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July 2014

Healthcare’s failure to address link between mental illness and violence putting lives in jeopardy

DATELINE:  JULY 28, 2014

Richard Plotts, the man who allegedly murdered a 53-year old caseworker at a suburban Philadelphia hospital last week by shooting her in the face, was formally charged with murder on Saturday following surgery to remove bullets in his torso.

According to Delaware County District Attorney Jack Whelan, police in Upper Darby, Pa., where Plotts lived, were aware of at least three mental health commitments, including once after he cut his wrists and once when he threatened suicide — but said such stays can last just one to three days. Whelan also noted in his press conference that Plotts had also spent time in a mental health facility.

Every week brings a new story in the media about murder-suicides, patients killing healthcare workers, random shootings and assaults.   We can read the new polls like the article on U.S. shootings in healthcare, as well as the recent healthcare crime study by the International Association of Healthcare Security and Safety (IAHSS) that routinely reports that violence in healthcare is soaring.

Not only in healthcare, but throughout the U.S., these random active shooter trends are increasing.  To see how much of this violence is related to severe mental health problems, we only have to look as far as these high profile incidents:

  • June 14, 2012 – Buffalo, N.Y., trauma surgeon shooting
  • July 20, 2012 – Aurora, Colo., movie theater shooting
  • Sept. 16, 2013 – Washington Navy Yard shooting
  • Dec. 17, 2013 – Reno, Nev. urology clinic shooting
  • Jan. 22, 2014 – LAX active shooter incident
  • April 2, 2014 – Fort Hood (2nd) active shooter incident

None of these incidents were related to poor performance review, losing a job, and only one of these could be called “domestic violence,” but what they all have in common is that the perpetrators were all severely mentally ill.

Guns scare me.  Guns kill people by accident and on purpose. I never let my children play with guns.  However, as I analyze the elements of these shootings and dozens more, my bias is changing.  I think it’s less about guns and more about mental illness.

Healthcare and hospitals would be the one industry where you would think that people would be concerned about the state of mental health of their patients and staff. Instead, it seems like mental health problems are walled off by society, treated ineffectively, and violent tendencies (which sometimes make their way onto patients’ Facebook pages) are largely ignored and unreported by the clinicians treating them.

So it’s left to the security and law enforcement community to deal with these individuals who are paranoid, depressed, angry, frustrated, disappointed, hurt, confused, and, ultimately, violent.

Now that mental health has been re-classified as another medical problem, the money is flowing to the treatment centers and it’s covered by Medicare. But progress doesn’t seem to be either easy or effective.

Dr. Graham C.L. Davey, Ph.D. writing in Psychology Today in January said: “Many of those health professionals (GPs and family physicians) at the first point of contact with people suffering mental health problems are poorly trained to identify psychological problems in their patients, and have little time available to devote to dealing with these types of problems. This increasingly makes medication prescription an attractive option for doctors whose time-per-patient is limited—an outcome which will have all the potential negative effects of medicalizing the problem into a “disease.”

And that’s exactly what we see, patients who don’t take their meds because of the negative side effects and so they become isolated and increasingly violent.  The side effects are clearly pointed out in TV commercials, that you’ve probably watched.

For example, one medicine has side effects that include sexual side effects, convulsions, brain shrinkage, stroke, death, suicide, violent thoughts, psychosis and delusional thinking.

The increase in hospitals adding seclusion rooms, expanding the number of beds for psych patients, and the time spent by both law enforcement and security professionals  in dealing with these troubled individuals, may account for one-quarter to one-third of an organization’s security budget.

Many of the security risk assessments we do are focused on handling mobile mental patients, including the baby boomers suffering from Alzheimer’s and dementia.

As violent incidents continue to increases in our society, our workplaces, and in our hospitals, we need to spend more time looking for, and demanding treatments that work and that are sustainable by the patients so they can lead happier lives and we can protect the rest of society, and our healthcare facilities,  from their potentially violent behavior.


http://www.securityinfowatch.com/blog/11598089/healthcares-failure-to-address-link-between-mental-illness-and-violence-putting-lives-in-jeopardy

Author:  Caroline Ramsey Hamilton

Since 1988,  Caroline Ramsey-Hamilton has been a Thought Leader in All Aspects of Active Shooter and Security Risk Assessment in both Public  and  Private  companies and organizations.  Specializing in Hospital and Healthcare Security. Hamilton is Certified in Homeland Security (CHS-III), Anti-Terrorism (ATAB) and Security Risk Assessment. As President of Risk & Security (www.riskandsecurityllc.com) she works with many hospital clients, and develops affordable risk-based apps for improving security risk assessments, and publishes the RISKAlert security awareness program.  She lives in south Florida with two beagles, a rescued kitty and (on weekends), 4-year old twins.

