Violence on the rise at heath care clinics across the country

Health care facilities have experienced a "significant" increase in violent attacks since 2004, according to a report issued last week by the Joint Commission, an independent health care oversight group. The suspected cause: dwindling mental health resources have led patients with severe mental illness to rely on hospitals and emergency rooms for services. There, they often wait hours before being treated, all the while growing more agitated until they reach their trigger point and commit violence, according authors of the report. A secondary cause of the increase in violence, according to those experts, are people who feel entitled to fast-food style service, even in a health care setting, and don't want to wait for treatment. They, too, reach a breaking point and turn to assault or other violent acts.

According to the Joint Commission's voluntary reporting system for these adverse events, there have been 256 assaults, rapes or homicides of patients and visitors to American health care centers since 1995, with 110 of those acts occurring since 2007. And the report also noted that the actual numbers are believed to be significantly higher. Some estimates say that only one out of five incidents are actually reported.

"Only a very small percentage of violent incidents are reported, so this is just the tip of the iceberg," Russell L. Colling, a health care security consultant in Salida, Colo., who advised the Joint Commission on the report, told HealthDay. "The reality is, there is violence every day in the emergency department." Colling blamed an increase in drug and alcohol abuse, and a decrease in available mental health and substance abuse service, for the violence spike: "In the last ten or fifteen years, the resources for the diagnosis and treatment of mental health patients have basically vanished, and that means hospitals often have to do intakes for all suspected psychiatric patients," he said. "In today's hospital environment, where there are often tremendous delays in treatment, these patients tend to get more agitated."

The emergency room is the number one spot in a health care facility where violence is most likely to occur. The mix of patients coming in for treatment - plus emotionally distraught or charged friends, family or, in some cases even, rival gang members - can create a setting where volatile characters take violent actions. According to HealthDay, the report also spells out 13 specific steps that health care facilities should take to prevent violence, such as evaluating the facility's risk for violence by examining the campus, reviewing crime rates, and surveying employees about their perceptions of risk. The report also recommended conducting thorough background checks of prospective employees. The report also recommends that facilities take extra security precautions in the emergency department, especially if it's in an area with a high crime rate or gang activity.

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