Monday, December 26, 2011

Mental Health Hospitals Are Hazardous Environments!

How Do You Hold Mentally Ill Offenders Accountable?
by Ina Jaffe
December 21, 2011
Mental health and law enforcement officials in California are trying to find ways to hold violent psychiatric patients accountable without punishing people for being sick. It's a response to escalating violence in the state's mental hospitals, where thousands of assaults occur annually. Only a tiny fraction of them, however, result in criminal charges.
In California, prison inmates who have committed serious crimes and have been diagnosed with a major mental illness can be forced to serve their parole in a state hospital. At Atascadero State Hospital, shown above in this 1999 photo, there are more than 600 such patients. "As a group," says the hospital's director, "the mentally disordered offenders are the most aggressive."
One case that did was the attack on Jill Francis, a psychiatric technician. She was punched by one of her patients at Atascadero State Hospital on California's Central Coast. Months after the incident, there's still a bruise under her left eye from reconstructive surgery.
"I received a laceration above my eye, which took seven stitches to close," she says, cataloging her injuries. "My eye was actually pushed back and down, I had fractures in the bone below my eye, and I got a concussion, [all] from one punch."
The patient who allegedly hit her is Desmond Watkins. According to law enforcement officials, Watkins has previously been in prison for assault with a deadly weapon. And when Francis met him, he was in Atascadero for the second time.
Francis says Watkins "just got fixated all of a sudden that he wanted to go back to prison, and that by hitting someone that would enable him to go back."
Watkins may get his wish. He's been charged with three felonies, including aggravated battery.
The 'Mentally Disordered Offender' Law
He's one of thousands of Californians caught in the revolving door between the state's prisons and mental hospitals. Many of those people make that back-and-forth trip because of a law unique to California known as the Mentally Disordered Offender law. It says prison inmates who have committed serious crimes and have been diagnosed with a major mental illness can be forced to serve their parole in a state hospital. And each year that they're in the hospital, they get a trial to determine whether they're still mentally disordered.
At Atascadero State Hospital, there are more than 600 mentally disordered offenders, as many as there are at all of the other state hospitals combined. In fact, they make up a majority of Atascadero's patients.
"As a group, the mentally disordered offenders are the most aggressive," says Atascadero hospital director Jon De Morales. That's why the toughest ones are housed on a special unit, he says, with tiny private bedrooms and windows that allow staffers to see inside.
"Kind of stark," says De Morales, peering into a room with a bed bolted to the floor and no other furniture or decoration.
De Morales, who has worked at Atascadero for decades, has developed a theory about his patients. First, he says, "there are criminals who happen to exhibit symptoms of a mental disorder." Then, "there are mentally ill people who happen to have committed crimes. They all end up in the same place."
And they all get treated the same. But they shouldn't, says San Luis Obispo County District Attorney Gerald Shea. He thinks mentally disordered offenders should be subject to the same laws in the hospital that they were subject to in prison, where any violent act against a staff member, no matter how slight, is treated as a felony and results in a longer sentence.
Shea says extending this law to cover parolees in the hospitals is only fair.
"We just feel that the employees at Atascadero State Hospital shouldn't be subjected to lesser protection than their counterparts at the state prisons," he says.
So Shea sent a memo with his legal arguments for the change to his state senator, Sam Blakeslee. Blakeslee now plans to introduce a bill that would turn Shea's idea into law. But the senator says the increased penalties would not apply to every patient.
"You've got people who have been determined to be so mentally compromised that they're not guilty by reason of insanity or incompetent to stand trial. This legislation would not apply to those individuals," he says.
'Enhanced' Treatment, More Staff
But some of those individuals are chronically aggressive. So even if Blakeslee's bill passed — and similar legislation has failed in the past — it would not solve the violence problem.
That's why the Department of Mental Health is now experimenting with what it calls an "enhanced treatment unit." The first one, a pilot project, just opened at Atascadero.
"Some of our own staff and the public ... think of the enhanced treatment unit as a 'bad boy' unit or a secure unit," says De Morales. "It is not."
The unit will have more intensive treatment, says De Morales, and more staff, all of whom have volunteered for the job.
"If it's successful," says De Morales, "we may export the program to other hospitals or take referrals from other hospitals to treat here."
But at full strength, the enhanced treatment unit can only take 27 patients. That means California's psychiatric hospitals will still be searching for ways to keep staff and patients safe.
Are California’s Mental Health Hospitals Hazardous Work Environments?
