Managing Aggressive Behavior in Mental Health Facilities: Dealing with Bullying and Fighting

In mental health facilities, staff must navigate a complex web of challenging behaviors to ensure the safety and well-being of both patients and staff. The environment can be volatile, with instances of bullying and fighting commonly reported. This article provides insights into the strategies employed by staff in managing such situations and the importance of maintaining a secure and respectful environment.

The Role of Staff in Managing Aggressive Behaviors

In mental health facilities, the safety of patients and staff is paramount. This is particularly evident in units like the one I worked at, Summit Behavioral Healthcare, an Ohio state psychiatric hospital. The forensic unit on our 23-bed male ward was designed to evaluate and teach patients, as well as determine their competency to stand trial or whether they were insane at the time of their crime.

To manage aggressive behaviors, staff often employ a point system, where patients are given levels from A to D. Level D offers privileges such as three snacks and access to a special room with a TV, making it a highly coveted status. However, levels can be lost due to misbehavior. Despite efforts to control behavior, hostility is almost a prerequisite for admission to this unit. As a result, there is rarely a day where no one is threatened, including staff.

Strategies for Dealing with Bullying and Fighting

When bullying or fighting occurs, staff react swiftly. A code yellow is called for patient violence and a double code yellow for violence with a weapon. At least one staff member from each unit and the state highway patrol team are required to respond immediately.

In my experience, staff were often physically involved in breaking up altercations, depending on the level of laziness and dedication to coworker safety. Once the fight was broken up, psychiatrists would decide if emergency medication was needed, often resulting in injection. The patients were then monitored to ensure the medication's effectiveness.

Creating a Respectful Environment

Creating an environment where patients understand that their attempts to bully or scare staff do not work is crucial. Staff must be resilient, appearing fearless while maintaining a healthy internal awareness of the danger. It is important that patients realize the consequences of their actions will be swift and often unpleasant.

A notable case involved a patient who, despite his non-violent nature, demonstrated dangerous behavior by stealing food from other patients during meal times. His actions provided a lesson to others, reinforcing the importance of mutual respect and adhering to the facility's rules.

Conclusion

Managing aggressive behaviors in mental health facilities requires a multi-faceted approach, with staff leveraging various strategies to ensure the safety and well-being of all individuals involved. From point systems to swift responses to incidents, the goal is to create a respectful and secure environment where bullying and violence are not tolerated. By understanding and addressing the root causes of such behaviors, staff can play a vital role in fostering a positive and therapeutic environment for all patients.