OSHA Investigation of Unity Center – 500 Assaults

The Oregon Occupational Health and Safety Administration (Oregon OSHA) finished an investigation of patient – on – staff assaults at Unity Center for Behavioral Health, Legacy Hospital’s ambitious gateway for people with acute mental illness in the Portland metro area.

READ THE OSHA INVESTIGATION- Citation and Notification of Penalty (PDF)

The report was mentioned in an earlier news story, see Two Unity mental health nurses say violent patients choked staff, broke bones, Oregonian February 18, 2018.

The OSHA investigation states staff at Unity reported over 500 assaults from patients since the facility starting tracking assaults in the March of 2017. Unity opened in January 2017.

OHSA found three “serious” violations and fined the billion-dollar-a-year corporation $1,650. Violations included not recording assaults in a log, and not investigating or evaluating assaults. The investigation also includes many cogent and reasonable recommendations for Unity to adopt.

READ – Oregon OSHA dings Unity Center for unreported assaults, Portland Tribune, March 19, 2018
READ – Unity Center for Behavioral Health in Portland fined by OSHA, KPTV.com, March 20
READ – State Fines Unity Mental Health After Workers Assaulted, AP Wire, March 20
READ – Oregon fines mental health hospital $1.6k for failing to protect workers from patient assaults, Becker’s Hospital Review, March 20
READ – Unity Mental Health Fined After Workers Assaulted, KXL.com, March 20
READ – State fines mental health center after workers assaulted, KTVZ.com, March 20
READ – State fines Unity mental health $1,650 after workers suffer hundreds of assaults, Oregonian, March 20
READ (paywall) – Unity Center fined by state regulators for unreported assaults on employees, Portland Business Journal, March 20

Patient – on – staff assault in a psychiatric inpatient unit is often a sign of poorly trained or oriented staff, understaffing, staff misunderstanding acuity of patients during intake, poor planning around discharge or transportation, inability to monitor patients, limited engagement, lack of experienced medical oversight, poor communications technology (panic buttons), restrictive setting or misuse of seclusion and restraint.

The result of patient – on – staff assaults left unaddressed by the facility can be overmedication, a higher level of security both in the structure of the facility and by staff members, fearfulness of patients from staff, and less care.

Left unstated in the OSHA report – and outside of their scope of work – are a set of remaining questions, such as, how many patient – on – patient assaults occurred? How many staff – on – patient assaults occurred? How many arrests have occurred at Unity? What did Unity – starting in March 2017 when they began to record assaults – do to address assaults by patients – on – staff? What additional training was provided to staff? How often is seclusion – a locked room – used to punishment patients for behavior? How often is physical restraint used at Unity? Were patients who were assaultive barred from returning to Unity in the future? How often is medication increased after an assault at the direction of a non-physician? Does Unity provide “trauma informed care” as advertised? What structural or policy changes have been made to address assault? And mostly – why should patients seek help from Unity in the future?