No one would contest that the work mental healthcare employees do is demanding – yet plenty of people outside the field would assume it’s only hard mentally and emotionally. What many don’t realize is that it’s also often demanding physically, because of the high risk of injury.
Three-quarters of all workplace assaults occur in the healthcare industry, and workplace violence is even more prevalent in mental health; almost one in five patients admitted to acute psychiatric units may commit an act of violence. The more extreme cases involve contraband like lighters or weapons – knives, guns, razor blades – that are brought into facilities from outside either by patients or their visitors.
It’s not just employees who need to worry about violence within mental health facilities. Patients, too, are at risk if another patient brings in or obtains a weapon or other restricted item while in a facility – and this can create a multiplier effect in which patients try to bring their own weapons in, thinking they need to protect themselves from others.
Violence within healthcare is increasing, according to a Modern Healthcare article, which calls it a “growing problem,” and mental health facilities bear an especially tough burden. Due in part to a lack of sufficient psychiatric beds, many behavioral health patients are being boarded in acute care facilities such as emergency departments for longer and longer periods of time. Such incidents result in increased elopement attempts and increased workplace violence incidents due to increased need for restraint and seclusion of these patients.
Additionally, rise in drug addictions in the United States and Europe means that many patients entering a facility have dual diagnoses: addiction and mental illness.
In Europe, the movement from the traditional model of hospital-based care toward community-based care is advancing mental healthcare. However, community-based facilities also experience overcrowding, with the result that some patients are sent to hospitals, which then suffer from an influx of acutely unwell and sometimes violent patients. Lack of space means patients may be discharged from facilities before they are completely well, and many acute care facilities lack the necessary resources to provide the necessary psychiatric care.
Yet mental health facilities of all varieties – inpatient, outpatient and residential – struggle with an effective way to ensure restricted items that incite violence are not introduced. An April 2016 editorial in the New England Journal of Medicine pointed out most research is centered on quantifying the problem of violence in healthcare rather than studying how to overcome it – but this is a mistake, especially in mental health facilities, where security is critical.
Meeting the challenges of securing mental health facilities involves enhancing not just the physical environment, but also the culture of security – because current methods aren’t working, and it’s made mental healthcare employees skeptical that anything meaningful can be done.
Each facility is unique in their own right, using different approaches to prevent security issues or resolve them once they arise. The more conspicuous processes involve walk-through metal detectors and/or uniformed security guards. A survey by STAT News found that emergency departments, for example, rely on a combination of hospital security and local police to prevent and handle violence, while some simply train their own staff on how to deal with violent attacks and rely upon response of local law enforcement when incidents occur.
Until now, screening for contraband was likely to be done manually, either by pat-down or with a hand- held wand. These processes have been proven ineffective as a primary screening tool in a study published in Medicine, Science and the Law. Remarkably, only five percent of prohibited items were detected with these hand-held wands, so their usefulness is as a secondary screening measure after detection by a primary screening tool (such as a walk-through metal detector).
Pat-downs and hand-held wands have several issues. They require staff to get up close and personal with a patient and invade their personal space while the staff member touches or waves a hand-held tool all over a patient’s body and in their face – which could trigger aggression.
Another issue is that such processes are not sensitive to many smaller concealable items like a razor blade hidden in someone’s hair or a needle or syringe in a closed fist. Physical pat-downs also put the searcher at risk of needle sticks and exposure to bloodborne pathogens, and hand wands need constant preventive maintenance to ensure proper operation.
Some hospitals and outpatient clinics, however, believe implementing such security measures may only exacerbate the anxiety experienced by their patients in a behavioral crisis and increase violence – and so they have only passive security methods like cameras and access controls, leaving them vulnerable to smuggled-in weapons. This can sometimes be attributed to perceived complacency by administrations to do more.
All facilities have a desire to balance security with a calming, therapeutic environment. Security options like conspicuous walk-through metal detectors; uniformed security guards (armed or unarmed); and pat-downs or screens with hand-held wands can create a prison-like, institutional feel – the opposite of a healing atmosphere. Patients’ emotional and psychological states are sensitive, and sometimes an unintentional slight can trigger violent behavior.
There’s a fine line to walk between security and patient comfort, and that has created the skepticism about being able to screen effectively without upsetting patients – but that’s because many facilities, and administrations, are only familiar with the older, more traditional screening technologies and processes.
The Rise of a More Effective Solution
There is a better way to ensure that patients and staff are kept safe with a screening practice that is both effective and unobtrusive – ferromagnetic detection systems (FMDS).
In the most basic terms, FMDS uses passive sensors that evaluate disturbances in the earth’s magnetic field made by something magnetic moving through its detection zone. Everything else is invisible to it; it doesn’t see people, clothing, backpacks, purses, etc.
Because it’s passive, there are no concerns it could interfere with a pacemaker or other medical device. Nothing can be used to shield the contraband or ferrous metal item, because FMDS doesn’t detect metallic mass; it detects a magnetic signature, down to a millionth of the earth’s magnetic field – so it can even detect small items like razor blades, lighters and needles. It also can detect when patients have internalized a threat item, or swallowed something in order to self-harm.
FMDS is designed to be run by anyone – because it is not based on an intrusive procedure like a pat-down or screening by a hand wand, staff don’t require extensive training in such techniques. The system runs on batteries – there is no need for an electricity source, as with a walk-through detector – and it can be placed on just about any form factor (a wall, a pole, a stand, etc.).
Its small footprint and portability give a mental health facility flexibility when deploying it, allowing them to place it in multiple areas of a facility and screen quickly and unobtrusively as patients walk by. Patients retain their dignity by not having to undergo a strip search or hand-wand screen, and staff can screen at a safe distance from potentially violent patients.
FMDS has applications in every type of mental health facility. It provides security screening for patients checking in for the first time as well as those with day-pass privileges returning from a day away from the facility. Its portability allows staff to take it all over a facility to perform searches inside a patient’s room or for cause whenever and wherever needed. If a staff member is suspicious a patient has a restricted item, the worker can discreetly take the patient to a private area and perform a search in seconds using FMDS.
FMDS screening technology offers an exceptionally high level of detection of ferrous objects. In comparison with the five percent the Medicine, Science and Law study found hand wands detect, FMDS in the same study demonstrated 100 percent detection of small, concealed contraband items or weapons.
Patients are put at ease by not having their personal space violated during a search and knowing no other patients or visitors have been able to bring in contraband or weapons. Staff can effectively screen new patients without using an invasive, anxiety-producing practice that puts them too close to a potentially violent patient. Families of patients can feel better, knowing their loved ones are in a safe environment where their mental and physical space isn’t being violated in order to maintain security.
A New Security Paradigm
Due to increasing patient populations and complexities of care, inpatient, outpatient and residential facilities all face security and safety risks, and the need for proper security technology to reduce these threats will continue to increase. With threats of violence and attacks on behavioral healthcare staff now all too common, it’s time to look at security differently to embrace safety while maintaining a patient-friendly environment.
A detection system with patient-centered care in mind, FMDS provides effective security screening capabilities while reinforcing behavioral or mental health institutions’ goal to create a calming, therapeutic environment. FMDS closes the security gap for mental health facilities while protecting patient dignity with a tool that minimizes behavior escalation while safely screening for both contraband and weapons – keeping both staff and patients safe, and giving everyone peace of mind.