By Lisa Aliferis
December 20, 2011
NPR’s Ina Jaffe has filed a series of reports this year about violence in California’s psychiatric hospitals. The spark was the October 2010 murder of a health care worker at Napa State Hospital, allegedly by a psychiatric patient with a violent history.
Today, Jaffe reports that “thousands of violent incidents occur every year” at the state’s mental hospitals, but few are treated as crimes.
Violence in California’s psychiatric hospitals has been increasing, partly because the kind of patients treated at the hospitals has changed. Generally, people with mental illness aren’t especially dangerous. But these days, about 90 percent of the patients in California’s mental hospitals are committed by the criminal justice system. They’ve been found not guilty by reason of insanity, for example, or incompetent to stand trial.
Jaffe further reports that the increase in violence came after a Justice Department imposed treatment plan in 2006-2007 following “horrifying” cases of abuse and neglect. Treatment improved, but the violence got worse. The Justice Department imposed similar plans on other hospitals around the country, but oddly only in California do the hospitals affected but Justice Department action treat patients who have committed serious crimes.
The state Legislature has been holding hearings on this issue. Psychiatrist Mona Mosk told lawmakers she was attacked by a patient who was sent to her hospital from a penitentiary “because that person was so dangerous, they couldn’t be managed effectively in prison.”
Metropolitan State Hospital employees and supporters gathered outside the hospital in Norwalk, Calif., this summer to protest repeated assaults at the hands of mental patients, and what they called dangerous working conditions.
Arrests Rare After Assaults
Mosk has been working at Patton State Hospital near San Bernardino, Calif., for more than 10 years. She explained that expectations for personal safety and accountability are completely different in the hospital than they are on the street.
“If anyone came up to you on the street and clocked you in the face, I’m pretty sure they would be arrested,” Mosk told lawmakers. But she said that at the hospitals, “arrest is something that happens very rarely, although assaults occur almost on a daily basis.
Thousands of violent incidents occur every year in California's psychiatric hospitals, but very few are treated as crimes. Among the exceptions was the murder last year of a hospital staffer by a patient. But for the most part, it's been a challenge for the criminal justice and mental health systems to figure out how to deal with assaults by the mentally ill.
Violence in California's psychiatric hospitals has been increasing, partly because the kind of patients treated at the hospitals has changed. Generally, people with mental illness aren't especially dangerous. But these days, about 90 percent of the patients in California's mental hospitals are committed by the criminal justice system. They've been found not guilty by reason of insanity, for example, or incompetent to stand trial.
[Right: Donna Gross] The spike in violence followed the adoption of a new treatment plan. It was imposed by the Justice Department in 2006 and 2007 to remedy "horrifying" cases of abuse and neglect. Treatment improved but, unexpectedly perhaps, violence got worse.
While the Justice Department has imposed similar plans on more than a dozen hospitals around the country, NPR's investigation found that none of those hospitals treats predominantly patients who committed or were accused of serious crimes, as California's hospitals do. Now, the Justice Department wants to extend its oversight of two of California's psychiatric hospitals, in part because it says the hospitals haven't gotten a handle on their violence problem.
The state Legislature has been holding hearings on this issue. Psychologist Mona Mosk told lawmakers she was attacked by a patient who was sent to her hospital from a penitentiary "because that person was so dangerous, they couldn't be managed effectively in prison."
Arrests Rare After Assaults
Mosk has been working at Patton State Hospital near San Bernardino, Calif., for more than 10 years. She explained that expectations for personal safety and accountability are completely different in the hospital than they are on the street.
"If anyone came up to you on the street and clocked you in the face, I'm pretty sure they would be arrested," Mosk told lawmakers. But she said that at the hospitals, "arrest is something that happens very rarely, although assaults occur almost on a daily basis."
Reports Of Assaults At Patton State Hospital
Year Crime Reports Cases Sent To District Attorney Cases Rejected By DA Cases Filed By DA
2007 340                 35                                             17                                 18
2008 1,098              27                                               5                                   2
2009 2,023               9                                                3                                   6
2010 1,454              91                                             81                                   8
2011 766                 27                                             16                                  11
Source: California Department of Mental Health
The numbers back her up. According to the Department of Mental Health, last year there were nearly 1,500 assaults at the hospital where Mosk works. Just 91 of those cases were submitted to the San Bernardino County District Attorney for prosecution, and the DA rejected 81 of them.
Mosk says staffers are told they're not injured severely enough for it to count as a felony offense.
