By Katina Caraganis
FITCHBURG -- A local human-services union is speaking out on the importance of protecting clients and social workers, after a Fitchburg man was sentenced this week to three years in state prison for slashing his social worker in the face over a package of gum.
Keyon Johnston of Fitchburg pleaded guilty Monday in Worcester Superior Court to aggravated assault and battery with a dangerous weapon.
Immediately after the ruling, Jason Stephanye, spokesman for the Massachusetts Human Service Workers Union SEUI Local 509, said the union had been keeping an eye on the case.
"This disturbing attack serves as a reminder of a very real safety risk that service workers face each day on the job," he said this week. "The only way we can truly protect both clients and caregivers is to ensure the appropriate staffing rations and safety procedures are in place and human service agencies throughout the commonwealth."
He said as far as he knows, there is no "hard and strict rules" on staffing levels.
"It varies based on the types of services that are offered and the types of clients engaged in those agencies," he said.
In a June 2011 report of the Massachusetts Department of Mental Health Task Force on Staff and Client Safety, one in four people involved in the mental-health profession experienced assaults and/or "near misses" in the 12-month period studied.
Slightly over one in 20 people experienced six or more of these events, the report said.
The report defines a physical assault as being punched, kicked, choked, struck with an object, cut, sexually assaulted or injured while breaking up a fight.
A near miss is defined as the worker not being touched because someone helped them out or the person missed in their threat.
The report also defined other threatening behavior that could be experienced as brandishing a weapon, aggressive acts without physical contact, or other threatening, non-verbal actions.
The Task Force was convened in 2011 after 25-year-old Stephanie Moulton, a mental-health counselor, was killed, allegedly at the hands of a resident, at the group home where she worked on Jan. 20, 2011.
Then-Department of Mental Health Commissioner Barbara Leadholm put the task force together and asked the panel to "review and systematically assess all current policies and practices relative to staff and client safety."
The task force, consisting of legislators and health workers, acknowledged there are a small group of people who suffer from serious mental illness that does have "an association with aggressive behavior."
However, according to the report, those people often have a history of past violence when their "contact with reality" has been "distorted or lost due to untreated psychotic symptoms."
However, the report reads, not everyone suffering from a mental illness has violent tendencies.
"We state unequivocally that most individuals with mental illness pose no greater risk of violence than any other members of society," according to the report.
The report determined, among other things, that there is an inadequate number of, and inadequate pay for, direct-care staff was as well as an inadequate number of clinical staff with the relevant training and experience needed.
One recommendation presented by the task force was that the commonwealth increase funding over a five-year period to the publicly funded mental-health system, according to the report.
Additionally, it is recommended that necessary coverage levels for group-living environments, home visits, and transports should be determined through ongoing formal risk review.
For circumstances that do not require double coverage, the risk review should specify the level of training or experience required for the person providing the single coverage.
The task force also recommended that social workers should have a "reliable way" to "rapidly summons" assistance when needed. Staff who may transport individuals receiving services or who work in the community, need safety procedures, features and/or equipment appropriate to their respective settings.
Johnston's social worker, 36-year-old Scott Smith of Milford, N.H., was able to flee and get to the police station to report what had happened.
Officers said when Smith arrived at the station, he was "bleeding significantly."
At the time, Johnston was a patient at Community HealthLink, a community mental-health center with an office on Main Street in Fitchburg. Smith worked at the center as a social worker.
Court documents showed the attack appeared to be unprovoked. Smith said he was "blindsided" as Johnston cut the right side of his face with a utility knife. Johnston then got out of Smith's car and walked home, where he was later arrested.
Stephanye said it is important for the provider to do its homework before meeting with clients.
"First and foremost, you want to make sure the appropriate staff levels are in place so no client or caregiver is ever placed in a situation where they are placed in danger or harm," he said. "Also important is that clinicians are fully informed of their clients' history of medication compliance and history of violent behavior so they can provide the best possible services for those clients."
State Senator Jennifer Flanagan, D-Leominster, was a member of that Task Force and worked in the mental health field before being elected.
She said she did not know the details of the Johnston case, but said there is no one-size-fits-all solution when dealing with mental health issues.
"When you're dealing with mental health, and you're dealing with a chemical make-up of the brain and pieces aren't functioning, there will be a different solution for everyone," she said. "There will not be one methodology. You can't legislate something like that. You can certainly try and put provisions in place or put safety measures in place, but I'm not sure that would work."
She said short of instituting team therapy with more than one social worker working with one patient, some instances will be unavoidable.
"The biggest thing is you can't protect them from everything. There aren't enough safety measures to protect everyone from everything," she said. "Even if that person was with another therapist, who's to say he wouldn't have hurt the both of them? Who's to say he wasn't strong enough to take away the tool and hurt them both?"
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