In fining mental-health provider, OSHA sends a strong message

EDITORIAL | Globe Editorial

August 12, 2011

Stephanie Moulton was a residential counselor at a Revere group home. (Wendy Maeda/Globe Staff )

ON THE day in January when 25-year-old mental-health case worker Stephanie Moulton was murdered at a group home in Revere, she was working alone with a patient who had a violent criminal record. That in itself justified the $7,000 federal fine levied against her employer last month for labor violations. The fine, the maximum available, sends an important message that mental-health facilities are no different from other employers in their duty to protect against obvious hazards.

Moulton’s murder - and the killing a week later of a Lowell homeless shelter worker, Jose Roldan, allegedly by a mentally ill man with a long history of violence - have underscored the inadequate safeguards for social workers in Massachusetts. The state’s mental-health system relies heavily on privately run homes like the facility where Moulton worked, which are often both understaffed and reluctant to turn away patients.

In announcing the fine, the government made a series of common-sense recommendations for these providers, some of which also appeared in a June report by a state panel convened after Moulton’s murder. Facilities that treat patients with violent histories should install panic buttons and other devices, and implement a buddy system for employees. Both the Occupational Safety and Health Administration and the state panel also urged mental-health facilities to collect more information about patients with criminal records; Moulton’s employer, North Suffolk Mental Health Association, did not conduct criminal background checks.

The organization, which has been sued by Moulton’s family, seemed to bristle at the recommendations. “We are concerned that the OSHA citation and recommendations reflect an intrusive approach to community mental-health care,’’ the organization said in a statement. But if there is anything that has become clear after Moulton’s death, it’s that the regulation of mental health care providers has not been intrusive enough.

Some providers have fought especially hard against suggestions that they make use of criminal records, fearing that subjecting patients to the checks would only contribute to the stigma surrounding mental illness. But past violence shows a capacity for future violence, and it’s information that workers and homes simply need to know. Whether sharing such data furthers a stigma has to be a secondary consideration; the safety of workers like Stephanie Moulton has to come first.