And if it's not a felony, it's a waste of time and resources to prosecute, according to Gerald Shea. He's the district attorney in San Luis Obispo County on California's Central Coast, which also has a large psychiatric hospital.
Shea says that if a patient commits a simple misdemeanor battery on a staff member, "for all practical purposes, they're not going to get any additional time [added to their commitment], and therefore it doesn't really provide that kind of deterrent or protection for those staff members."
But there are cases where the criminal justice system does get involved. For example, there's the case of psychiatrist Alex Sahba, who works at Metropolitan State Hospital near Los Angeles. He told his story to fellow employees at a demonstration to protest hospital violence. He said he was talking with a patient one day, when another patient came up behind him, put him in a chokehold and bit his left ear.
Sahba has no idea how long the struggle went on. Eventually, other staff members separated them. His ear hurt like crazy. Sahba said he "noticed that blood was coming down my left ear to my left shoulder and body and leg."
Then he saw about a dozen patients standing in a circle, staring at something on the floor. "I realized they were looking at the piece of my ear that was actually bitten off ... and was spat on the floor."
Sahba had five reconstructive surgeries. His assailant, Kai Chang, was charged with attempted murder and felony battery. It was Chang's second attempted-murder charge. He'd been found not guilty by reason of insanity on the first one. And for his attack on Sahba, Chang was found incompetent to stand trial and transferred to another state hospital.
Mental Health Care May be Mandated in California, But Most Aren’t Getting Treated
By Shuka Kalantari
December 1, 2011
More than two million adults in California say they need mental health care, but about half of them aren’t getting it, according to a report released Wednesday by the UCLA Center for Health Policy Research.
California mandates health insurance companies provide equal care for mental and physical health problems. But mental health services are often inadequate–or they don’t exist at all, says lead author David Grant.
One reason is when hospitals want to cut costs, mental health care is often the first to go. Grant notes that, just this morning, LA’s Cedars-Sinai Medical Center announced it is cutting most of its psychiatric services.
“It’s a disaster,” Grant said about Cedars-Sinai’s closing. “Health care is undergoing so much change and it’s under so much financial stress right now. Providers are really looking for ways to reduce health care costs.”
As The Los Angeles Times reports, these cuts are a part of a larger, statewide trend:
California has roughly 6,500 acute in-patient psychiatric beds, down from 8,500 in 1996, according to the California Hospital Assn. There have also been significant cutbacks in Medi-Cal funding for mental health services statewide.
But closing mental health facilities might not save money in the long run. Grant says that’s because people with mental health needs are more likely to have chronic diseases like high blood pressure, heart disease and diabetes.
“These are folks that are going to have higher smoking rates, drinking rates, higher rates of disability,” Grant said. “And these are factors that will cost the state more and more financial resources.”
The study also shows there are huge disparities in who actually needs mental health services. Statewide, eight percent of Californians report a mental health issue. But within the LGBT community 20 percent, more than double the state average, report a problem; 17 percent of unmarried women with children, and 12 percent of US-born Latinos also have mental health needs.
Grant says he hopes the report will increase awareness that these groups need to be screened more frequently … assuming their hospital still has a psychiatric program.
Violence At Calif. Mental Hospitals: 'This Is The Norm'
by Ina Jaffe
July 21, 2011
Thousands of assaults occur each year at California's state psychiatric hospitals. Last October, a patient allegedly murdered a staffer at Napa State Hospital. Employees there demonstrated, demanding greater safety.
Now, the protests have spread to Metropolitan State Hospital near Los Angeles, where about 100 workers recently spent a broiling hot lunch hour marching in front of the place where they work.
Psychiatrist Laura Dardashti, who has worked at Metropolitan since 2006, says that when she started, co-workers told her, "It's not if you get assaulted — it's when."
Her turn came about a year and a half ago.
"I was attacked by an extremely psychotic patient who grabbed me by my hair and had me down ... in a pretty significant headlock," she says, "and it took about four staff to get her off of me."
But that wasn't the worst part: "I remember driving to work the next day with a wave of panic coming over me and tears welling up in my eyes, thinking, 'I don't know how I can do this.' "
But, she says, "I think with time, you forget. And there's a sense that somehow this is the norm."
Here's what state statistics say about "the norm" at Metropolitan: Last year, staff members were attacked by patients more than 1,300 times — nearly double the number of assaults from the year before. Meanwhile, patients assaulted other patients at a rate of almost seven times a day.
Rehabilitation therapist Denise Nicks says that staffers' demands for safety began years ago.
