Develop office policies to help deal with potential violence
The potential for violence often looms in a therapy office, particularly when a clinician is working with a patient who has a serious mental illness. Two horrific attacks over the past five years illustrate the threat.
A psychologist was hacked to death in her Upper East Side office in New York two years ago by a man with a meat clever. The killer, who was caught, had come into the office looking for the psychologist’s colleague, a psychiatrist.
In 2005, San Francisco area psychologist Ira Polonsky was shot to death in his office. The masked killer was never found despite a $50,000 reward offered by the governor’s office.
A July 9 Psychiatric Times piece, Safety in the Evaluation of Potentially Violent Patients, outlines a few of the steps clinicians can take to lessen the threat. They include: maintaining a personal “safety zone” of at least four to six feet around you; staying at least two steps away from a patient who looks to be on the offensive; and making sure you have access to an exit door.
In previous Psychotherapy Finances pieces on this topic, clinicians have also recommended making sure there is furniture – such as your desk – between you and the patient.
After the New York murder two years ago, there was renewed discussion of installing panic buttons in therapy offices. But in extreme cases you may want to conduct interviews with the door open or another staff person present.
Statistics from the Crime Victimization Survey conducted by the Department of Justice show that the annual rate of nonfatal crime against psychiatrists was 68.2 per 1,000 people. The rate for all occupations is just 12.6.
Clearly, this is a subject that should be front and center when you’re developing office policies in your private practice. Planning for “what if” scenarios can help you reduce risk.