Supervision | Worker Safety

The men and women who comprise mental health and substance recovery staff are faced with multiple forms of hostility, aggression, and assault at work.

Whether potential violence and the stress of possible violence adversely affects staff well-being may be related not only to its presence, but also to an individual’s stress reactivity.

At a large public psychiatric hospital, an online survey was completed by 323 clinical care staff, of whom 69.5% had experienced physical assault in the previous 12 months.

Staff well-being (depression, anger, and physical health) and staff safety concerns are often adversely affected by conflicts with other staff members and by individual reactivity to social conflict and to assault. To improve staff well-being, in addition to safety protocols, interventions should target staff relationships, personal health maintenance practices, and individual coping skills for dealing with adverse workplace experiences.

Well-Being and Safety among Inpatient Psychiatric Staff: The Impact of Conflict, Assault, and Stress Reactivity Read Report
US National Library of Medicine – National Institutes of Health

Worker Safety and Secondary Trauma
– Staff safety is essential
– Issues related to staff safety and standard safety precautions should be included in orientations and trainings
– Program should have clear protocols and guidelines for staff safety
– Monitor and address secondary trauma.

Assessment: Safety and Risk Factors
– Risk Factors: elements of a youth and family’s life (people, environments, danger) that contribute to the development of negative behaviors (violence; delinquency)
– Safety Risk: Potential for harm to self, others, property, and/or community

Tools:
– Safety and Risk Screen (Pictured right – Download PDF here.)
– Risk and Protective Factor Checklist

Long Term Multiple Risk Exposure (Katz; Sameroff & Rosenblum)
– Some conditions can be so overwhelming it can override our inherent resiliency(Katz).
– The number of risk factors was a better predictor of child outcomes than any specific single risk factor or characteristic of the child.(Sameroff& Rosenblum)
– The cumulative effects from multiple risk factors increase the probability that development will be compromised. (Sameroff& Rosenblum)
– Those who “beat the odds” may have enjoyed better odds (Katz).

Multiple Risks Require Multiple Interventions (Sameroff, Gutman, and Peck)
– Interventions need to be as complex as the multiplicity of risk factors and contexts
– Most interventions in single domains have not produced major reductions in problem behaviors
– Most youth experience risks across multiple social contexts
– Interventions need to address all the social contexts in which the risks occur

Training and Competencies
– Crisis intervention and safety planning
– Family therapy
– Individual therapy
– Skill building
– Cross-system collaborative teaming
– Resiliency and trauma
– Cultural humility and strength-based engagement
– IHBT supervision and ethics.


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