"And what does the hospital do: They make excuses. They say it's a budget issue. That's not OK." And not only are the staffers affected, she continues, "the patients are assaulted. The patients are being re-victimized."
Limited By Cost?
Metropolitan Hospital's medical director, Dr. Michael Barsom, says there's no conflict between management and staff on what should be done.
"I think the conflict, as it were, arises from what is feasible to be done," he says. "So to hire more staff, to hire more police officers, to implement an alarm system are very expensive items. And we're limited in what we're able to do."
Because as pretty much everyone knows, California is hard up for cash. The budget that was passed last month made painful cuts to just about everything. The state psychiatric hospitals, however, got $10 million more than last year.
On the one hand, that's amazing, says Diana Dooley, the secretary of California's Health and Human Services Agency. On the other hand, she says, "$10 million isn't enough; $100 million wouldn't be enough in terms of the advocates of the patients and the workers and the need."
But she says $10 million is enough to begin improving safety. For starters, the hospitals have been exempted from a statewide hiring freeze and are adding staff. A new alarm system is about to be tested, and a new department will be created to focus solely on the hospitals.
"But the problem has existed for a very long time," she says, "and we're not going to dig out of this hole as quickly as everyone would like us to do."
Some state lawmakers are nearly as impatient as hospital workers. They've introduced at least five bills that are designed to make the hospitals safer. Metropolitan State Hospital is in the district of Assemblyman Tony Mendoza. His chief of staff, Sharon Weissman, had this message for the demonstrators:
"Assembly Member Mendoza and I are both state workers. And you do not deserve any less safety when you go to work each day than we do."
Weissman said lawmakers will try to figure out what's causing the surge in hospital violence — and how to stop it — at a hearing next month.
At California Mental Hospitals, Fear Is Part Of The Job
First of a two-part series
by Ina Jaffe
April 7, 2011
The tipping point for major change is often tragedy. That may be the case in California at the state psychiatric hospital in Napa, where an employee was killed last October, allegedly by a patient — one of thousands of violent acts committed at the hospital that year.
[Left: At a rally at Napa State Hospital in January, workers demand better safety measures for staff and patients. One worker carries a sign with a photo of Donna Gross, a hospital worker killed last year, allegedly by a patient.]
Donna Gross, a psychiatric technician who had been working at Napa State Hospital for 14 years, was  walking on hospital grounds late in the afternoon
when she ran into a patient named Jess Massey. Like many patients at Napa, Massey had a pass that allowed him to wander on the grounds unsupervised. He allegedly cornered Gross between a couple of buildings, attacked her, stuffed dirt into her mouth — which kept her from screaming — and strangled her.
Massey, who has pleaded not guilty, had a criminal history that included aggravated sexual assault, armed robbery and attempted murder. These days, that's not so unusual at Napa.
More than 80 percent of the patients arrive by way of the criminal justice system, considered incompetent to stand trial, not guilty by reason of insanity, or just too dangerous and mentally ill to be paroled to the community.
But 20 years ago, hardly any of Napa's patients were criminal commitments. And staffers complain that this hospital wasn't designed to deal with the patients it's now serving.
A Sharp Rise In Assaults
At a recent demonstration held by Napa employees demanding better safety measures, finding people who had been attacked by patients wasn't difficult.
There's Chris Cullen, a psychiatric technician who says he was punched in the face; and Zach Hatton, a recreation therapist who recounted two injuries. "I was punched in the face about a year and a half ago," Hatton says, "and then my wrist was twisted up pretty badly and just has never healed."
Dr. Richard Frishman, a psychiatrist, was attacked while interviewing a new patient. "He came flying across the table, fists flying," Frishman says. "He was able to hurl me against the wall where I struck my head and fractured my wrist."
There are statistics to support these stories. According to a report mandated by the federal government, patients at Napa committed 75 physically aggressive acts against staff in a single six-month period ending in early 2009. In the same period one year later, there were nearly four times as many assaults. The report also shows that patient-on-patient aggression more than doubled during that same time.
Asked what it's like to be afraid of the people he's tasked with helping, Frishman says: "You have to be able to separate your own traumas from the moment, and if you can walk away at the end of the day and feel that you've helped those truly in need of help, that seems to outweigh the risks that we currently take."
'I Have No Desire To Be Violent'
One Napa patient, whose name is not being used because he says he fears retaliation, says a relatively small percentage of predatory patients make violence and intimidation part of daily life.
