Medical Records & StethoscopeThose that work in a mental hospital or psychiatric ward–doctors, nurses, caretakers, and other staff–are exposed to a potentially dangerous environment everyday. While injuries from slip and falls, lifting, straining, and restraining patients do occur, one common cause of injury is patient attacks. Many state hospitals are not prepared for the potentially dangerous and violent situations that can occur.

With many patients’ rights laws and state health laws, psychiatric patients are given a growing amount of freedom, which unfortunately may factor into the growing amount of violence in mental health facilities. With mental health workers’ frequent contact and close proximity to patients, they are often the target of violence (other patients are also a frequent target). Our legal system is one that places a high amount of value on patients’ rights, but workers’ rights are just as important.

Can these attacks be prevented? Maybe not completely, but there are always ways to decrease the amount of intensity of attacks. The state of New Jersey operates a few mental health facilities, including Trenton Psychiatric Hospital and the Ann Klein Forensic Center. These hospitals are known specifically to house criminally insane patients and patients that pose a danger to themselves or others. If you work at one of those two, or any other mental health facility in New Jersey, it’s important to learn some tactics to prevent patient violence, and know what to do if you become a victim.

Contributing Factors to Violence in Mental Health Facilities

Staffing numbers are inadequate. Increase in patient violence is associated with the decrease in hospital staff. This could be because the patient seeks attention of the caretaker, and violence is the quickest way to achieve that.There are often too few security guards in mental hospitals and psychiatric wards, and sometimes none at all. Many facilities also are not employing enough medical staff and caretakers–providing one nurse to look over more patients than he or she can adequately manage.

Patients are free to walk as they please. The majority of patients (even untreated) are free to roam about the facility as they please. It’s important to note that not all mental health patients become violent, however. In fact, most psychiatric patients are peaceful and have never had a violent episode. A small amount of patients–15 percent–is reported to be responsible for 90% of violent incidents in psychiatric facilities. In most states, a judge can not require criminally insane patients to accept medication or even therapy.

Excessive use of forceful restraint. It is not to be suggested that all mental health patients should be controlled by physical restraint, medication, or isolation at all times. That is not realistic and is unfair to the patients that have a very low risk factor for violence. Forceful restraint has actually proven to encourage violence in the long term. Because patients receive much more attention after becoming violent, they can perceive this as an effective way to express feelings of anger, frustration, or fear.

Injury Prevention Tips for Mental Health Care Workers

Try your best to pay adequate attention to each patient and their needs. While this is not always the easiest thing to do because of the abundance of patients and lack of sufficient staff, get to know your patients to the best of your ability. Try to be perceived as a caretaker and not an authority figure or enemy. Be aware of their needs and figure out how you can best help them. Interact with the same patients on a regular basis if possible. Patients that have stability of and familiarity with their caretakers are reported to be less violent.

Learn to identify warning signs of violence. Techniques for identifying and rectifying violence should have been taught to mental health workers during training. Make it a point to re-familiarize yourself with the warning signs and signals on a regular basis. Become knowledgeable of the approved techniques for managing violence, as reacting too aggressively can result in termination. It is not possible to prevent every violent incident, adequate training can decrease many situations and help the worker to de-escalate others. The knowledge of simple verbal techniques to dealing with violence can decrease the seriousness of an incident. If training did not provide you with adequate instruction on violence detection and prevention, do some additional research on your own time.

Teach conflict resolution. If possible, teach patients to communicate feelings verbally, to recognize when anger is escalating, and how to remove oneself from a situation. Assertiveness should be taught in replace of aggressiveness.  Internal conflict resolution skills are very helpful as well as the recognition that negative thought processes can turn into violent behaviors.

Stay aware of surroundings and patient behavior. Always stay very aware of surroundings at work and the behavior of your patients. Be observant of any unusual or changing behavior patterns, especially if a patient has a history of violence.

Encourage family member involvement. Family member involvement is reported to be associated with a decrease in violence. If a patient has local family members, encourage their involvement in the patient’s life.

Become familiar with the policy and protocol for reporting attacks at your place of work. Always learn the policies for reporting incidents at your workplace. If you ever become a victim, you will know exactly how and to whom to report it.

Tips for Injured Mental Health Workers

Always report the incident. It is a common attitude in this field that assaults by patients are an inevitable part of the job and that there is little that can be done. Some victims may even think it was their fault for not looking after themselves and the patient better. Others are discouraged by their workplace to report incidents because of the time-consuming paperwork it requires. Still others are worried they may lose their job by reporting an incident or feel their coworkers and supervisor will not be supportive.

Remember the importance of your well-being. While a mental health worker is certainly in the field because they want to help others, they must remember the importance of their own well-being. Their own health is essential in order for them to effectively perform their job duties. Injured mental health workers should always seek supportive counseling and medical care if needed. Violent assaults can have lasting physical and psychological impacts if the victim does not receive proper care.

Contact a workers’ compensation lawyer in New Jersey. Because of the psychiatric diagnosis of mental health patients, injured workers likely cannot seek a personal lawsuit against the patient. However, they can file a claim under New Jersey’s Workers’ Compensation Law. Injured workers can receive monetary benefits for lost wages, medical expenses, and permanent injuries. Contact a local workers’ compensation lawyer to assist you with this process.