Preventing Workplace Violence at Napa State Hospital: Barriers to Effective Reporting of Assault

Violence at Napa State Hospital has been widely publicized after the murder of Donna Gross. Cal/OSHA, union leaders, and legislators have already identified key issues that must be addressed, such as understaffing, reforming the Wellness and Recovery Plan, and increasing police involvement. However, underreporting of assaults has not received much attention within the discussion of improving safety. This project interviewed 57 employees to investigate the extent of underreporting of patient-on-staff assaults and barriers to reporting at Napa State Hospital. We found that underreporting is prevalent due to an ineffective reporting system. The major barriers to reporting are management inaction, perception that assaults are too minor to report, a disjointed and time-consuming system that includes multiple reporting methods, and lack of consequences for the patient perpetrator. We recommend that Napa State Hospital and the California Department of Mental Health make the reporting system more streamlined, consolidated, and consistent; shift documentation responsibilities to office staff where possible; increase staffing; communicate assault data to staff; reform training on procedures following an assault; and re-evaluate the Wellness and Recovery Plan.

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