California’s Atascadero State Hospital, which houses mental patients in the criminal justice system, has seen a 66 percent jump in hitting, kicking, and other aggressive acts against staff in the last two years, reports the Los Angeles Times. There were 374 such assaults between July 2004 and June of last year, up from 225 two years prior. Psychiatrists, nurses and others say they face particular peril because the facility is taking on increasingly combative patients in already-crowded wards as it contends with an unparalleled staffing shortage.
The facility houses the state’s largest share of mental patients likely to be violent – including criminal defendants acquitted by reason of insanity, mentally ill parolees and those who have completed parole but pose too much of a threat to be released. “In 16 years here I’ve never felt unsafe,” said Dr. William Walters, a psychiatrist and vice chief of the medical staff that covers 75 severely ill parolees in two units. “I now feel I’m just waiting to get hit.” The facility took a national lead more than 15 years ago in calling attention to violence as an occupational hazard. Through its Clinical Safety Project, the hospital dramatically reduced serious staff injuries, trained employees to manage aggressive patients and enlisted patients in counseling peers. A recent analysis shows that the rate of assaults against staff members by patients considered the most volatile – on parole or confined beyond their parole terms – has tripled since January 2003. Staffers say a key factor is court rulings in 2004 that gave patients the right to refuse psychotropic medications.