Workers Want Safety Training

In “Is Social Care Work Safe?” I was reading the comments of fellow social care workers responding to the death of Philip Ellison:

Lins:  “When is something going to be done to protect workers?  In Children Services we are told not to go out alone if there is a potential for violence, but how many times, due to staff shortages, have we taken the chance?  If it was a police officer would they go out alone?”

Well said Lins.  As a former cop I would most certainly confirm that we wouldn’t go to a violent situation alone.

Anne:  “Managing conflict is essential training for any isolated worker.  As is appropriate lone working policies and procedures.  The real danger is when a violent/aggressive incident arises out of the blue.”

As they too often do.  Which is why we ought not to be having social workers out there alone if it can be helped.  The real danger is always there, even if it only seems to be coming “out of the blue”.  The fact is it rarely does.  Too often the clues are there to warn us but we don’t attend to them.

Preeta:  “The people who you see on doubled up visits have usually done or said something to warrant joint visits, it is sometimes impossible to gauge that you are walking into a high risk situation if you have had no warning that a service user is relapsing (for example).”

Most of the time there is a clue to warn you.  Safety awareness is an ongoing reassessment of your situation.  Safety is about 75 % attitude, 15 % skill, 5 % physical, and only 5 % luck.

Brian:  “It is long past the time for society to acknowledge that those of us who work in the social care profession have the right to go about our duties without the fear of abuse and assault.”

I totally agree with Brian’s assessment.  I came to that conclusion eleven years ago and went on to try to do something about safety for my colleagues in the helping professions.

A study cited in Brody’s article support’s Brian’s view.  This study, which estimated that 50,000 social care staff are attacked in Britain each year, showed that two thirds of social workers wanted some sort of self defence training.  There is certainly nothing wrong with this approach, but it requires an enormous investment in time and money to make a large group of social workers competent enough in self defence that they can rely upon this skill.  You can’t become a martial artist in a weekend workshop.  I point this out in the hold-release section of my book The Safe Approach.  Brody admits that he once argued that “self-defence training could do more harm than good, if it increased confidence without developing skills to a level where they would be useful in real life.”  There you go.  However most of the safety problem can be dealt with by recognizing the escalating situation and getting out before it turns to violence.  Basic principle from Sun Tzu’s The Art of War:  The best general is the one who wins without fighing.

Charles Ennis

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Check the History and Take Cover

How many of you have been faced with this task: trying to get a decompensating mental patient to return to treatment?  It is a task that I am very familiar with, having spent many years as a police officer working in the Mental Health Emergency Services unit of the Vancouver PD.  Many of these clients were resistant to such efforts, since they had no insight into their condition, were paranoid, and often were self- medicating with street drugs.  One of the things that motivated me to write The Safe Approach was to help social workers and nurses to deal with this sort of scenario.

I was reminded of all this when I reviewed an older article from the UK’s The Independent newspaper, “Frenzied Attack on Social Worker“.  This told of dedicated social worker, Jenny Morrison, 50, who went alone to try to convince Anthony Joseph, a schizophrenic male, that he needed to return to psychiatric hospital.  This schizophrenic killed her, stabbing her more than 100 times, breaking the first knife and calmly walking back to the kitchen in the halfway hostel to get another to continue the attack.

Apparently Morrison had gone there alone, and although some other workers had arranged to be there to cover her, they had not shown up.  This demonstrates the paramount importance of taking adequate resources to cover the situation that you expect to face upon arrival.  Going alone to see an unstable and possibly violent client is never a good idea.  Having fellow workers accompany you is better, but in such situations it is always best to have the police with you.

Another incident which underscores the hazards of going to dangerous dwellings alone, is the case of a West Virginia social worker who was murdered when she conducted a solitary home visit, as reported in Tony Rutherford’s article “Social Worker Attacked, Sexually Assaulted, Murdered, Burned”.

Checking collaterals is another issue I covered in The Safe Approach. Before attending to see the client, you need to check any and all sources of information to get as clear an idea as possible of the risks that you are likely to face. The author of the Independent article, Terri Judd, reports “Mr Joseph had not picked up his medical prescription for five months and had told fellow residents at the social services hostel that he was selling his pills to “clubbers”, while taking a cocktail of heroin, crack cocaine and ecstasy himself. Three weeks before the attack, care staff were well aware that he had stopped taking his medication, yet he remained free to come and go as he pleased, the court heard.” The staff had specifically asked for assistance, because Joseph’s behavior had deteriorated dramatically since his release from the psychiatric hospital. He was described as abusive, as having paranoid delusions about being pursued by fascists, as being “tortured by dark spirits”. Joseph made no secret of the fact that he did not believe he was mentally ill and that if returned to the psychiatric hospital, he would be tortured. All of these behaviors are ‘red flags’ that should have led to the police being brought along to the scene for back up.

Usually safety problems result from a combination of factors. Training may fail to accurately reflect reality. Perceptions of the true risk may not match the actual risks involved. A study by Carmel and Hunter in 1990 found that frequent training can improve the likelihood of avoiding assault.

Yet workers may receive no training in safety considerations at all (*). More often than not they are expected to pick up whatever they need to know on the job. Workers become complacent in the knowledge that most people in the profession reach retirement without ever being in a potentially dangerous position. Day in and day out, workers investigate situations where nothing happens and complacency sets in. They may approach a situation casually, hastily, and with over-confidence, as “nothing ever happened before”. They begin to assume that “nothing ever will happen”. And then it does.

Charles Ennis 

(*) US Dept. of Labor, Occupational Safety & Health Administration; (1996) Guidelines for Preventing Workplace Violence for Health Care & Social Workers OSHA 3148-1996. pg 9.