"There is nothing therapeutic about what's going on here, nothing at all," he says. NPR wasn't allowed to enter the secured area or speak to any patients at the hospital, so the patient was reached by phone.
"So what do I do? Stay in my room," he says. "Because other than that, I have no desire to be out in the unit fighting. I have no desire to be violent. I'm not a violent person, you know, I'm just not."
At least, he's not when he's on his meds. This patient was sent to the hospital after being arrested for assault and found incompetent to stand trial. But as he describes it, violence is almost inescapable at Napa — like the night he heard an alarm go off in the hall outside his room.
"So I got up and got out of my bed," the patient says, "and this guy was around here throwing garbage cans, you know. He looked at me and told me I needed to take my old ass back to bed and blah blah blah, and he attacked me, and I put 11 stitches in his hand, but I broke my hand doing it."
An 'Inherent' Risk
That's the view from inside the security fence. In her office outside of the fence, the hospital's executive director, Dolly Matteucci, says that she wants nothing more than for her staff to be safe on the job. But "there's an inherent kind of risk in treating and working with individuals that are severely mentally ill," she says, "and I think all of our staff recognize that when they come to work here."
Matteucci first came to work at Napa 20 years ago as a dietician and rose through the ranks. She got her current job after Napa's previous chief executive was arrested on child molestation charges. He has since been convicted.
Matteucci says she welcomes the staff's renewed focus on safety. "I think that that is wonderful, in terms of us all talking more pointedly about what the concerns are, what the recommendations are and taking action," she says.
Among the actions taken since Gross' murder is the elimination of grounds passes like the one that Gross' alleged killer had. The campus-like layout of the hospital, with foliage and walled courtyards between buildings, provides too many places to hide.
A Plea For Help
But staffers want more, and they're hoping state lawmakers can help.
State Assemblyman Mike Allen, a Democrat, represents the Napa area. The hospital's employees are his constituents and a couple of hundred were at a hearing he convened at a local community college. Allen said he was there to listen — and he did, to a two-hour saga of injury, anger and grief.
Brad Leggs, a psychiatric technician at Napa and a union representative, created an image to go with the words. "If I may, I would respectfully like to ask those in the audience to briefly stand up if you've been injured or assaulted, or your co-worker has been assaulted."
Nearly everyone stood.
That sight motivated the acting head of the state Department of Mental Health to call a summit meeting to deal with safety issues at all of California's psychiatric hospitals. The meeting, held last week at Napa State Hospital, was picketed by staff who say they don't need more meetings — they need action.
Violence Surges At Hospital For Mentally Ill Criminals
Second of a two-part series
by Ina Jaffe
April 8, 2011
Atascadero State Hospital, on California's central coast, was built from the ground up to treat mentally ill criminal offenders.
Violence is on the rise at the hospital, and according to state and federal documents, it's gotten worse since 2006 — the same year the state signed an agreement with the federal government to put in a detailed new treatment plan.
The 92-page plan, which covers everything from psychiatry to dentistry to nutrition, came out of a civil rights investigation — something the Justice Department has done at a lot of public hospitals around the country. In California, the investigation found some serious problems: abuse and neglect of patients; substandard care; and lousy record-keeping.
The new treatment plan was supposed to make things better. And it did, according to Justice Department documents and some conversations with hospital staffers. But violence has risen at three of the four hospitals covered by the treatment plan. At Atascadero, it's gone up 36 percent.
That's what brought Republican state Sen. Sam Blakeslee there recently — and not for the first time.
"I have constituents who ... work in the facility that are just distraught about their sense of threat and risk and potential injury," he says. "And it's just an inherently dangerous population."
But the hospital appears more blandly institutional than dangerous. The halls seem endlessly long. The patients wear identical khaki pants and shirts, and usually stare straight ahead as they walk. In the day room, no one looks up from the television when visitors walk in.
"You know, that's how things are most of the time," says Blakeslee. "And when things change, it changes very quickly."
A former psychiatric technician named Ramona Goodman found that out the hard way.
'We Began To Struggle'
In September 2008, a patient made a routine request: He wanted some clean socks from the laundry room, which was down the hallway.
"So he and I walked down the hall," she recalls. "And as we were walking together, I had asked him: So you had a really hard time this weekend, and do you want to talk about that later with me? Maybe we can get things worked out?
Ramona Goodman, a former psychiatric worker at Atascadero State Hospital, was attacked by a patient in 2008.
