Alleged On-the-Job Violence, Racism, Prompts Psych Workers to Head to DC

Alicia Ault

October 08, 2021

A dozen workers from a psychiatric hospital near Seattle flew to Washington, DC to picket the National Association for Behavioral Healthcare's annual meeting in an effort to get their employer to meet demands for a safer work environment, better staffing, and the hiring of security professionals.

They are also demanding that their employer, Cascade Behavioral Health Hospital, a private psychiatric facility owned by Acadia Healthcare and located in Tukwila, Washington, address what they call "racist harassment" by managers who have allegedly told many workers, who are primarily people of color, that they are going to be "filtered out," Alazar Yirgu, a mental health technician at the facility, told Medscape Medical News.

The workers have been conducting a "safety strike" to protest working conditions at Cascade since early August. The protest in Tukwila began after a dozen or more workers were hurt in an August 1 incident during which they had attempted to restrain a violent patient.

"We've been out there for 2 months and we will continue until our voice is heard," said Yirgu, who was hospitalized as a result of the August patient outburst that he said has left him unable to work since the incident.

Behavioral health workers marching in Washington, DC on October 7.

Yesterday, Yirgu and co-workers brought the protest to Washington, DC, in a continued effort to voice their need for adequate personal protective equipment, increased staffing, and the hiring of security personnel.

"Any healthcare professional should not be fearful to do their job, because once they are in that state of mind, once they are fearful for themselves, then they are not doing their jobs; they are preoccupied with their fears," said Yirgu, who has worked as a technician for 6 years.

Unsafe Patient Load

The workers reacted quickly after the August 1 patient outburst because there have been multiple previous incidents, Yirgu said.

In a 2019 news story by the Seattle Times, the newspaper reported there had been 65 assaults on patients or staff at Cascade from 2016 to 2018, resulting in concussions and broken bones in some instances.

Yirgu said that more recently, a patient broke a second story window, jumped to the ground, and ran off. 

At the facility, workers are often assigned to as many as a dozen or more patients, he said, noting that at other psychiatric institutions, he's cared for a maximum of five patients at once.

The Tukwila police have pushed back against the workers' description of the incident in which Yirgu was injured, and Cascade Behavioral Health has aggressively defended its facility.

According to Yirgu, the expletive-spewing patient was clearly a danger to himself and others — especially after he stole a key card that would give him access to the entire facility, including the kitchen where knives were stored.

When more than a dozen staff answered the unit's "Code Grey," they were unable to subdue or restrain him. Yirgu ended up on the floor underneath the patient after the patient had jumped off a table.

As the incident unfolded, several workers called the police, who initially refused to go to the facility, saying that a new law prevented them from assisting with the restraint if there was no assault.

The Tukwila Police Department report shows officers finally did go to the facility and determined that "a crime had not been committed based on the information presented to them, that there was no imminent threat of bodily harm, and that there was no legal grounds or authority for them to assist medical staff with physically restraining a patient."

Cascade Pushes Back

A Service Employees International Union (SEIU) report shows about 70 workers refused to come in to work after the incident and began picketing outside the facility.

Cascade called it an illegal strike because the protesters had not given 10-days' notice, as required by federal law, and moved to terminate those who participated. The local SEIU chapter, 1199NW, suggested the workers call their walkout a "safety strike," because it was organized primarily to protest working conditions.

Meanwhile Cascade, which has erected a large fence so that no one in the facility can see the protesters, has said the strike is primarily about ongoing contract negotiations with the facility's nurses and its union.

"The Union has been trying to apply unfair — and in some cases we believe unlawful — external pressures to this process, including picketing, work stoppages, smear campaigns, and false accusations," Cascade CEO Christopher West wrote on the company's website in mid-August.

West also claimed the union had "exaggerated stories of unfavorable work conditions to bolster its contract bargaining objectives." He said the facility had "ample personal protective equipment," and that the "well-being and safety of our patients and staff always have been and will be our key priorities."

In response to a request for comment from Medscape Medical News, Cascade said in an emailed statement that physical confrontations had decreased by almost 50% and elopements (unauthorized leaving of the facility) by 80% from 2018 to 2021.

Cascade spokesperson Gretchen Hommrich said in the statement that the workers it has terminated "were let go for cause in violation to their employment agreement," and said the company still aimed to negotiate a new agreement with the union.

The "efforts outside of the bargaining process serve no productive purpose and have only brought harm to the residents they claim to serve," said Hommrich.

"Safety is the Sole Purpose"

Yirgu said it was outrageous to suggest workers were picketing over contract negotiations. "Safety is the sole purpose of this strike," he said.

He noted that his patient care goal is to have a lot of one-on-one time with his patients, helping them navigate back to the outside world. The facility is supposed to be a safe place, Yirgu added. Violence inside the facility traumatizes the patients and may worsen their condition and delay their progress, he said.

"If I can't keep them safe there's no way I'm going to be able to see them eye-to-eye when I told them I'd keep them safe and then they're not anymore," said Yirgu.

So far, 22 workers have been "terminated," meaning they received a termination notice, have been taken off the work schedule by the employer, or otherwise been informed that the employer has deemed them to be separated, the SEIU reports. The organization has filed unfair labor practice (ULPs) for all 22.

Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including JAMA, Smithsonian.com, the New York Times, and the Washington Post. You can find her on Twitter @aliciaault.

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