I have worked in multiple treatment facilities ranging from residential facilities, schools, and community centers, to hospitals, stand alone clinics, and probation programs for teens. Within each of these settings, there was always something very important missing and that was security. Why are mental health facilities lacking in security? Well…most places claim it is money related, that there isn’t enough money to pay for security to watch staff and clients for long periods of the day. Other organizations claim that there is security but that a part-time schedule is all that can be afforded. Other places arrogantly state they do not need security presence. One Director of an Ohio clinic stated arrogantly to me: “there has always been a low level of impulsive behavior among our clients.” Still, other places do not want to give the impression that violence or impulsive behavior stems from some individuals with severe, persistent, or untreated mental illness. In other words, reducing stigma is the ultimate goal, not protecting their professional mental health therapists and other staff including clients.
This is a tragedy for more reasons than one.
- Firstly, security presence sets the tone for many places of business and puts up an important barrier between staff and clients or people who may walk into clinics for appointments. When security presence is unavailable, some people feel more prone to challenge staff or disregard others in the agency or clinic.
- Secondly, the reality is that impulsivity and violence does occur in a small proportion of cases involving mental illness, primarily untreated, persistent, and severe. Individuals who are being controlled by hallucinations or delusions are likely to report feeling unable to control impulses or wanting to harm others. About 1,600 cases of severe mental illness include homicide.
- Thirdly, security presence is important for clients who visit or reside in mental health facilities. We have a history involving cases where patients have been abused by staff, sexually assaulted by staff, and staff have been assaulted by patients.
In order for us to remain safe, we must have a balanced, realistic perspective. We should not operate within or visit facilities that do not have proper security. A great deal of facilities do not have security and this needs to change. What disaster needs to happen for this lax perception of the system to change? Hopefully another death, homicide, sexual assault, suicide, or assault on a staff member will not occur before we change this. But knowing our slow-to-learn society, it probably will.