Security measures
A non-intrusive system to keep hazardous items out
Nick Jordan, director of International Sales at Metrasens, takes a look at the security benefits of modern metal detection technology in keeping restricted and potentially dangerous items out of mental healthcare facilities, and thus helping to keep service-users staff and visitors safe.
No one would contest that the work mental healthcare employees do is demanding – yet plenty of people outside the field would assume it’s only hard mentally and emotionally. What many don’t realise is that it is also often demanding physically, because of the high risk of injury. Three-quarters of all workplace assaults in the US occur in the healthcare industry, and workplace violence is even more prevalent in mental health; almost one in five patients admitted to acute psychiatric units in America may commit an act of violence. The more extreme cases involve contraband like lighters, or weapons – knives, guns, razor blades – that are brought into facilities from outside, either by patients or their visitors.
It is not just employees who need to worry about violence within mental health facilities either. Patients, too, are at risk if another patient brings in or obtains a weapon or other restricted item while in a facility – and this can create a multiplier effect, in which patients try to bring their own weapons in, thinking they need to protect themselves from others. Violence within healthcare is increasing, according to an article in the US magazine, Modern Healthcare,1 which calls it a ‘growing problem’, and mental healthcare facilities bear an especially tough burden. Due in part to a lack of sufficient psychiatric beds, many behavioural health patients are being boarded in acute care facilities such as emergency departments for longer and longer periods. Such incidents result in increased absconding attempts and a rise in workplace violence incidents, due to the increased need for restraint and seclusion of these patients.
RISE IN DRUG ADDICTIONS Additionally, a rise in drug addictions in the United States and Europe means that many patients entering a facility have dual diagnoses: addiction and mental illness. In Europe, the movement from the traditional model of hospital-based care toward community-based care is advancing mental healthcare. However, community-based facilities also experience overcrowding, with the result that some patients
are sent to hospitals, which then suffer from an influx of acutely unwell, and sometimes violent, patients. Lack of space means patients may be discharged from facilities before they are completely well, and many acute care facilities lack the necessary resources to provide the necessary psychiatric care.
Against this backdrop, mental health facilities of all varieties – inpatient, outpatient, and residential – struggle with an effective way to ensure that restricted items that incite violence are not introduced. An April 2016 editorial in the New England Journal of Medicine2 pointed out most research is centered on quantifying the problem of violence in healthcare, rather than studying how to overcome it – but this is a mistake, especially in mental health facilities, where security is critical.
MEETING THE CHALLENGES Meeting the challenges of securing mental health facilities involves enhancing not just the physical environment, but also the culture of security – because current methods aren’t working, and this has made mental healthcare employees sceptical that anything meaningful can be done. Each facility is unique in its own right, employing different approaches to prevent security issues or resolve them once they arise. The more conspicuous processes involve walk- through metal detectors and/ or uniformed security guards. A survey by STAT News found that emergency departments, for example, rely on a combination of hospital
security and local police to prevent and handle violence, while some simply train their own staff on how to deal with violent attacks, and rely upon the response of local law enforcement authorities when incidents occur. Until now, screening for contraband was likely to be done manually, either by pat-down, or using a hand-held wand. These processes have been proven to be ineffective as a primary screening tool in a study published in Medicine, Science and the Law.3 Remarkably, only five per cent of prohibited items were detected with these hand-held ‘wands,’ so their usefulness is as a secondary screening measure after detection by a primary screening tool (such as a walk-through metal detector). Pat-downs and hand-held wands have several issues. They require staff to get ‘up close and personal’ with a patient and invade their personal space while the staff member touches or waves a hand- held tool all over the patient’s body and in their face – which could trigger aggression.
Metrasens says of its Proscreen 200 system: ‘Designed to be discrete and non-threatening, Proscreen 200 accomplishes the task of contraband screening while not interfering with a facility’s focus on patient dignity.’
SMALLER CONCEALABLE ITEMS Another issue is that such processes are not sensitive to many smaller concealable items, for example a razor blade hidden in someone’s hair, or a needle or syringe in a closed fist. Physical pat-downs also put the searcher at risk of needle stick injuries, and exposure to blood-borne pathogens, and hand wands need constant preventative maintenance to ensure proper operation. Some hospitals and outpatient clinics, however, believe implementing such security measures may only exacerbate the anxiety experienced by their patients in a behavioural crisis, and increase violence – and so they have only passive security methods such as cameras and access controls in place, leaving them
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