Wider issues at play
Collins said the biggest reason for the assaults at the hospital aren’t its physical spaces.
“It’s our philosophical and clinical approach,” he said.
In the last three or so years, the staff at the hospital has been instructed to reduce the use of restraints and seclusion in the name of providing a more therapeutic environment for patients.
Jesson was blunt about these new realities — “going back to restraint and seclusion is not on the table” — but said the staff could still use these tools if a patient is going to hurt himself or others.
And Olson said the staff is being re-educated about that standard of “imminent risk” of harm.
The hospital’s state license to operate is on conditional status until December, which has heightened oversight. A different part of Jesson’s human services department made that decision, so she has a complicated role here.
Tim Headlee, a lead security counselor and president of the local union, said the staff has “adopted a new way of providing treatment.”
There’s some tension, he said, between making a safe environment and providing effective therapy. In other words, you can provide a secure environment by putting troublemakers in restraints but that experience can be traumatic for them.
It’s not a new problem; the lobotomy picks and crude shock therapy devices in a nearby museum provide plenty of evidence of how therapists have grappled with this tension in the past.
But Collins said the pendulum has now “swung too far” in the other direction. For example, staff members often aren’t allowed to tell patients to clean up their messes for fear of upsetting them, he said.
Headlee put a similar sentiment this way: "A lot of (security) counselors want real-life expectations." Staff aren't there to punish, he said, but at the same time an environment where patients can do no wrong doesn't prepare them for the real world.