Lansing — The health and safety of Michigan mental health hospital patients is at risk because of mandatory overtime rules that lead to exhausted employees unable to control violent behavior, according to a new lawsuit seeking to stop the state from forcing “excessive” shifts.
The federal complaint was filed last week on behalf of Alan Teasel, one of roughly 600 involuntary patients at the Caro Center psychiatric hospital in Tuscola County. Attorneys are seeking class-action status on behalf of all Caro patients in a lawsuit they say could also help protect employees.
Teasel has observed “increased violence among patients” as residential care aides have been forced to work extra overtime shifts more often, according to the suit, which notes that Caro residents include felons who were unfit to stand trial, deemed not guilty by reason of insanity or otherwise committed.
“Where patient populations residing in locked wards have assaultive and murderous criminal records and suffer psychotic conditions, including severe depression, a wakeful and alert staff is required at all times,” says the complaint filed with the U.S. District Court in Detroit. “That staff is now virtually non-existent, and patients have suffered significant injury to their health and well-being as a result.”
In a signed affidavit, Teasel said residential care aides at the hospital seem to be getting sick more often and appear more irritable.
“Almost every day, I see staff asleep in their chairs,” he said.
As a result, Teasel claims, there has been an increase in patient-on-patient and patient-on-staff violence.
Michigan law allows employers to require overtime shifts, but the suit notes that some states have moved to ban overtime for nurses. A Michigan task force on nursing practices in 2012 noted concerns about patient safety linked to mandatory overtime, and Democrats have introduced legislation that has not advanced.
Bruce Miller, a Detroit-based labor attorney who filed the suit, said the “involuntary” status of his client and other state-run mental health hospital patients makes them uniquely qualified to challenge overtime rules for residential care aides at Caro.
The suit alleges patients have been denied fundamental rights afforded by the state and federal constitutions.
“This is a serious problem,” Miller said. “These patients can’t just get up and leave, and because of the character of their illnesses, they require the services of an alert staff.”
A spokesman for the Michigan Department of Health and Human Services, which runs the aging Caro Center and is named in the suit, said he could not comment on pending litigation.
In his budget request for next fiscal year, Gov. Rick Snyder has proposed building a new facility to replace Caro and “provide a safer and more modern setting for state psychiatric hospital patients and staff.”
Plaintiffs are seeking a preliminary injunction to block mandatory overtime at the hospital.
Miller said some mental health hospital patients demand extra attention and one-on-one supervision, including dangerous patients, those considering suicide and others who suffer from polydipsia, a psychotic condition marked by an intense need to consume water in potentially fatal amounts.
Former Caro employee Renae Goyette, in an affidavit filed with the suit, said she quit her job because “excessive overtime” was affecting her health and well-being, leading a doctor to prescribe a limited schedule.
She described working extra eight-hour overtime shifts up to eight times in a two-week period.
“This means that, typically, I worked from 6:15 a.m. until 11:00 p.m.,” Goyette wrote. “I then left work, only to return at 6:15 a.m. the following morning.”
Goyette said the schedule affected her physically and emotionally, impacting her job performance. She felt fatigued and developed sleep deprivation and anxiety. In her affidavit, she said she frequently dozed off at the wheel driving to and from work.
For residential care aides, “who are being repeatedly mandated to work 16 hour days, for multiple days in a row, it became very difficult to stay awake while watching a dangerous patient,” Goyette wrote. “This creates a tremendous hazard.”
State psychiatric hospitals have often struggled to retain and recruit staff, said Mark Reinstein, president and CEO of the Mental Health Association in Michigan.
While he was not familiar with the details of the lawsuit, Reinstein called mental health hospital jobs “incredibly stressful” and said he “would be concerned about anyone having to work extra shifts or do double shifting, because it’s hard enough as is.”
The Michigan Occupational Safety and Health Administration in October cited the state health department and Caro for failing to provide employees, as required, with a workplace “free from recognized hazards that are causing, or are likely to cause, death or serious physical harm to the employee.”
The citation noted that facility employees had suffered fractures of the skull and leg, detached retina, torn rotator cuffs, torn biceps tendon, torn labrum, concussions, ruptured discs, exposure to blood or other potentially infectious materials, hair torn out and soft-tissue injuries as a result of assaults.
Teasel, the plaintiff in the case, has been in and out of mental health facilities most of his life and has been involuntarily committed to Caro since 2000. He is psychotic, Miller said, but “fairly lucid, articulate and able to describe the conditions under which he exists.”
In his affidavit, Teasel said he no longer feels safe at Caro “because staff cannot protect the patients when necessary due to their lack of sleep.”