Editorial: State mental hospitals need immediate attention

While it’s impossible to guarantee the safety of employees working in high-risk environments, that doesn’t absolve the state of the duty to take every precaution possible to ensure the well-being of staff at its state mental hospitals.

Judging by the trend of increasing violence at these facilities — including Atascadero State Hospital — the state has not been meeting that obligation.

As reported in last Sunday’s Tribune, violent assaults against staff members at ASH have been rising steadily over the past few years. There were 105 aggression-related injuries to staff in 2008; 135 in 2009; and while statistics for 2010 were incomplete, there were 100 staff injuries through early September. By comparison, there were fewer than 100 assault-related injuries in each of three previous years.

The situation at other state hospitals is just as bleak. Indeed, the need to revisit the issue of staff security took on even more urgency after the October killing of a psychiatric technician at Napa State Hospital.

It isn’t just staff who are at risk; patient-on-patient violence has increased as well. According to a Los Angeles Times report, at Napa, patient assaults on one another increased six-fold — to 692 — in the second quarter of 2010, when compared to the same period in 2009.

The escalation of violence is due, in part, to a change in population. In the past, many patients were sent to state hospitals as a result of civil commitments. But today, as many as 90 percent of patients in the state hospital system have committed crimes and are ordered to hospitals by the criminal courts.

To his credit, state Sen. Sam Blakeslee has been working for years to improve safety at ASH.

He’s met with employee groups numerous times, and on Friday, he “shadowed” employees there to get a better understanding of the challenges they face.

Blakeslee is working on four proposals to improve safety for staff members at ASH and other state hospitals.

Those include:

Making it a felony — rather than a misdemeanor — for patients to throw excrement and other bodily waste at employees. This crime already is treated as a felony at state prisons, and we see no reason why that standard should not be extended to state hospitals.

Giving hospitals more leeway to medicate individuals who pose a serious threat to other patients and staff but refuse to voluntarily take medication.

Streamlining the process of returning violent individuals back to prison, if it becomes apparent they aren’t suited to a hospital environment.

Adding a high-security unit at each of the state’s mental hospitals, to house the most dangerous patients.

Each of these measures deserves careful — and immediate — attention.

We understand that the civil rights of patients must be protected.

We also believe, however, that there must be a balance that protects the rights of patients without seriously compromising the safety of workers.

Doctors, nurses, psychiatric technicians and others who work at state mental hospitals provide an invaluable public service.

They should not have to wait until another brutal attack or killing for the state to act to improve safety at ASH and other state hospitals.

We strongly urge all legislators to make safety and security issues at our state mental hospitals a top priority.