It Was a Rough Day - Spitting

April 18, 2016 was a rough day. I am a social worker in a psychiatric prison, and I was scheduled to do a group. The topic of the day was Progressive Muscle Relaxation.  One of the patients was so upset about being demoted from level 3 to level one, that he could not hold it together enough to stay in group, and walked out.  The reason his level was demoted was because he refused to meet with me when he first moved to my pod, and then, when he did agree to an interview, he was so upset about the topic (questions about his functioning), he walked out of the interview.  I took the time in group to try to explain to him he has to participate appropriately, but that did not work.

So, a second group member, who can usually barely hold it together, sat in group and repeatedly did the "Heil Hitler" salute. He was disrupting the group, and would not stop.  He spit at me once, and continued his behavior, so I dismissed him from group, and as he left group, he spit on me again.  He did not have much saliva, it hit my face and my glasses, and I just washed it off.  But there was disciplinary paperwork to do (he did this in front of a correctional sergeant no less.) My boss was called, and came to check on me.  That was comforting, but I just wanted to get back to the group.  I needed the Progressive Muscle Relaxation exercises for me. One of the group members applauded my return, and after doing the relaxation exercise, the group members made a varied selection of music, all of which was good.

This was not the first time I was spit on by a patient.  The first time was during treatment team. We were in a divided day room, with a metal grate between the treatment staff and the patient. The patient spit at the physician assistant who was providing services to him, and got me in collateral damage.  This was a patient with whom I had worked very had to establish a good rapport.  So, the next time I saw him, he apologized for spitting on me when he meant to spit on the PA.  This opened the door for a long discussion about the unintended consequences of negative behavior, and this patient took that to heart, and really did make some behavioral changes. 

The second time I was spit at by a patient was through a cell door. Like the patient on 4/18/16, this was a patient who has a lower level intellectual functioning patient, and who had been coaxed by his row mates to learn to spit through the door crack.  And, he spit at me. He missed. Amazingly, one of the patients who was instrumental in teaching this patient to spit through the door apologized, because they did not mean for this patient to spit at me. Again, we were able to have a discussion about unintended consequences.

Being spit at, in a prison setting, is considered an assault.  On 4/18/16, I felt assaulted. That is disconcerting. It is something that happens in prison, but still, it is disconcerting. There are no free world charges made, it was a "minor" assault. But the patient will have to deal with the consequences which are more restricted movement.  Will this help, I do not  know, but for the time being, I am in accordance with the restrictions because they will keep me safer than I was.