By | September 26, 2016

Many different studies and publications have been created around addressing workplace violence. People have taken out their angers on coworkers, and in mental health facilities, caregivers face the possibility of workplace violence committed by those with disabilities. However, a true understanding of workplace violence goes much deeper than simply reporting an incident to Human Resources.

The safety of your staff and persons served are inherently threatened by the possibility of workplace violence, and the prevalence of workplace violence is much higher in the health care industry than any other industry around the globe. Fortunately, you can proactively manage workplace violence by understanding what it actually means, its prevalence and preventative measures, promoting a more holistic healing and rehabilitation environment.


What Does Workplace Violence Actually Mean in Mental Health Facilities?

Most often, workplace violence is used to describe an angry employee taking out aggressions on coworkers. However, the definition of workplace violence exclusively explains any act or threat of violence, intimidation, disruptive behavior, aggression or harassment at the work site, explains the United States Department of Labor’s Occupational Safety and Health Administration (OSHA).

Workplace violence is categorized in severity by what happens to the victim. The overwhelming majority of all workplace violence incidents is nonfatal, explains CNN Money. However, the nonfatal aspect makes some view issues involving harassment, “horsing around” or other non-physical actions as part of work. However, each incident represents workplace violence, and the statistics on workplace may go unnoticed as some chose to forgo reporting such crimes.

But, in mental health facilities, workplace violence can occur without warning.


Workplace Violence Prevalence

Workplace violence occurs more often in health care than any other field. The health care field is built on accurate documentation, a key part of any scientific venture. In other words, caring for individuals with disabilities is a type of science. So, part of the prevalence of violence in the workplace in health care may be the result of ongoing documentation and additional efforts to identify trends and risk factors. But, that does not make the problem any less severe.

Some of the most notable statistics on workplace violence in health care include the following:

  • Up to 20,000 serious workplace violence-related injuries occurred annually between 2011 and 2013 among health care workers.
  • Assaults constitute approximately 11 percent of all serious workplace violence-injuries in health facilities.
  • Compared to other large sectors of the economy, including construction, manufacturing and retail, health care and social assistance workers experienced nearly 400-percent more cases of serious injury due to workplace violence per 10,000 full-time equivalents (FTEs).

People with mental disabilities, including intellectual or developmental disabilities (IDDs), may be more likely to exhibit aggressive behaviors. In some instances, those with mental health problems may not even be aware of their surroundings. Moreover, delusions or hallucinations may alter how they perceive their environments. In addition, aggression can be a symptom of the disability.

For example, individuals living with bipolar disorder, anxiety disorders, depression or other “serious emotional disturbances” may become aggressive when medications are not being used correctly, asserts the Substance Abuse and Mental Health Services Administration (SAMHSA). Unfortunately, each incident of workplace violence represents an increased cost to the respective health organization.

The best way for health professional to manage aggression in children is through direct therapy for a child’s respective health conditions or an alternative training program.

Some of these costs are immediately evident. Broken office furnishings or damaged property has an immediate monetary drain on the organization. However, the costs can continue to add up. Staff members may ask for higher wages to continue working in an environment that has proven to be unsafe, or additional training on workplace violence may need to be repeated after an event occurs, driving up overhead costs.

In addition, an incident of workplace violence can easily cost respective organization thousands of dollars in medical bills, workers’ compensation claims or additional lawsuits. As a result, all health care organizations must eliminate the “minor, notify HR” mindset that revolves workplace violence because it is a very real threat to the future of the organization.

Some health care facilities may be more likely to experience an incident due to the age of those they serve. The prevalence of aggressive behaviors is exacerbated in young people, especially young children, explains the Centers for Disease Control and Prevention (CDC). These aggressive behaviors may include the following:

  • Biting.
  • Hitting.
  • Kicking.
  • Screaming or shouting.
  • Refusing to complete certain requests.
  • Using inappropriate language.

But, how do you prevent workplace violence from occurring if you cannot restrain or control others’ actions? In fact, the whole concept of using restraints to prevent aggressive behaviors in mental health facilities has been the subject of criticism and extreme study. The solution is a resounding focus on preventing workplace violence and aggression through the creation of a stable environment that inhibits it.


Combating Workplace Violence

There are several ways to reduce the likelihood of workplace violence. If not already in place, an organization must adopt a zero-tolerance policy for any and all forms of workplace violence. However, this can be difficult to enact in mental health. In other words, the exhibition of aggressive behaviors will occur regardless of existing policies. However, staff members and caregivers should be trained to de-escalate situations through strong communication with people who are angry.

OSHA has stepped up the frequency of its inspections of health care facilities for adherence to workplace violence prevention laws, reports the Government Accountability Office (GAO). In addition, the GAO is pushing Congress to enact legislation that imposes stringent mandates that would require health facilities to create and adopt intervention-style programs, which would the rate of workplace violence.


Putting It All Together

Regardless of personal belief, workplace violence undermines the ability of health workers, including social workers, case managers, program or clinical directors, psychiatric aides and clinical staff, to provide superior care to individuals with mental disabilities. Rather than waiting until an incident occurs, you need to adopt an organization-wide policy to proactively manage workplace violence.

Since you cannot know who is and is not going to commit an act of violence, you must prepare all staff for the possibility. In addition, you need to understand that is not a matter of if it will occur; it’s a matter of when. The odds are not in your favor, but you can do something about it by providing the proper education before it happens.

Jason Vanover

Working in health care since 2005, Jason's body of experience encompasses dozens of care settings, including Senior care, psychiatric facilities, nonprofit health service centers, group homes for those with developmental disabilities and beyond. Jason understands the need to tailor his skills to each setting to encourage the best treatment outcomes and promote an inclusive, healing environment.

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