TEWKSBURY — In October, officials in Tewksbury celebrated the completion of the long process of bolstering security at Tewksbury Hospital after a string of security incidents and patient escapes.
Those reforms included new protocols for transporting high-risk and court-committed forensic patients (an individual with a mental health or cognitive impairment who is usually involved in the criminal justice system), more secure entrances with visitor screening and X-ray machines, and physical tools like pepper gel, handcuffs and batons for the better-trained security team.
Less than a year later, some of the new tools carried by the security team are suddenly being taken away by the state Executive Office of Health and Human Services, leaving hospital staff and town officials confused and vocally disappointed.
In a letter seen by The Sun Thursday, Tewksbury Hospital CEO Amy Dumont told officials and staff at the hospital that EOHHS has determined that security team specialists at the hospital “will not carry or use defensive tactical weapons, including pepper gel, batons, and handcuffs.” Dumont listed several reasons for this change.
“Clinical hospital guidance advises that weapons in hospital settings conflict with the therapeutic mission of care. The American Psychiatric Association agrees. The health care environment should be one of trust, dignity and respect,” said Dumont. “The use of these tools in clinical spaces carries risks. It can make the situation worse, harming patients and staff.”
Dumont pointed to regulations surrounding restraints in healthcare setting, which she said is considered “a clinical intervention.”
“Tewksbury Security Team Specialists are security professionals, not law enforcement or clinical staff,” said Dumont. “The state’s policy aims to reduce inconsistencies in practice and risk. This action brings Tewksbury Hospital in line with other [Department of Public Health] and [Department of Mental Health] hospitals.”
In a phone call Friday afternoon, Tewksbury Hospital nurse and Massachusetts Nurses Association representative Ryan Wilkins said great effort had been made to make the hospital campus safer for staff, patients and the surrounding community in recent years since there has been an influx in patients with histories of violent crimes.
In recent years there have been multiple forensic patients who have escaped the hospital, prompting a response from the Tewksbury Police Department to apprehend the individuals, and frustration among town officials.
The underlying issue still has not been addressed, Wilkins said, with more than 65% of the patient population being forensic patients and there being little separation between them and the rest of the patient population.
“Not once have we been brought to the table with these decision-makers and key policymakers to give our input,” said Wilkins.
Wilkins said there was an incident in the fall in which pepper gel was successfully deployed on a patient who was attacking Tewksbury Hospital staff.
“The deployment of pepper gel was used in a successful attempt to deescalate and gain control of a very volatile and very dangerous situation,” said Wilkins.
Wilkins acknowledged that the memo announcing the change was signed by Dumont, but said from his observation it “is not reflective of the views of the leadership inside the building on workplace safety.”
“I think that decision was made at a much higher level … without any input from frontline healthcare workers in this environment every day,” said Wilkins.
Wilkins said he and his fellow nurses are “happy to provide care for any individual in the commonwealth,” but they ask that they have the tools and infrastructure to do so safely.
The biggest ask they have though, Wilkins said, is to have “a seat at the table to discuss the situation at Tewksbury Hospital and provide feedback about our work environment.”
In the meantime though, the nurses are asking for the security tools to be restored, Wilkins said.
In a statement Friday, the Massachusetts Nurses Association said the state “announced a policy that removed all tools security staff have at their disposal to address violent confrontations against staff and other patients” without consulting hospital staff. “This has left staff feeling abandoned and victimized by a system that refuses to listen to or protect them and their patients. We have staff left without any means of timely support to protect themselves in a chaotic environment that has not been staffed or designed to provide care to the population of patients they are now required to serve.”
The statement continued, “Remember, these facilities were designed and staffed to care for patients with chronic mental health conditions, a 45 year old women with severe PTSD and anxiety, a 50 year old man who may be bipolar, a 35 year old with crippling depression. But over recent years, this and other state facilities have been admitting criminally involved patients, many oppositional behavioral conditions that make them prone to extreme violence. They are admitted for evaluation to see if they are competent to stand trial. Many, because of the need to be evaluated, are not medicated. And these patients are allowed to roam freely among the non forensic population. Because many of them come from a corrections culture, they exhibit those behaviors, intimidating or abusing the non forensic patients, or attacking staff.”
