Carol Wilkinson, MD. MSPHCarol Wilkinson, MD. MSPH Medical Director, IBMMedical Director, IBM

November 15, 2004November 15, 2004 Baltimore, Md Baltimore, Md

VIOLENCE PREVENTION: VIOLENCE PREVENTION: TRANSLATING RESEARCH TO PRACTICETRANSLATING RESEARCH TO PRACTICETYPE III: TYPE III: CURRENT OR FORMER EMPLOYEECURRENT OR FORMER EMPLOYEE

Agendaƒ Workplace Violence: Type IIIƒ IBM's Past Experienceƒ Violence Prevention Programs: IBMƒ Threat Assessment & Managementƒ Summary

WORKPLACE VIOLENCE: TYPE IIIWORKPLACE VIOLENCE: TYPE IIICURRENT OR FORMER EMPLOYEECURRENT OR FORMER EMPLOYEE

WORKPLACE VIOLENCE: WORKPLACE VIOLENCE: TYPE III: TYPE III: Current or former employeeCurrent or former employee

Most media attention, least frequentFrightening: not safe at workContinuum

ƒ Hostile evironment:verbal aggression, insult, bullyƒ Verbal: ThreatsVerbal: Threatsƒ Physical attackƒ Lethal

Acts of desperation, poor judgementCurrent approach is based on trial and error, experience and judgement

Workplace Violence: IssuesWorkplace Violence: IssuesType III: Type III: Current or former employeeCurrent or former employee

The meaning of wordsƒ Normsƒ Changing standards of acceptabilityƒ The challenge of communication

Our culture of violenceThe power of emotions such as angerMultiple life stressors

VIOLENCE PREVENTION PROGRAMSVIOLENCE PREVENTION PROGRAMSOVERVIEWOVERVIEW

Customize to workplace culture, the organizational structure and the risks

Common factorsIBM as an example

ƒ Early leader in workplace violence preventionƒ Responsibility owned by securityƒ Ongoing process of assessment, refinement, enhancement

Keys to program successƒ Consistencyƒ Anticipationƒ Collaboration

TYPE III: Current or former employeeTYPE III: Current or former employee

IBM's PAST EXPERIENCEIBM's PAST EXPERIENCE 1980's Two Incidents:

Bethesda, MD Raleigh, NC

Casualties: Deaths: 4 Physical injury: 25+ Psychological injury: many

" Never Happen Here "

" Defining Experiences "

TYPE III: Current or former employeeTYPE III: Current or former employee

Structural/organizational approachBuilding/regional levelMembers: Legal, HR. Mgt, Medical, Finance, Security, Communication, etc

Structural approachFormal list, with back-up, phone contact information

Annual trainingRapid, effective responseMulti-purpose

Fire in buildingBomb threatWorkplace violenceNatural disaster

IBM WORKPLACE VIOLENCE PREVENTION IBM WORKPLACE VIOLENCE PREVENTION

Crisis Management Teams:

TYPE III: Current or former employeeTYPE III: Current or former employee

IBM WORKPLACE VIOLENCE PREVENTION IBM WORKPLACE VIOLENCE PREVENTION (CON’T)(CON’T)

ƒ Physical Security - Type I, II or IV

ƒ Pre-employment Background Checks: Type IVƒ Criminal record, violent crimeƒ Does not address risk of current/former employees:

ƒ Training: Type I, II, III, IVƒ HRƒ Managersƒ Receptionistsƒ Mailroom

TYPE III: Current or former TYPE III: Current or former employeeemployee

IBM WORKPLACE VIOLENCE PREVENTION IBM WORKPLACE VIOLENCE PREVENTION (con't)(con't)

ƒ "Zero Tolerance" Policy: Type IIIƒ Identificationƒ Investigatedƒ Addressed: warning...suspension...terminationƒ Importance of

ƒ Limit setting,, consequencesƒ Consistency ƒ Reasonablenesss

ƒ Employees right to be safe at work

ƒ EAP: Type IIIƒ Troubled employeesƒ Assistance with life's stressorƒ Risk can remain after termination

TYPE III: Current or former employeeTYPE III: Current or former employee

THREAT ASSESSMENT PROCESSTHREAT ASSESSMENT PROCESSEarly identification

Information collectionƒ Details of the threat

Avoid the "chicken little" syndromeWhat was said, how, when

ƒ Current & prior behaviorBest predictor of future is the pastAt work, away from work

ƒ Objective *** & subjective ***Importance of non-verbal behavior

Professional Evaluation ***ƒ Experienced: forensic psychiatrist, FB!, ƒ Known, reputableƒ Limits to predictive value of any assessment: only one point in timeƒ Useful part of process for employee and management

TYPE III: Current or former employeeTYPE III: Current or former employee

Protect PeopleAvoid direct contact: communicate by phoneSecurity on hand for meetingPanic alarms

Set Limits Acceptable vs unacceptable behavior

Meet employee's needs as much as possibleMaintain dignityGive employee a chance to be heardAssistance for underlying problems

THREAT MANAGEMENT PROCESSTHREAT MANAGEMENT PROCESSTYPE III: Current or former employeeTYPE III: Current or former employee

TYPE III: Current or former employeeTYPE III: Current or former employeeChallenges to effective violence preventionChallenges to effective violence prevention

Need to get it rightƒ Infrequentƒ Potentially high stakes

Collaborativeƒ Multiple persectives

Failure to act -ƒ Problem often won't go away ƒ May get worseƒ Long-standing situations are the most problematic

ToleratedImplicitly condonedCan be effective behavior for employee

Over-reactƒ Can exacerbate the situationƒ Need to avoid panic driven behaviorƒ Need to consider options, consequencesƒ Can undermine credibility

Importance of management practicesƒ Treatment of employees

Knowledge and experience transfer

TYPE III: Current or former employeeTYPE III: Current or former employeeChallenges to effective violence prevention Challenges to effective violence prevention (CON’T)(CON’T)

SUMMARY: Workplace violence:SUMMARY: Workplace violence: Type III: Current or former employeesType III: Current or former employees

Threats & hostile workplace

Experience is fragmented and inaccessible

Law enforcement shifting perspective to preventing violence

Mental health providers increasing understanding of public health implications

Challenge of translating what we know about the psychology of individuals associated with employee violence into education and processes

Danger of over-simplification(white male in 40's with weapons)

The need to building the scientific foundation of empirical knowledge