Protecting Your Behavioral Healthcare Workforce with Staff Duress Systems

TLDR
The Joint Commission’s Violence Prevention in Behavioral Health Care and Human Services report has once again raised the bar for staff safety in BHC environments. I believe that many of the reports requirements can be addressed through the use of staff duress systems, with better leadership, response, and analysis giving your center the tools it needs to tackle WPV and improve outcomes for both patients and staff. 

Workplace violence (WPV) within healthcare settings is a growing issue, with more than double the amount of workers facing harassment in 2022 (13%) than in 2018 (6%). Behavioral healthcare centers (BHC) are at particular risk, with workers within these settings regularly dealing with patients with poor mental health, substance and alcohol abuse issues, PTSD and trauma, and anger management issues.

While there are numerous approaches to addressing the concerning prevalence of violence in healthcare, usually beginning with the creation of a Workplace Violence Prevention Plan, our experience in helping clients across multiple industries point to the efficacy of staff duress systems.

But what exactly is a staff duress system, how does it relate to workplace safety, where can they be used, and how can you implement these systems within your BHC? Here, we explore those questions and look at the best solutions for behavioral health centers.

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What Are Staff Duress Systems?

Staff duress systems, which include panic buttons, are essentially technological security solutions designed to protect healthcare workers by enabling them to quickly and discreetly call for help in emergency situations. The term is increasingly being used within professional settings over those that include “panic” or “SOS”, aiming to reduce some of the stigma associated with triggering an alert and normalizing their use in any situation of duress.

These systems can be integrated into wearable devices or strategically placed in work environments, allowing staff members to trigger an alert when they feel threatened or face a duress event. Some duress systems may also use real-time location systems (RTLS) and functionality that connects the system directly to 911 emergency services with the push of a button.

Importance of Staff Duress Systems in Behavioral Healthcare

In July 2024, The Joint Commission updated its requirements for Joint Commision-accredited behavioral healthcare organizations to address the rising levels of workplace violence within these settings. Three new and one revised requirements were included, focusing on how leadership, hospital security policies and procedures, reporting systems, data collection and analysis, post-incident support and follow-up, and staff training and education could be improved with the aim of reducing WPV.

In my experience, each of these areas can be addressed through the carefully planned rollout of a duress system. Beginning with strong leadership that advocates the use of wearable devices for each staff member, through non-judgemental or punitive policies that encourage their use, to the improvement of staff training through simplified data collection, reporting, and analysis.

Finally, with a growing number of duress buttons laws being introduced across the country mandating the use of duress systems and panic buttons, taking proactive steps to ensure your staff are protected through the use of these devices can help BHCs realize better ROIs through improved staff wellbeing and quality of care.

Common Use Cases for Staff Duress Systems in Behavioral Healthcare

Behavioral healthcare covers a broad range of environments and settings, with these services offered in centers ranging from hospitals to residential facilities. Below we list some of the most common use cases.

1. Psychiatric Hospitals — Staff can quickly call for help when dealing with aggressive patients in psychiatric wards.
2. Emergency Rooms — Immediate assistance is available for hospital staff managing patients in mental health crises.
3. Residential Treatment Centers — Staff working alone or in small teams can discreetly signal for help during high-risk situations.
4. Outpatient Clinics — Protects therapists and counselors during sessions with potentially volatile clients.
5. Substance Abuse Facilities — Ensures quick response in cases of agitation or violence from patients undergoing withdrawal.
6. Group Therapy Sessions — Provides security when tensions rise among patients during group therapy activities.
7. Home Healthcare Visits — Healthcare workers visiting patients at home can call for help if a situation becomes unsafe.
8. Long-Term Care Facilities — Ensures rapid intervention if patients with dementia or other mental health issues become aggressive.
9. Adolescent Behavioral Programs — Protects staff in settings where teenagers may become confrontational or disruptive.
10. Mobile Crisis Teams — Field teams can discreetly alert backup during in-person interventions with at-risk individuals.

Best Practices for Implementing Staff Duress Systems

1. Conduct a Thorough Risk Assessment
Before implementing any duress system, I would advise that you perform a detailed risk assessment to identify high-risk areas, patient interactions, and situations where staff might be most vulnerable. Evaluate factors such as patient behavior, facility layout, staffing levels, and previous incidents of workplace violence. This assessment helps determine where and how to deploy the duress system for maximum impact.

2. Ensure Discreet Activation
The ability for staff to discreetly trigger the duress system in behavioral health environments is vital. Choose a system that allows for discreet activation via wearable devices (such as wireless panic buttons) or under desk options, ensuring that staff can signal for help without raising alarm or aggravating patients.

3. Integrate with Existing Security Systems
For optimal safety, I would advise a client to integrate the staff duress system with existing security systems such as surveillance cameras, access controls, and alarms. Integration ensures that when an emergency signal is triggered, all security measures, including video monitoring, can be activated in sync to provide a comprehensive response, as well as allowing for a “bigger picture” of the alert to be painted post incident.

4. Train Staff Regularly
Implementing a staff duress system is only effective if staff are trained to use it correctly, and I have used my experience within the hospitality industries to guide regular training sessions. A Workplace Violence Prevention plan should cover how to activate the system, how responders will be notified, and what to do after an alert is triggered, as well as safety tips for security officers who are likely to be first responders. This training ensures that all staff feel confident using the system and are aware of emergency response protocols.

5. Test the System Periodically
Conduct regular system tests to ensure the duress system is functioning correctly. These tests should include both technical assessments and mock scenarios where staff trigger alerts and response teams practice reacting to them. Regular testing prevents system malfunctions and keeps the team prepared for real emergencies.

6. Establish Clear Response Protocols
When an alert is triggered, rapid response is crucial, and I would suggest that clear response protocols are a guiding principle of any workplace violence prevention plan. Collaborate with security personnel and other staff to develop clear protocols for responding to duress alerts. Assign roles, establish communication channels, and ensure all responders know how to access real-time location information. Regularly review and update these protocols based on test results and any incidents that occur.

7. Select a System with Instant Notifications
A robust staff duress system should send instant alerts and notifications to relevant personnel, such as security teams, supervisors, or emergency responders. I recommend that clients ensure that a duress system can deliver notifications in real-time, providing both the staff member’s precise location and any other relevant details about the incident.

8. Collaborate with Behavioral Health Experts
Behavioral healthcare presents unique challenges due to the complexity of patient behavior. Work with behavioral health professionals to understand the specific needs of your facility and staff, tailoring the duress system accordingly. This collaboration ensures that the system is adapted to the nuances of the environment, such as areas with particularly high levels of patient-staff interaction.

9. Monitor and Evaluate System Performance
Continuously monitor the effectiveness of the duress system after implementation. Gather feedback from staff on ease of use, responsiveness, and any areas for improvement. Additionally, I advise our clients to evaluate the system's performance using concrete data gathered within a centralized response center, identifying any potential adjustments that could improve future response times or functionality.

Conclusion

Choosing the right staff duress solution for your behavioral healthcare facility is a vital step towards protecting your workforce and ensuring a safe, secure environment for both staff and patients. With this in mind, I regularly advise our clients on how precise location tracking, instant notifications, and discreet activation, can bring comprehensive coverage and peace of mind to your facility.

To learn more about how ROAR can help you implement an effective duress system, contact the team today to discuss your facility's specific needs. Alternatively, request a demo today.

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