Staff members at an East Bay psychiatric emergency room are speaking out about dangerous and overcrowded conditions they describe as "inhumane" and befitting "a third world country."
2 Investigates obtained leaked hidden camera video of the conditions inside the John George Psychiatric Hospital in San Leandro. The video shows overcrowding so severe that patients are sleeping and eating on the floor, some of them moaning and crying out for help.
"It's inhumane," said one employee.
Staff members say the facility was designed to hold 23 patients but the count often exceeds 70 or 80 patients, overwhelming staff who can't keep up with those suffering mental distress.
Four staff members who work at John George sat down with 2 Investigates - on the condition of anonymity - to describe ongoing acts of violence between patients and attacks on staff members. All of the workers told KTVU they had been the victims of violence and that a number of staff members are on medical leave after suffering injuries that have resulted in knee and shoulder surgeries.
One worker had to have facial surgery after suffering a broken nose, according to colleagues.
"I've been hit. I've been pushed. I've been threatened, verbally threatened and physically threatened," one worker told 2 Investigates.
"I've been kicked most recently and punched, assaulted," said another. "I've had urine thrown on me."
One staff member said he was bitten by an HIV positive patient.
And employees aren't the only ones at risk, according to staff. The workers also say patients too have suffered serious injuries over fights for limited chair and bed space. One staff member described a fight in which a patient picked up a phone receiver and began slamming it against the head of another patient who sat in a chair.
"It was a very vicious attack. Blood everywhere. This patient who was attacked had to be sent out to get medical treatment for his wounds."
The staff members told 2 Investigates they didn't want to reveal their identities for fear of retaliation by management. They say they've repeatedly expressed concerns to administration about the conditions but that little has changed.
"Morale is very low," said one employee.
"All we want is a reasonable work environment," said another.
Last December Alameda County Health Systems, the agency that oversees John George, issued an internal audit report
that found "inconsistencies with staffing ratios." The report cites some instances when staff to patient ratio "was either under or over the 1:6 and 1:4 ratio."
But staff members tell 2 Investigates that in reality there are more often 20 patient to every one nurse, and up to 70 patients for every doctor.
And it's not the first time the hospital administration was warned about staffing levels. After a patient hanged herself in 2005, the Alameda County Grand Jury investigated John George and issued a report
that found a "failure to hire enough nurses or provide up-to-date care" at the facility.
The report also found that the facility was not in compliance with state law, saying the problem "creates an undesirable environment for both patients and staff."
"Is it ideal? No. Of course it's not ideal," said Dr. Joe Walker, Chairman of Psychiatry for Alameda Health System and Medical Director for John George Psychiatric Hospital.
Walker told KTVU there's been an explosive growth of patients at psychiatric hospitals around the Bay Area and across the country and the overcrowding at John George is an infrequent occurrence. When an influx of patients begins to overwhelm staff members, Walker said, additional staff are called in to help and when possible, patients are diverted or held at other facilities until there's a ratio of at least one staff member to six patients.
"Do I understand how difficult it is for a patient and certainly for a family member to have to endure one of those periods? I absolutely do," he said. "We take it as our highest priority to make it as brief as possible."
Walker says work is currently underway to improve conditions at John George. That may mean more diversions of patients to other facilities or earlier diagnoses of psychiatric conditions that could be treated outside of John George.
But there's no timetable for when that will reduce the workload for staff members who say they're continually overwhelmed.
"The overall solution is going to happen tomorrow? No," said Dr. Aaron Chapman, Medical Director for Alameda County Behavioral Health Care Services. "It's going to be an ongoing process and I'm confident we're taking necessary steps to address it."
In the meantime, staff members will have to endure the conditions at John George. They say as bad as it can be for them, it's even worse for the patients and their families seeking much needed psychiatric help.
As one worker said, "It's somebody's daughter, somebody's son, somebody's loved one. We're fighting for them."