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Union members protest violence at Western State Hospital. Photo by John Ryan.

Union members protest violence at Western State Hospital. Photo by John Ryan.


Mental Hospital Staff Bear Brunt Of Workplace Violence

John Ryan

Just south of Tacoma is a 260–acre paradox. It's a beautiful, park–like campus, but most people are here against their will. It's a place where people go to heal. It's also the most violent workplace in Washington.

It began as Army Fort Steilacoom. Then it became the Insane Asylum of Washington Territory.

For more than a century, it's been simply Western State Hospital.

At Western, healing of the severely mentally ill often comes at the expense of their caregivers' health. For part four of our "Danger At Work" series, KUOW's John Ryan takes us inside the state's largest psychiatric hospital.


It's lunch time on a third–floor ward at Western State Hospital. This ward provides care for people who have both mental illness and a developmental disability. Counselor Rick Caldwell checks in with a patient.

Caldwell: "Well, sounds like you're having problems today. What's going on?"

Patient: "You're not done with your lunch either?"

Just one small interaction of many over the course of a day. This one goes smoothly. But often, they don't.

Workers at psychiatric hospitals are more often assaulted on the job than anybody else — 60 times more than the average worker in Washington state.

No cameras are allowed inside the state's largest mental institution. That protects the patients' privacy. I didn't get to interact with patients at the hospital. But I did speak with various people who work at Western about how they cope with violence from their patients.

Jamieson: "My name's Jess Jamieson and I am chief executive officer here at Western State Hospital. I think people have sort of sometimes a misconception of what a state psychiatric hospital is. This ward is also typical: bright, airy, open. We try and individualize patient rooms with their own items, we have things on the walls so that it's as warm and inviting and therapeutic as we can make for the patients."

Ryan: "You have a problem of patients assaulting staff. I wonder how often that happens here?"

Jamieson: "There's probably some event that happens, you know, on a daily basis somewhere in this hospital. But with all of our efforts to make this a more safe environment for both patients and staff, the number of those assaults have continued to go down."

Thompson: "My name is Larry Thompson, I'm a psychology associate at the Center for Forensic Services at Western State Hospital. That's a master's–level therapist, working with the criminally mentally ill. On the 28 of March of this year as I was getting ready for group at 8:35 in the morning, a patient threw a cup of scalding hot water in my face. I saw him coming, I just don't move quite as fast as I used to, and I couldn't block it, and he got me. I suffered second–degree burns and a partial loss of vision in my left eye until the burns healed over."

Ryan: "You had to miss work for a while?"

Thompson: "Yes, I'm still on L&I [Labor and Industries compensation] right now. I will go back to work. I love what I do, I love Western State. You know, you hear a lot of negative things. I think this really is a good place for me to work. This is just an occupational hazard of the job, and I've been working in mental health for 40 years. So, yeah, I won't give it up."

Much of the staff at Western State Hospital is unionized. The unions hold an annual rally for workplace safety on the hospital grounds.

Sound: (Applause)

Robinson: "Hello, my name is James Robinson and I'm the local president of 793. Western State Hospital still is the most dangerous work site in Washington. We have had 313 assaults over the past year. We are working hard on safety. We've had a nearly 30 percent reduction in assaults per patient–care hours. I want to thank the staff for their hard work out here. And with that, I'm going to introduce Carol Dotlich, our Council 28 president."

Dotlich: "This memorial represents 313 reported assaults. The word 'reported' is a really significant word here because we know many of our coworkers don't report the assault [because of] the paperwork, the time to investigate the incident, the pressure to keep your head down, don't make waves. We demand a culture of safety in this place, a culture where reporting is rewarded and where retaliation does not exist. The number we want to see is not 313, is it?"

Audience: "No."

Dotlich: "The number we want to see is zero."

McCants: "I don't think it'll ever be a safer place because of the kind of people that we work with. My name is Andy McCants, Jr., and I work on C–4 with the DD clients, development–disabled. It's a dangerous job, I mean, anything you do these days is dangerous, but working in here is very dangerous. You never know when someone's going to hit you, so you have to be on your guard every day that you're here."

Schwartz: "I'm Richard Schwartz. I'm an institutional counselor on the treatment mall here at Western State Hospital. Staffing has been cut back, and our ability to deal individually with patients has been somewhat compromised. That means that we're at a level now that if we lose any more staff, we won't be able to deal, work safely with these patients. Our ward's getting more and more crowded. There's less room out in the community, we're having difficulty discharging patients as a result, and we just have more and more patients coming in that are unstable."

Severson: "My name is Kate Severson, and I'm a registered nurse. It's not like Western is a horrible place to work or this terrible unsafe place, but it does happen. Assaults happen. I might be a little bit numb to it in a certain way because we walk into a potentially dangerous situation every day. When staff are assaulted, it's nearly impossible to get any kind of law enforcement involvement or prosecution of those assaults. So, for example, if a patient spits on a police officer in jail, or out there, that's a fourth–degree assault. But we can come here and be spit on all day."

Ryan: "So it's a tough line of work that you're in. I wonder why do you do it?"

Severson: "Well, I do like working here. I find that the patients are really fascinating and interesting. I appreciate being able to meet the patients and not be scared and meet them with some compassion and grace. I think they're pretty marginalized in our society. So it gives me a chance to maybe reach out with something that they're not used to getting."

Staff: "Hey sweetie, what's up?"

Patient: "I'm learning to follow my routine schedule."

Staff: "I'm glad! That's great!"

Ryan: "So, Jess Jamieson, do you feel like you provide a safe workplace?"

Jamieson: "I do. And safety is never something all of a sudden at the end of the day you say, ah, we're finally safe. We have to constantly make certain that we pay attention to safety and learn from incidents and issues that occur in the hospital to work to continuously improve that."

The CEO also says, thanks to the culture of safety at Western State Hospital, most assaults do get reported.

But researchers who've studied workplace violence at Western and other hospitals say the majority of incidents never get reported. So the official violence statistics only capture the tip of the iceberg.

I'm John Ryan, KUOW News.

© Copyright 2011, KUOW

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