Psychiatric staff at one of New York City’s public hospitals are growing increasingly alarmed about high numbers of workplace injuries amid what they describe as an overall atmosphere of combativeness and violence that has only worsened since the pandemic began. Many of these injuries have been debilitating for staff, who say patient safety is also at risk.

Documents obtained by Gothamist and interviews with nine current and former employees at Harlem’s Metropolitan Hospital show that workplace injuries have caused employees to miss thousands of work days over the past four years and have led many psychiatric staff to leave altogether. The medical center is run by NYC Health + Hospitals, whose facilities treat a large share of the city’s psychiatric patients.

The employees, including nurses and support staff such as behavioral health associates, describe the psychiatric department at Metropolitan as an often understaffed, volatile environment that lacks the resources to accommodate the range of acute needs patients have and offers little in the way of therapeutic care. Some NYC Health + Hospitals staff say they are now afraid to speak out about workplace violence themselves because they believe a union representative was fired for repeatedly flagging workers’ concerns.

“When you don't have the support that you need and then you run into another crisis, it's always in the back of your head, like, ‘I don't want to get hurt again,’” said Humberto Garcia, a former inpatient psychiatric nurse at Metropolitan Hospital.

On the day Garcia was injured last July, he said he first noticed one of his patients getting increasingly agitated around lunchtime. At first, he said the patient was complaining about the food and the staff not paying attention to him before repeatedly demanding to be discharged. The patient finally got so frustrated that he started throwing chairs and food, according to Garcia. An altercation ensued while staff tried to subdue the patient with medication. Garcia ended up with a black eye, and an injured shoulder that forced him off work for a month, according to a doctor’s evaluation reviewed by Gothamist.

Most of the employees who spoke to Gothamist said they had been injured multiple times during violent incidents, which are reported to the New York State Department of Labor along with other workplace injuries.

In response to Gothamist’s findings, Stephanie Buhle, a spokesperson for NYC Health + Hospitals, said, “We know that there has been an increase in violence nationally since the start of the pandemic, coupled with an increased need for emergency behavioral health care.” She added that the health system is aware of safety concerns at Metropolitan and already working to address them.

The troubles in Metropolitan’s psych department got worse over the past couple of years, state Labor Department records show. There were at least 21 violent incidents involving behavioral health patients in 2018, keeping employees out of work for 866 days overall. This figure remained somewhat steady in 2019 with at least another 21 incidents resulting in 826 missed work days. That’s about 40 missed work days per incident, on average, over those years.

By 2020, the number of workdays missed per incident shot up 68% — with at least 36 violent incidents resulting in 2,375 days out of work. A year later, staff working with Metropolitan’s behavioral health patients missed at least 2,840 days of work due to 27 incidents of violence — or 100 days per episode.

These include injuries incurred while breaking up a fight, while restraining a patient, or from a patient attacking an employee. Such incidents accounted for more than half of all the days staff were out due to workplace injury at the hospital that year.

Morning Edition host Michael Hill speaks with WNYC health reporter Caroline Lewis about her investigation into the hospital.

Click listen in the player to hear their conversation, and visit Gothamist for more details on the story.