“Whether you agree with the specific tools removed, the result of this process has been to remove any ability for security folks on staff to provide timely support to staff and patients being threatened with bodily harm or worse,” the MNA said.
Tewksbury Police Chief Ryan Columbus had championed the security measures implemented last year at the hospital, and questioned why some of those measures are being removed.
“The security of the hospital, from my perspective, has improved significantly under the leadership of Public Safety Director Jason Smith. I cannot speak highly enough of his leadership, expertise, and overall impact. Since the security assessment that we advocated for, along with the subsequent leadership change, I have been extremely pleased with the level of safety and security at the hospital,” said Columbus in a statement Thursday afternoon. “I was surprised by the discussion regarding the removal of less-lethal tools from Public Safety Officers. I struggle to understand the rationale behind such a decision. In my view, this change would place Public Safety Officers, hospital staff, patients, and the Tewksbury community at unnecessary risk.”
Columbus expressed concern that decisions surrounding the hospital “are being made by individuals without relevant expertise in security or law enforcement.”
“Regardless of perspective, the hospital serves individuals who can present significant safety challenges. The focus should be on enhancing tools, training, and support for Public Safety personnel, not reducing them,” said Columbus. “[In] my view, these Public Safety Officers should fall under the Executive Office of Public Safety and Security, not the Department of Public Health.”
In a statement on Facebook Thursday, Tewksbury Select Board member James Mackey said these new changes followed “a recent incident in which security measures were appropriately deployed against an individual who had injured staff and hospital security personnel.”
“My request is simple: this policy should be paused so that further discussions can take place,” said Mackey in his statement. “Tewksbury State Hospital cannot be treated the same as its peer facilities. Its unique population, including individuals served by both the Department of Mental Health and the Department of Public Health, requires a different level of consideration.”
He continued, “As many of you know, I have consistently supported a collaborative approach with the State Hospital, and staff there have made meaningful progress over the past 18 to 24 months in improving security. This decision puts hospital staff, surrounding residents, and some of Tewksbury’s most vulnerable populations at greater risk. Given the location of the hospital in the heart of our community, I find this wholly unacceptable.”
Select Board Chair Mark Kratman told The Sun Thursday said he intends to call the decision-makers for this change to attend the board’s next meeting on April 14.
“This is serious. We worked with them and applauded them when they did these safety improvements,” said Kratman. “Now they are going backwards … They are trying to make the Tewksbury Police Department into their private security without notifying us.”
State Rep. David Robertson told The Sun Friday morning he had been hearing rumors of discussions of a change like this happening at Tewksbury Hospital, but he had been assured the discussion was “tabled.”
With that change suddenly being made in the hospital in his district, Robertson said he intends to file legislation to move control of the Tewksbury security team specialists from DPH control to the Executive Office of Public Safety and Security.
“The most confusing thing about this is that this has to be the most humanitarian-minded police response escalation ladder in the commonwealth,” said Robertson.
He called the decision an example of “ideological purity.”
“We can absolutely strike a balance between compassionate care and reasonable public safety,” said Robertson.
Robertson and Mackey said upon learning of the change Thursday they immediately both drove to the State House in Boston to speak with somebody from the governor’s office, and set up a meeting with DPH and EOHHS officials Friday morning. In that meeting was Robertson, Mackey, Kratman, Select Board member Eric Ryder, Columbus, state Rep. Tram Nguyen, state Sen. Barry Finegold, Tewksbury Town Manager John Curran, EOHHS Undersecretary Chris Harding and DPH Commissioner Robbie Goldstein, among others.
Mackey said Harding and Goldstein would not commit to pausing this change in policy Friday.
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