Oregon OSHA dings Unity Center for unreported assaults
State safety officials have issued a proposed $1,650 fine for the Unity Center for Behavioral Health after an investigation that found a culture in which some employees felt discouraged from reporting incidents.
The center was set up by Adventist Health, Legacy Health, Kaiser Permanente, and Oregon Health & Science University to divert people in mental health crisis from emergency rooms where some doctors say vulnerable people were often warehoused without appropriate care. The Northeast Portland facility opened in January 2017 as a 24-hour hospital providing mental health emergency services for adults and adolescents, employing about 450 employees. It is frequently used by police for dropping off people who may be dangerous to the community or themselves, but don't belong in jail.
The report by the Oregon Occupational Safety and Health division, however, suggests the center may not be appropriately addressing the safety issues that had led to the founding of Unity in the first place. Issued in the wake of two lawsuits filed against the Center, first reported by The Oregonian, notes of interviews with staff there largely support the claim made in the suits by two former nurses that safety concerns were either dismissed or met with retaliation.
The investigators found ample evidence that assaults were not addressed or followed up on by management. They also confirmed the anonymous complainant's claim that there had been hundreds of assaults on staff at the facility.
According to the report, investigators' review of records found that hundreds of incidents were not reported properly, with many discrepancies between different logs and record systems. In interviews, the employees at the new center cited a litany of complaints. They told investigators of poorly functioning equipment, lack of training and staffing, and some claimed they were under pressure not to report assaults.
"Employees claimed they were not going to report assaults such as being punched or slapped in the face as it was not a serious injury in their opinion," according to the report.. Other employees claimed they would not report the assault because they would save their write up for when they need it. Some employees believed that each time [a report] was written it was placed in the employee file and was seen as a negative action. It made the employees look like complainers. Some employees felt that because they did not notice any changes when a co-worker was assaulted that nothing would change so why report it …. A few employees stated that they realize where they work and it was dangerous, and it's OK to get hurt."
OSHA dinged the facility for three violations it dubbed "serious," involving poor record-keeping that hampered follow-up investigation to prevent dangerous situations from re-occurring.
Jason Renaud of the Mental Health Association of Portland praised the report, but said confirmation of so many assaults suggests a deeper and more varied array of problems than the report addresses. The facility and its practices are well suited for some people suffering behavioral health issues, but not others, he said.
"It's a real bad sign" he said of the report's findings, saying it raises questions whether the center is being over-used for types of people it is ill-suited for. "There's a lot of other questions to be asked."
He added that the full array of outreach and services that had been envisioned for the center has not fully come to pass, such as strong community outreach and relationships.
"There's a whole bunch of parts and pieces of this that did not come together," he said. He expressed concern that the number of assaults will make it more difficult for the center to keep good staff.
A spokesman for Legacy Health, the lead organization running the center, said the hospital chain could not immediately comment on the report.
"We recently received the results of the investigation conducted by Oregon OHSA. Our staff are reviewing the letter to better understand the findings and will determine a response based on that review."
One factor that may be complicating Legacy's response — the pending $1 million lawsuits filed by two former nurses that were reported by The Oregonian last month. The suits claimed they were fired for raising safety concerns.
Cops and advocates have been concerned that patients leaving Unity Center haven't had the expected treatment options, creating a revolving-door situation. Last month, to improve the situation, the Multnomah County board launched a revamp of the old Budget Motel in Southwest Portland. Rooms there are intended to help people leaving psychiatric care such as Unity transition into other services and get stabilized.