Violence inside Western State Hospital leaving more workers injured, costing taxpayers millions

LAKEWOOD, Wash. — For years, KIRO 7 has reported on the problems inside Western State Hospital. But new interviews and thousands of internal documents show it’s only getting worse.

“That day, the patient was behaving terribly.” Sherina Ross describes something that happens often in the halls of Western State Hospital: an out-of-control patient and the attempts to calm them down.

“He bit her while people were trying to hold him down.”

Photos obtained by KIRO 7 show the finger that Ross's co-worker nearly lost when Anthony Chang bit her. Additional photos from Lakewood Police show they also had trouble controlling Chang. When officers tried to transport him, the Pierce County Jail refused to take him, according to the police report.

“And they brought him back saying he was too hostile and they didn’t have enough room where they needed to take him,” Ross told KIRO 7. “They brought him right back to the ward, where he has remained since and has since bitten another employee.”

It's a story told again and again in more than 3,000 pages of incident reports from Western State Hospital over the last two years, many of them assaults on staff, including:

---August 2018: Tommy Lee Berlin punched a nurse, knocked her to the ground, and stomped on her head, according to charging documents. Berlin previously faced charges for attacking a police officer.

---Sept. 30, 2018: Christopher Jones, a repeat criminal and sex offender, is charged with jumping over the nurses station counter and throwing a nurse to the ground, where he slammed her head, then bit off a portion of her ear.

Photos of the aftermath are part of an extensive investigation by the Washington State Department of Labor and Industries, which earlier this year fined Western State, saying the hospital and the Department of Social and Health Services “did not do everything reasonably necessary to protect employees."

Ross, who works as a psychiatric security attendant, knows this first-hand. “I have personally been punched in my head 15 times,” she said. When asked what management is doing to address their concerns, she replied, “I’m not sure what they’re doing, but it doesn’t feel like a lot because people are still getting hurt.”

An anonymous complaint to L&I last fall detailed 38 assaults in just one two-week period. The investigation focused on five serious assaults in 2018, including one in which DSHS failed to report that an employee was hospitalized.

KIRO 7 obtained the investigators' notes from interviews with 40 employees.  Page after page detail years of issues they say the state continues to ignore.

Nurse Barbara Shelman laughed when KIRO 7’s Amy Clancy asked if Western State has a safe work environment, “That’s a far, far stretch to even begin to think that Western State is a safe work environment. It’s very unsafe: it’s very frightening.”

Shelman has worked in what's considered one of the more high-risk wards. “I’ve seen broken eye sockets, broken noses. It’s not an easy thing to talk about when you see a co-worker really suffer a serious injury.”

In response to recent violence, the Service Employees International Union representing many Western State employees sent a letter to DSHS this spring, stating "the continuing assaults upon our members require immediate action." The letter was signed by union executive vice president Jane Hopkins.

“Every day when our members come to work, they don’t know if they’re going to go home in a box or going to be safe.” The letter included a number of recommendations from the union, including:

*A new risk assessment tool to identify patients most likely to act out.
*Enclose nurses' stations to better protect staff.
*Creating a more secure unit to transfer violent patients.

“Another big issue is staffing. Our members are short-staffed every day. It doesn’t matter how long or how often management has tried to recruit, they haven’t been able to get enough people to recruit and stay.”

State investigators found staff is continually pulled from one ward to another to cover open shifts, which creates shortages elsewhere and forces employees to work with patients they're not familiar with.

According to Hopkins, staffers also don't get the additional training they need to handle certain patients. “You are worried that you’re talking to this person and they could just turn on you and hit you in the face. You’re scared because you feel you don’t have the skills or training to be able to do that, so it’s doubly hard for them.”

The violence not only affects the staff, but also comes at a high cost to taxpayers. Since 2009, more than 1,900 injury claims have been filed against Western State. There were 282 in 2018 and the number in 2019 is on track to be even higher. The state has paid more than $62 million for these injury claims.

“We take each of those assaults seriously.”

KIRO 7 took these concerns to Sean Murphy, an assistant secretary at DSHS for the Behavioral Health Administration, which oversees the state's psychiatric hospitals. “One of the big challenges today is truly treating folks who don’t necessarily have the tools to handle day-to-day problems in the same way. Folks can act out in violence.” Murphy claims the hospital is still rebuilding from the cuts forced by the 2008 recession but acknowledges more needs to be done to protect staff members. He says the legislature provided an additional $21.7 million for safety in the current budget cycle, which began in July. It will help pay for the STAR Ward to treat up to 12 patients at a time, those most prone to violence, provide additional crisis intervention training for staff, and begin enclosing the nurses’ stations. Three have been enclosed so far, but spending must still be approved to finish 13 more, possibly by the end of 2020. “They can’t get up off the ground overnight, and the money that came in in July we’re actively working to get those programs up and running.”

While Murphy wouldn't commit to adding nursing staff, he says within the last few months the hospital began working to level out scheduling to avoid shortages on certain shifts. “Stabilizing that population, leveling it out, getting folks assigned to the right wards is important and an important part of our safety initiative.” KIRO 7’s Amy Clancy asked Murphy if he’s confident that in five years we won’t be asking the same questions again. He responded: “I’m confident in the improvements that we’re making, that they will definitely make an impact. It’s too soon to tell how significant of an impact.”

Often the question is asked: Why should the public care about what happens within the walls of this hospital? In addition to the $62 million in tax dollars paid in claims, Hopkins says the answer is simple: “We need to keep people in Western State so that they’re not out in the community hurting other people, so it’s a public safety issue.”

Shelman responded to another common question: “I talk to so many people who are like, ‘Why do you work at Western State?’ Well, there’s a reason people work at Western State. Yeah, it’s not safe, but they have a compassion and a heart for these suffering people. And they do have a huge impact, we all have a huge impact on our patients.”

KIRO 7 also reached out to Gov. Inslee’s office about our investigation and received this response:

This is an issue that has been, and continues to, be very important to Gov. Inslee.  Working at the state hospitals is both incredibly important and challenging work, serving some our state’s most vulnerable citizens and the governor fully supports the workers there.  There have been a number of investments that the governor has supported and that were achieved in the past legislative session that address staff safety, including additional staff, expanded training, enclosure of nurses stations, and a new specialized ward for some the hospital’s most acute patients. Staff safety and well-being is critical to the successful operation of our state hospitals and improving the conditions for staff in this challenging environment remains a focus of the governor and his administration. While much has been done, we still have additional work to do.

See our previous coverage of Western State Hospital below.