Today, NPR did another story (linked here) about the California state mental health facilities, particularly one in Los Angeles. The employees picket at lunch time, gathering support from those who drive by. They had talked about it's not if they get assaulted, it's when they get assaulted. Even though California is in debt, they were able to give an extra $10 million dollars to the state facilities. I'm not entirely sure how many state hospitals there are and if this includes any state hospital or just the mental hospitals, but if there's more than 10, that's about or less than $1 million dollars each. They are the only state facilities that are hiring during the time of debt because there are great issues with safety. In the article, Diana Dooley, the secretary of California's Health and Human Services Agency, says that even $100 million dollars isn't enough "in terms of advocates of the patients and the workers and the need." No, no, I think that $100 million dollars is enough to hire more people, have police presence, and to ensure safety regulations and precautions of both workers and patients.
I wonder about the facilities that are not state run. In the 1990's, many state run facilities in CT were closed. Some former patients are still being reintroduced into society and trying to make it work with some state supported agencies. Others had difficulty and were sent either out of state or to other in-state facilities. There are a few for-profit, privately ran facilities remaining in CT. Although the state and federal government can give money for certain things such as becoming a teaching hospital or accepting patients with state insurance, there is little that can be given in the name of safety.
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| This is the arm of my coworker, Mike, after a rough code from a young patient. Codes are when patients' behavior are out of control. |
I worked at a privately run behavioral health facility for over 2 years. For two years, they worked me hard and often criticizing every little detail while not showing much appreciation for me or many other workers. At some point, they decided it would be better if they were a hospital that accepted patients with state insurance. For all of its history, it had been a place for upper class (wealthy) people to go to when they were mentally unstable. It had been a place where there was a sense of community and stays were long. Over the course of the years, the length of stay became shorter and shorter and the patients have become increasingly hostile and physically aggressive. Once the state insurance was accepted, patients who had been in prison and who were low income were admitted. The staff was concerned at the onset that there would be issues with people who had previously been to jail for violent crimes.
I saw many fights, heard of many attacks, and witnessed some of these attacks on patients and staff. The administrators were saying that they were not admitting violent patients while all staff knew they were. In one instance a patient (Patient A) was isolated from the community because he attacked another patient (Patient B). And staff and administrators blamed the Patient B for flirting with the Patient A. They did not point out that the Patient A waited for the chance when no staff would be around so that he could attack her. It could be that the administration's definition of violence was different from the rest of the staff.
Administration felt that they would be best to cover their own butts. They made every person who worked for the hospital, including the desk clerk, secretaries, and people who worked in the gift shop, to attend a safety meeting. They gave lots of cock and bull stories and emphasized that everyone had a role in safety. After taking this course, any incident that caused harm to a patient or staff was blamed on every staff who was around. This included the injuries sustained to a security guard who was injured while pulling two patients apart during a fight. He was blamed for the injury because he was doing his job. This safety meeting was developed after they had lawsuits on their hands (Isn't that a big surprise?-- sorry, had to get sarcastic there for a second).
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| This is another angle of Mike's arm after a rough code. |
The fact is that many of the nurses and mental health workers say repeatedly that there aren't enough staff, especially for evening shifts and on weekends. An evening weekend shift has the least amount of people. Patients pay attention to these things. If they were to make sure of a calculated time to attack others or to get out of control, they would do it at that time.
Administrators and doctors have the most control over policy. They also tend to have numerous biases and lack understanding of the duties of mental health workers and nursing staff. I challenge any of the doctors or administrators there to work as a mental health worker at mental health worker pay for a week. I would expect that after experiencing the difficulty with duties as well as lack of good pay, appreciation, and other staff around, there would definitely be changes. On a side note, many mental health workers work 16 hours and go home for 8 hours only to come back for another 16 hours. If you've ever been up for that long, it doesn't make for a good, alert worker. I would hope that doctors and administrators would have a better understanding of the difficulty of a the job of a mental health worker or worse if they could even imagine being in that job.
After I gave my notice to terminated my employment there, there were more out of control patients, security guards who usually work at night would be called in for earlier shifts, and more of my sweet coworkers were attacked. A known violent patient was admitted while the doctors and administrators were surprised and said they didn't know how that happened. In the following four days of this patient's admission, he assaulted at least two staff and knocked out another. He was supposed to be in chemical restraints, which meant that he was on a great amount of medication that made him too drowsy to do much than sleep. He went to a facility for violent patients where staff receive hazard pay and can retire at an early age because of the difficulty of their work. As time has gone on, I have encouraged all of my coworkers to demand hazard pay. At this point, I'd love to see them picket and watch administration scramble.
At this point, the LOS is very short, staff is burning out fast, and the administration is only looking at the bottom line and to protect themselves. They appear to me to have little interest in the well being of staff or patients. It's gotten the feel that staff just baby sits and can't do anything while patients act out or require higher levels of care than the facility can't provide.
As you can tell this is a subject that I'm very passionate about and will continue to write about.
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