Posted on Wed, Sep. 01, 2010

An influx of new patients at Atascadero State Hospital has created a more aggressive environment for workers, according to hospital administrators and union leaders.

State hospitals such as ASH were required in May to admit patients deemed incompetent to stand trial until they are declared fit, which resulted in a spike in admissions that state Mental Health Department spokeswoman Nancy Kincaid said has created a parallel increase in aggressive behavior among patients.

Aggressive behavior is classified as anything from throwing missed punches, pushing and yelling profanity to something more serious such as a fight, but not resulting in serious injury, she said.

Several ASH employees who declined to give their names for fear of retribution contacted The Tribune this week to describe recent troubles inside the hospital.

Fights often break out, one psychiatric technician said, and staff members fear patients because they “try to bite us, hit us and kick us almost every single day.”

ASH has approximately 30 patient units, 2,300 staff and nearly 1,200 patients, hospital spokesman Craig Dacus said. It is licensed for 1,275 patients.

From May 1 to June 30 — the most recent ASH data available — patient admissions increased from an average of 100 patients per month to 150 patients per month. A total of 165 patients deemed incompetent to stand trial are included in that time frame, Dacus said. The aggressive incidents also increased in that same period, he said, because there were more patients and statistically, patients are more hostile in the first 90 days.

Employee concerns were prevalent even before the May change, according to Paul Hannula, president of the California Association of Psychiatric Technicians’ ASH chapter. Among the safety risks, he said, are overworked staff and that the hospital is running at the minimum legal staff-to-patient ratio.

For example, floor staff can include unit supervisors who are also busy with managerial duties and staffers coming off 16-hour shifts exhausted from mandatory overtime, he said. Unit supervisors are starting to be included more often because the hospital can’t cover the shifts when mandated overtime gets capped out, he said.

“Right now, from a union standpoint,” Hannula said, “a lot of our members feel extremely unsafe inside the facility.”

Hospital officials say ASH doesn’t have a staffing shortage and that shifts can be filled with overtime on a voluntary or mandatory basis.

In recent weeks, the hospital has been on two lockdowns, Dacus said. One was last Thursday and another was from Saturday to 10 a.m. Monday. The hospital didn’t disclose what occurred.

An employee said the three-day lockdown last weekend was due to a patient confrontation in a courtyard that led into a hallway.

A patient also stabbed a staff member Aug. 23, Dacus said, and the staffer was treated at the hospital’s urgent care. Employees said he was stabbed in the face with a homemade shank. Dacus declined to release more information Wednesday because the incident is still under investigation, saying only that the stabbing suspect was arrested and booked in County Jail.