Editorials

890 assaults against staff, 9 months, 1 hospital. That’s intolerable. This small step could help

An ambulance leaves Western State Hospital in Lakewood. With around 850 beds, it is Washington’s largest psychiatric institution.
An ambulance leaves Western State Hospital in Lakewood. With around 850 beds, it is Washington’s largest psychiatric institution. Associated Press file photo, 2018

One nurse’s ear lobe was bitten off by a mentally ill patient who jumped over the nurse’s station and knocked her to the floor. She also suffered a fractured spine in the Sept. 30 assault, according to a lawsuit.

Another nurse was punched in the face by a patient, then suffered knee injuries while trying to subdue the man. He was laid up and couldn’t work for more than six months.

These and other recent accounts of staff members being attacked at Western State Hospital are harrowing. Even worse is that reports of violence are growing. An Associated Press investigation in December found assaults on employees at the Lakewood mental health hospital had doubled compared to five years ago, depleting staff and driving up disability claims.

In 2018, there were 890 incidents just in the first nine months — a staggering number for an 850-bed hospital.

New workplace-safety legislation in Olympia, which has the backing of several Pierce County representatives, is an appropriate response. But it’s not a panacea for the complex web of problems facing Washington’s beleaguered mental-health system.

House Bill 1931, introduced by freshman Rep. Mari Leavitt (D-University Place), would raise standards and increase the frequency of violence-prevention planning, training and record-keeping at all health-care facilities in Washington. It was scheduled for a public hearing Wednesday in the House Appropriations Committee.

The proposal, along with a companion bill in the Senate (SB 5912), recognize the risks that attend the medical profession as a whole. Health-sector workers are at least four times more likely than the average U.S. worker to face serious on-the-job violence, according to federal statistics; assailants can range from a vengeful gang member outside an emergency room to a distraught family member at a nursing home.

But the bill, while not limited to Western State, was drafted with Washington’s largest psychiatric institution in mind — and rightly so. The hospital’s safety record and quality of care have received such poor marks from federal regulators that, after three years of monitoring, they yanked its certification last summer, along with $53 million in funding.

Violence-prevention plans are nothing new; they’ve been de rigueur in Washington health-care settings for two decades. Leavitt’s bill would require they be updated every three years with employee input and an annual review of violent encounters, rather than a formulaic one-time plan that doesn’t adapt to changing workplace conditions.

Frequency and flexibility are critical in the dynamic world of health care. Consider Western State; the campus is in constant flux whether due to security needs, such as upgrades that were done after two violent offenders escaped in 2016, or for therapeutic reasons, such as the reduced use of restraints and isolation.

All these changes can affect employee safety. And more change is on the way as state lawmakers talk about shifting most civilly committed patients into community-based settings. Meanwhile, Western State will be left to focus on hardened criminal patients.

Leavitt’s proposal is good as far as it goes. Would it prevent nurses from ever being tackled, punched or bitten? Of course not. But we won’t argue against anything that aims to make health-care professionals safer.

And yet by itself, her bill is like a finger stuck in one hole of the proverbial leaky dike.

Washington needs system-wide reform, including better integration of mental health, substance abuse and primary care. It needs to act on familiar ideas that Gov. Jay Inslee rolled out in a five-year plan last spring, including the decentralization of psychiatric treatment. It needs to spread the burden of housing patients after they’re discharged, which now falls heavily on Pierce County communities.

But none of this holds together unless the supply of mental-health workers keeps up with rising demand. That happens through first-class training, competitive wages, professional support — and confidence that the job isn’t more dangerous than it needs to be.

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