Mental-health work can be fatal

Marty Smith, of Bremerton, died last November working in one of the most dangerous occupations around: mental-health worker.

Smith, 46, was stabbed to death in the dining room of Larry Clark, a child rapist whose mother had summoned help, saying Clark was schizophrenic and off his medications.

Deaths such as Smith's need not be inevitable dangers for mental-health professionals, according to a report released Thursday about workplace violence in the state's community mental-health services. The report was commissioned after Smith's death by Service Employees International Union 1199NW, which represents 2,000 mental-health workers in Washington.

The union supports the "Marty Smith" bill, which would require mental-health workers to work in pairs when making high-risk home visits. The bill died in the Senate this year but will be reintroduced when the Legislature convenes in January.

Among the study's recommendations are putting more money into community mental-health services to help reduce workers' caseloads, mandating that an extra person accompany mental-health workers on high-risk home visits and training workers in how to cope with violence.

The state's Department of Social and Health Services (DSHS) will address safety concerns of mental-health workers at two conferences next week, DSHS spokesman Jim Stevenson said.

These "brainstorm sessions" will draw on workers' experiences to develop improved protocols to help mental-health workers avoid unnecessary danger and prepare for dangerous situations that can't be avoided.

Kathleen McPhaul, assistant professor with the University of Maryland's Department of Family and Community Health who interviewed mental-health professionals and other experts for the field report, said caseworkers have the power to prevent violence in people with mental illness.

"It's the face time with the worker that keeps the patients stable," McPhaul said. "Violence is not necessarily a symptom of being mentally ill."

Violent acts by the mentally ill are "ultimately preventable. It's not random," she said.

Based on Washington workers' compensation claims between 1995 and 2000, workers at psychiatric hospitals experienced by far the highest rates of workplace violence.

They suffer 2 ½ times more violence-related injuries than the next-highest group, residential-care workers, and nearly eight times the rate of police officers.

Psychiatric work "is not thought to be a risky job, but it's highly dangerous," said Michael Foley, a senior economist with the state Department of Labor and Industries.

Social services and health services have the highest rates of assaults and violence among major industries, Foley said. In July, Maritza Dowe, a clerk at a public-health clinic in downtown Seattle, was blinded after a former mental-hospital patient attacked her with a knife.

Rep. Tami Green, D-Lakewood, who sponsored the "Marty Smith" bill and will speak at the DSHS conference next week, said she is more hopeful that it will pass next year.

Smith's widow, Yolanda Smith, said she blames the system perhaps more than Clark for her husband's death.

After the attack, Clark was initially deemed mentally incompetent to face a first-degree murder charge. After receiving treatment at Western State Hospital, he was declared competent and awaits trial in Kitsap County Jail.

Seattle Times staff reporter Carol Ostrom contributed to this report.

Kyung Song: 206-464-2423 or ksong@seattletimes.com