Assaults Are "Constant Disruption" At State Mental Hospitals

Oct 11, 2013

Violence is a “constant disruption” at the state’s two main psychiatric hospitals, according to a new report jointly commissioned by The Department of Social and Health Services and the SEIU Healthcare 1199NW union that represents much of the front-line staff at the hospitals. 

The independent report calls for dozens of reforms to make Western State Hospital and Eastern State Hospital safer for patients and staff alike.

In 2012, Western State Hospital reported 322 assaults on its staff. In addition, a Western patient killed another patient, and a third Western patient committed suicide.

Eastern State Hospital also had an apparent patient-on-patient-related killing last year. 

The report’s top recommendation echoes a demand that the hospitals’ unionized employees have made for years: Hire more front-line staff.

The report, by New York-based safety consultant Jonathan Rosen, said the hospitals’ “lean staffing, driven by state budget cuts … is in conflict with the mission, vision [and] values of the hospitals.”

Western State Hospital’s new CEO, Ron Adler, disputed that his hospital is understaffed.

“I think we have scheduling problems,” Adler said, pointing to difficulties keeping the wards well-staffed on weekends. “Right now, I want to make sure I have all of my employees ready, willing and able to work a seven-day work week.”

Adler also disputed the study’s suggestion and newspaper headlines that violence is on the rise at Western. The Rosen report extrapolates an annual rate of patient-on-staff assaults from just three months of data in 2013. Adler said data from January through August of this year show that the rate of assaults is actually lower than it was in 2012.

‘Punitive and discouraging’

The report faulted poor management and a “spider’s web of duplicative policies, procedures and committees” for failing to come to grips with the hospitals’ chronic violence.

“Union leaders, middle managers, nursing supervisors, and rank and file staff expressed that the hospitals' leadership personnel seldom seek their input, rarely make rounds on the units and wards, and frequently are punitive and discouraging when staff express concerns or ideas for improvement,” the report said.

Adler did not dispute that conclusion.

“It is accurate to say that Western State Hospital has a culture of top-down decision making,” Adler said. He said the hospital was working to improve the flow of information up the chain of command – from its front-line staff, who bear the brunt of hospital violence, to management.

The Rosen report did not estimate the cost of its two dozen recommendations.

Adler said he’s too new to Washington state to predict these recommendations' chances of getting funded by the state legislature. Adler became Western’s CEO in July after running the Alaska Psychiatric Institute in Anchorage for a decade. API, Alaska’s largest psychiatric institution, is about one-tenth the size of Western State Hospital.

The Rosen report in full: