Josh Akeo, a registered nurse at the Hawaii State Hospital who suffered a concussion in August after being tangled between two patients in a fight, is out on workers’ compensation, suffering from memory loss and post-traumatic stress disorder. He’s lost 35 pounds.
One of the patients kicked Akeo in the head while Akeo was on the floor.
“We have nothing to protect ourselves with,” said Akeo, 43, who has worked at the hospital for five years.
Akeo and three other State Hospital employees talked Wednesday about serious injuries from assaults at the mental health hospital in Kaneohe due to lack of staff, support and training. The comments came during a news briefing by state Sens. Clayton Hee and Josh Green announcing hearings to investigate the matter sometime after Thanksgiving.
“The whole system may need
to be overhauled,” said Green (D, Milolii-Waimea), an emergency room doctor and chairman of the Senate Health Committee.
Assaults on staff by patients have been a continuing problem for years. The Department of Health has reported that employees at the hospital are assaulted at the rate of one every three days.
The department says 132 assaults to staff by patients occurred in 2011, 120 assaults in 2012 and 90 assaults this year to date.
Hee (D,Kahuku-Kaneohe), Judiciary Committee chairman, recalled hospital safety was an issue raised by union shop stewards several years ago. This time around, staff members directly approached him and Green for assistance.
Hee and Green said the assaults are unacceptable and they fear a fatality will occur.
“We have to find a way to make it safe,” Green said.
In a telephone interview after the briefing, Randy Perreira, executive director of the Hawaii Government Employees Association, said there is insufficient staffing and a lack of training to deal with patients who are considered by the courts as criminally insane.
The assaults are of grave concern, Perreira said.
The facility itself is inadequate for the patient population, he said. What is needed, he said, is a facility dedicated to treating patients who are committed to the State Hospital by the courts and that provides adequate treatment and appropriate security.
“We don’t have such a facility in Hawaii,” he said.
In an email, Dr. Mark Fridovich, chief of the Adult Mental Health Division who oversees the State Hospital, said, “We take it very seriously whenever one of our employees is injured at work. It is a serious situation whenever someone is hurt and we never want to put our employees in danger. While the rate of assault has not increased, we are very concerned about the number of staff who are injured as a result of assault. Assaults are also critical evidence that treatment is not progressing.”
Of staffing, Fridovich said the staff-to-patient ratio is good.
“We increase staffing to patients when needed,” he added. “We increase staff for types of patients who are behaviorally or medically acute. Hiring and filling positions is a priority and exempted from the state’s hiring freeze. The staff also uses overtime and agency staffing when necessary.”
The hospital’s patient population was 196 as of Nov. 14. The capacity is 202.
About lack of training concerns, Fridovich said staffers undergo conflict prevention management training every six months for direct care and annually for all. They also undergo training during employee orientation that includes a self-defense component.
“The hospital uses emergency interventions, including restraint, seclusion or medication, which themselves create risk,” he added.
Psychiatric technician Kalford Keanu Jr., 36, who suffered a concussion when he was assaulted by a patient last month, said he worries about the patients when there is a lack of staff because workers are recovering from injuries.
“If we’re getting assaulted, who’s going to help the patients?” he asked.