"He said, 'Yeah, but I don't want to talk about it right now.' "
And then they reached the laundry room door.
"I got my key in the lock, and I felt his arm come around underneath my chin. And I dropped my chin down as far as I could into my neck so he couldn't choke me out," she says. "So we began to struggle. He was hitting me alongside the head as I was biting him. And after a couple of minutes, I realized I was not going to win this fight."
Eventually, she managed to scream and a co-worker came to her rescue.
Goodman now has two artificial discs in her neck held in place by a titanium plate. Her surgeon told her she can't work at Atascadero anymore.
"Because I could get knocked down, or whatever, and be paralyzed," she says.
Putting Paperwork Above Patients?
The attack was one of more than 1,000 violent incidents at Atascadero that year. Goodman blames the treatment plan the hospital was forced to adopt after the Justice Department's investigation. She says it drove a wedge between the staff and the patients by requiring massive amounts of documentation.
"Spending more time on paperwork than you are treating the patient," she says. "That's really the security problem right there."
Violence At Atascadero State Hospital
In 2006, a treatment plan was put in place to help make the hospital safer. Instead, assaults by patients — against both staff and fellow patients — are on the rise.
She's not exaggerating, says psychiatrist William Walters. "I spent three or four hours a day typing, maybe sometimes six hours a day typing," he says.
Walters left Atascadero about a year and a half ago after working there for nearly two decades. He says something else changed when the hospital went to the new treatment plan: Their safety program was disbanded. It had won awards and been cited as a national model.
"They made it a hospital-wide mantra that safety was the first consideration," he says. "And they did a really fine job of it."
In 2008, the hospital started a new committee to deal with violence after a patient was murdered by a fellow patient.
NPR spoke with a number of current staffers at Atascadero but isn't using their names because they've been warned not to speak to reporters without going through hospital administration.
The employees mostly share Walters' skepticism about the plan calling for patients to identify their own goals and interests in choosing treatment options.
That, they say, is poorly adapted to a psychiatric hospital that treats felons and people who had committed violent crimes.
California is the only state where the Justice Department has imposed this regimen on hospitals that exclusively treat mentally ill criminals. California's second such hospital, Patton State Hospital in San Bernardino, has also seen violent incidents rise by 36 percent.
The Justice Department declined requests for an interview. NPR also tried to speak with the court-appointed monitor who tracks California's compliance with the treatment plan, but he's barred from speaking with the media.
The treatment plan does have a champion, though, in Jon DeMorales, the executive director of Atascadero. He welcomes the demands the plan has made on the hospital — demands "that we establish reasons for commitment, discharge goals, obstacles to discharge, and [that are] geared to the strengths and weakness of an individual," he says.
Its goal, he says, is to give patients "a realistic opportunity to recover from the reasons that led to their commitment here."
That's not to say the plan can't be improved. California's agreement with the federal government expires later this year. DeMorales says he's already cutting down on those paperwork requirements in order to reduce his staff's workload and allow them to spend more time with their patients.
Proposed Laws
Walking through the hospital, Sen. Blakeslee says there are things that have nothing to do with the treatment plan that can make this place safer — like new furniture.
Republican state Sen. Sam Blakeslee, shown at a committee hearing earlier this year, says the Atascadero hospital has "an inherently dangerous population." He's proposed new laws designed to make the hospital safer, including a bill that would make it easier to medicate patients against their will.
Republican state Sen. Sam Blakeslee, shown at a committee hearing earlier this year, says the Atascadero hospital has "an inherently dangerous population." He's proposed new laws designed to make the hospital safer, including a bill that would make it easier to medicate patients against their will.
"You notice the chairs are intentionally so heavy that they're almost impossible to pick up and throw," he says.
But ultimately, Blakeslee thinks it'll take new laws to make the hospitals less dangerous. Other lawmakers agree. There are now at least half a dozen measures pending in the state Legislature, all focused on hospital safety.
One of Blakeslee's measures would make it easier to medicate patients against their will. "Those that are acting out and behaving in a way that could impose a risk to themselves, to other staff and other patients," he says.
In the end, says Blakeslee, it's a matter of keeping faith with the taxpayers who are spending more than $500 for each day a patient stays in the hospital.
"The public has a right to expect that these individuals will get the treatment to make them less dangerous, because ultimately many of these people will be back on the streets," Blakeslee says. "They'll be our neighbors, they'll be at our grocery stores. Our kids will walk by their homes."
And they won't be less dangerous on the streets, he says, if they're trying to get well in a violent place.