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Attacks on Ancora employees declining

Kim Mulford
@CP_KimMulford

WINSLOW - Employees at Ancora Psychiatric Hospital are punched, kicked, knocked over and sometimes knocked out by patients. But a Courier-Post analysis of public records shows such assaults are declining following a state investigation.

In May 2013, as injuries climbed, an employee filed a complaint with the state Department of Labor about the hospital’s dangerous workplace conditions. The state hospital was cited for its inability to appropriately respond and manage violent disturbances and for its failure to conduct annual reviews of its violence prevention plan.

After Ancora organized a violence prevention committee and began conducting monthly reviews, it found 19 patients were responsible for a large number of the assaults in 2013. Those patients received particular attention from their treatment teams. Training policies also were updated.

As a result, records show the incidents of employees injured in patient attacks dropped from 141 incidents in 2013 to 63 in the first 10 months of 2015.

That’s good news for staff, said Phil Lubitz, associate director of National Alliance on Mental Illness New Jersey and chairman of the state’s Behavioral Health Planning Council.

“We’re hopeful the same trend holds true for the safety of patients,” Lubitz added, “but unless the division is more open in their reporting, families remain concerned about the safety of their loved ones in the hospital.”

Ancora briefly lost its Medicaid certification this year after failing repeat inspections. The state removed the hospital's top three administrators in June and named Christopher Morrison, former deputy CEO of Trenton Psychiatric Hospital, to lead the troubled hospital in Camden County. The state has declined repeated requests to interview Morrison about reform efforts.

Report: Multiple problems found at Ancora

The Courier-Post filed Open Public Records Act requests with the state Department of Labor and Workforce Development and the state's Division of Mental Health and Addiction Services. The records obtained include three years' worth of employee injury logs, compliance orders and other materials related to the state's investigation.

Additionally, the Courier-Post examined administrative decisions published by the state's Civil Service Commission, as well as patient census and incident reports published by the Department of Human Services.

The hospital’s patient population declined along with the drop in violent incidents. In 2013, Ancora’s patient population averaged 472 patients a month. In 2015, it has averaged about 430 patients a month.

State incident reports show violence between patients may be dipping, as well: In 2013, there were 1,208 assaults between patients. In 2014, there were 925. Though the state Department of Human Services is required to publish data on assaults in its psychiatric hospitals each quarter, the numbers for 2015 have not been released.

Joe Waite, associate director of AFSCME Council 71, said Ancora faces a double-edged problem, since it must work to keep both employees and patients safe. The union represents many Ancora employees who work directly with patients.

"The behavior with psych patients is unpredictable," Waite said. "Things like that can erupt at any time."

Ancora remains an inherently dangerous place, according to its own records. Between January and October of this year, employees lost nearly 800 workdays because of patient assaults.

On Aug. 24, for example, a nurse was kicked in the head by a patient and knocked out. During a two-week period last month, 10 employees were injured by patients during attacks and fights. One missed five workdays after a punch to the head.

Conditions two years ago were far worse: Employees missed 3,139 workdays in 2013 because of assaults by patients. One attendant missed 240 workdays that year following an attack by a patient. Another missed 114 workdays after a patient stabbed the employee with a pen.

Employee injury logs do not explain the circumstances that led to each attack.

However, patient advocates have raised concerns about the use of restraints in psychiatric hospitals. Ancora employees were injured at least 18 times while restraining patients in 2013, a dozen times in 2014 and at least eight times between January and October this year.

In some cases, employees’ own aggression can lead to attacks by patients, according to administrative findings by the state’s Civil Service Commission.

On June 16, 2014, a suicidal patient refused to hand over a fork and spoon to the technician assigned to supervise him and put them in his pocket instead.

After the technician warned he would call for help, the patient threw the utensils on the floor and began spitting food. The employee swung a clipboard at the patient’s head, and in response, the patient attacked the technician, sending him to the hospital.

State: More Ancora workers accused in patient assaults

Though the incident is not noted in a log of work-related injuries, Civil Service Commission records show the technician was out of work for a week.

On March 2, 2014, a human services technician was told to retrieve items from a patient’s pocket. Security video showed the technician pushed the patient against a wall and wrapped his arm around the patient’s neck in an apparent choke hold for 29 seconds, violating Ancora’s training and policies.

As the technician walked away, the patient retaliated by punching him in the back of his head.

Both technicians were fired for patient abuse, according to records. Both patients were put into restraints following the attacks.

Because privacy laws protect patient health records, it's not clear what injuries are sustained by patients or what happens to them following an assault.

Indeed, patients are far more vulnerable than employees, Lubitz explained. Most people with mental illness are not violent and are more likely to be the victims of violence, according to the National Association of Mental Illness. Research has shown that patients are much less likely to commit a violent act after receiving appropriate treatment.

“We always have to keep in mind, they’re in the midst of an acute psychiatric ailment,” Lubitz said. “With proper treatment, they reconstitute and can go on living a very productive life. That doesn’t mean they’re going to be a perpetually dangerous person.”

Kim Mulford: (856) 486-2448; kmulford@gannettnj.com