Reprinted with permission from www.SecurityInfoWatch.com



Psychiatrist Shoots Mental Patient who Killed His Caseworker at Mercy Fitzgerald Hospital

Psychiatrist Draws Gun in Mercy Fitzgerald Hospital and Shoots the Mental Health Patient who Killed his Caseworker by Shooting Her in the Face.  Witnesses near the scene reported hearing screaming and gunfire, as suspect and mental health patient Richard Plotts confronted his caseworker, Theresa Hunt, and then drew his gun, and killed her.  Another bullet grazed a doctor, adjacent to the scene, but the doctor had a gun of his own, and he shot Plotts 3 times in the torso.

The doctor, identified as Lee Silverman, was treated was  treated for a head wound and released after being taken to the Hospital of the University of Pennsylvania.  The shooter, Richard Plotts, of Upper Darby, Pennsylvania,  who had a long criminal record, was undergoing surgery Thursday night at the Hospital of the University of Pennsylvania. If he survives, he will be charged Friday with murder,  said Delaware County District Attorney Jack Whelan.

There is a Lesson Here KEEP POTENTIAL SHOOTERS WITH WEAPONS OUT OF HOSPITALS.

A is for Access Control!  Once a potential shooter brings a weapon into a hospital, everything is much more difficult to control.  Keep them out.

Weapons should be checked at the hospital entry points and no-weapons signage should clearly indicate that weapons are not allowed, and that should be followed up with either stand-alone, or wand metal detectors which give staff members a initial level of protection.

usa-shooting-pennsylvania

Bernice Ho, a spokeswoman for Mercy Fitzgerald Hospital, said Thursday it was against hospital policy for anyone other than security guards to carry weapons, so there are questions about why this doctor disregarded the policy, although Donald Molineux, chief of the Yeadon Police Department, said “If Silverman returned fire and wounded Plotts, he without a doubt saved lives.”

District Attorney Whelan described how the meeting among Plotts, Silverman, and Hunt abruptly took a violent turn.  Plotts and Hunt went to Silverman’s third-floor office shortly before 2:30 p.m., Whelan said. Plotts was apparently armed, and people near the room soon heard shouting.

Concerned, a hospital employee “actually opened the door, saw him pointing a gun at the doctor,” Whelan said. The worker shut the door quietly and immediately called 911.     Plotts then opened fire.  According to Whelan, he shot Hunt two times in the face. The psychiatrist then ducked under his desk, retrieved his gun, and came up shooting, striking Plotts three times.

Keep Weapons Out of the Hospital to Dramatically Reduce Violent Incidents!



Aventura Hospital Patient Strangled in his Room on July 1st,, 2014

RiskAlert INCIDENT REPORT 565 –

Patient Strangled in Aventura Hospital, Florida

32-year old Behavioral Health Patient found Strangled to Death
in his Hospital Room

32-year old Alex Paloumbis diagnosed with bipolar disorder and schizophrenia at a
young age, had been in the hospital for two weeks. He was on the fourth-floor psychiatric
ward when he was attacked by the patient in the next bed. 

The other patient in the room, identified by police as Alexander T. Jackson, 31,  was
charged with first-degree murder and remained in Miami-Dade County Jail on Monday
with no bond. Jackson, who is homeless, was admitted to the hospital around 10 a.m
Thursday,  the day of the murder, which occurred about 3 p.m. the same day. He was
put in the same room with Rios, according to the arrest report. 

 LESSONS  LEARNED:  

Behavioral health patients require extra controls including
live, continual camera monitoring, use of appropriate
medication and possible use of restraints.

Patients may pose a danger to others, as they did in this tragedy,
and should be under continuous supervision.

Rios was last seen alive at about 2:45 p.m. Thursday. At 3:36., a hospital
housekeeper found him face down on the floor.  “The defendant admitted
to killing the victim by strangling him with his hands and a bedsheet,”
according to the report.

While administrators declined to comment on the security procedures at the
hospital, IAHSS 
(the International Association for Healthcare Security & Safety)
President Marilyn Hollier said psychiatric floors generally have lock-down
procedures, metal detectors, seclusion rooms and cameras at the access
points.  It is not known whether any of these security controls existed at the
hospital.  Hollier also stressed that security officers need specialized
training to deal with behavioral health patients.

Aventura Hospital, located near I-95 north of Miami, Florida, has a large
behavioral health unit with 46 beds.  The victim’s mother said her son was
never violent. “He never, never, never raised his voice,” Paloumbis said.
The mother was summoned to the hospital Thursday. She was told come
quickly and then was ushered into a room where police officers and detectives
were waiting. Though she had limited English skills, she understood that
her son was dead and initially thought that he may have died from a heart attack
or other natural causes.

Stay Situationally Aware and Continuously Monitor Behavioral Health Patients!

 RISKAlert® is a publication of Risk & Security LLC at www.riskandsecurity.com




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