Protecting staff from assaults by patients: OSHA steps in

The risk of injury from violent acts committed by patients is a major concern for those who work in psychiatric facilities (1). Until recently, grievances, civil lawsuits, and workers’ compensation claims were the only means available to pressure facilities to provide greater protection for staff members. Now, however, assistance has appeared from an unlikely source: the federal OccupationalSafety and Health Administration has begun to investigate and penalize hospitals that expose their employees to unreasonable risk of assaults by patients. As Soloff(2) noted, “Violence and assaultive behavior are part of the working reality of the modern psychiatric milieu.” Although fellow patients may be the most common targets of violence by patients (3), assaults against staff members are also common. In a Maryland state hospital, an estimate of 140 assaults per 100 staff members each year has been reported (4). An estimate from a maximum-security hospital in California was a good deal lower, about 32 assaults each year per 100 staff