Assaults plague state psychiatric hospital for children in Lakewood

Officials institute costly training and security measures to deal with problem blamed on handful of patients

Staff writerSeptember 28, 2013 

Assaults on staff have spiked at the state psychiatric hospital for children.

The Lakewood facility saw more than one assault every week on average in the year that ended in June.

Much of the recent violence at the Child Study and Treatment Center is blamed on just a couple of its young patients.

“We have had a select few kids who really kind of stand out from history here. They’ve come in and they have been much more violent than some of our kids over a longer period of time,” said Rick Mehlman, the hospital’s CEO.

In 2012, the rate of assaults as a share of patient days soared to triple what it was just two years earlier, according to a report this month by the Department of Social and Health Services, which runs the hospital. But a single youth committed more than a quarter of those assaults.

By the time that patient was discharged in February, a different youth was in a similar situation, blamed for 30 percent of assaults over the first three months of 2013 and half of those committed in the building, Orcas Cottage, that holds some of the most violent youth.

The hospital has put new training and security measures in place, adding extra mirrors, door alarms, radios and a camera, for example. But some employees are asking for more training on techniques similar to those used in juvenile detention.

At the state’s two adult psychiatric hospitals, the rates of assaults have stayed roughly steady in recent years and are far fewer at Western State Hospital than they were in the middle of the last decade.

The child treatment center is next to Western State and plays a similar role for children ages 6 to 18 as its neighbor does for adults. It’s the only facility of its kind in the state. Youths with the most serious mental or emotional problems go there — some who have been abused and some with histories of gang activity or other violence.

It’s small, with room for just 47, so statistics are bound to jump around. But assault rates in 2012 hit levels not seen in at least a decade.

“It just makes no sense to have that high number of assaults because in the end taxpayers pay for it through shelling out workers’ comp,” said Tim Welch, a spokesman for the Washington Federation of State Employees, which represents some of the center’s roughly 130 employees.

Injuries have become more serious as well as more numerous.

Before 2012, the most serious assaults — those with injuries causing the loss of more than three days of work time — were almost always outnumbered by less serious injuries. In 2012, the serious injuries were much more common, and in the first few months of this year, they outnumbered the less serious attacks more than 7-to-1.

In the most serious cases, employees’ tussles with youth can lead to temporarily disabling sprains and strains or, more rarely, shoulder or knee injuries that require surgery to repair.

Assaults dipped in the early part of this year from 2012 highs, according to the report. According to figures provided by Mehlman, they have continued to ease somewhat, with four reported assaults in July, down from seven in the same month last year, and two August assaults, down from six a year earlier. Mehlman cautioned that many assaults go unreported.

But the earlier assaults continue to result in lost time, which shot up in early 2013.

DSHS wrote in the report that it expects “we will be able to curb this trend” and reduce the number of serious assaults this year, because of a safety work group, analysis of assaults and expansion of evidence-based practices.

The hospital spent $14,000 for training that ran through Aug. 1 on new techniques for dealing with behavior.

Other recent spending includes $20,000 for upgrades to hardware aimed at keeping patients from hanging themselves and $4,200 on improvements to Orcas Cottage based on recommendations from the state Department of Labor and Industries. L&I had investigated an injury and fined the hospital $11,000, which an appeal reduced to $1,000.

Mehlman said staff isn’t forbidden from using physical force but is trained on verbal de-escalation.

“We try not to put hands on kids. A lot of these kids have physical trauma histories, so even in a situation where we safely put hands on kids it re-traumatizes them,” Mehlman said.

The hospital is not a prison, and unlike juvenile lockups, it doesn’t use mechanical restraints, he said. Welch said workers aren’t necessarily asking for restraints, but want more strategic, nonviolent techniques that juvenile-detention officers use.

When local police are called in, youths might be taken away for a while, but it takes a series of many accumulated crimes to send them to detention, Mehlman said.

Jordan Schrader: 360-786-1826

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