporate Counsel.

Workers who have been badly injured on the job don’t want to be told what a great job they are doing. They want to hear the hazard they faced has been addressed and that the workplace they are returning to will be a safe one.

Both OPSEU and ONA have been trying to secure a joint meeting with Zahn since last October. Up until now, she has closed her door to such a meeting.

The last time they met, the workforce wanted CAMH to look at Vocera, a secure two-way integrated communications system that has been successfully used by many other hospitals in North America to enhance public and worker safety. The Toronto East General Hospital recently reported on its experience with the system during a special June OPSEU meeting on the issue of workplace violence.

In July the unions were told by CAMH that Vocera was too expensive. This suggests CAMH has a price in mind for the safety of its patients and workforce.

The question is, how much of that cost will instead be spent going to court to answer fresh charges under the Occupational Health and Safety Act? The last time CAMH paid $70,000 in fines on top of their legal costs.

In her e-mail Zahn trotted out a variety of initiatives CAMH has made.

Zahn’s idea of “recent” initiatives includes training on the use of the Dynamic Assessment of Aggression (DASA) tool. The tool involves a short daily assessment of patients to determine the likelihood of aggressive behavior within the next 24-hours. That initiative was introduced three years ago, and the international criticism of it appears to be validated by CAMH: while it does increase the probability of identifying a potential threat of violence, one report in Behavioral Science and the Law states “many more patients will be identified as being at risk for physical aggression than will actually be physically aggressive.” That makes it very hard to use that information effectively.

The same paper notes “decision making tasks supported by the DASA may be of limited value to ward staff, who are continuously monitoring, managing and treating patients whilst taking account of fluctuating potential for violence.”

Nobody is disparaging efforts expended to date in making CAMH a safer place to work. Some have helped, others haven’t. There is little doubt that ongoing provincial austerity is contributing to the hospital’s woes. Staffing levels are key to a safe workplace, yet CAMH has been reducing staff to keep its budget balanced. Given the recreation programs associated with many of those staff, they may be amplifying the conditions that have spawned a spike in aggressive behavior.

On one thing Zahn is correct – we do need collaborative efforts to eliminate violence in the workplace. That includes a joint effort by the clinical leadership, representatives of the patients, academic experts and the elected union leadership of CAMH’s staff.

We would strongly urge Zahn to start there.