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WorkSafeBC doesn’t rank occupations according to risk, but when it comes to workers being assaulted health-care workers are at the top of the list in BC.

Data provided to iNFOnews.ca by Interior Health shows home support is by far the riskiest part of healthcare.

“There’s this sort of historical acceptance that a certain amount of verbal abuse or getting slapped or being pushed away has been traditionally seen as just part of the work,” BCGEU president Stephanie Smith told iNFOnews.ca. “But now, I believe, workers are understanding it isn’t part of their job being hit, being spat at, being verbally insulted, having things thrown at you. It is not OK.”

Smith's union represents thousands of home support workers in the province.

From 2013 to 2022, WorkSafeBC recorded 13,899 cases of violence in the workplace being directed at health-care and social services workers.

Number two on that list was education with 2,638 files.

There about half as many education workers in BC compared to health-care and social services workers but five times the number of health-care worker claims accepted by WorkSafeBC.

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Interior Health broke down the data in more detail for the region.

It showed that from 2018 through 2022 for every 100 full-time equivalent home support positions there were 37.2 reports of assault (physical, verbal or psychological). Because most of these workers are part time, 100 full-time equivalent positions could mean hundreds of people.

The next highest area was for those working in mental health and substance use services at 12.6 cases followed by long term care at 11.4 incidents.

“Home support is unique in the sense that these are workers are going into individuals’ homes,” Smith said. “In institutional care settings, like a hospital or a clinic, there are different levels of control. When you’re going into someone’s home, it’s not controlled in the same way. There’s no on site security. Often times there may be family members that are also in the home, other people, visitors, that sort of thing.”

Workers are trained on ways to avoid conflict and build empathy. They're encouraged to document issues so when the next worker goes to that home they have some idea of what to expect and what might trigger an adverse response.

“Sometimes because of staffing levels our members have to expedite the services they’re providing.” Smith said. “They have to rush because there’s just not enough workers to meet all the demands and so, perhaps, a client wants something additionally done and our member has to say no just because of time constraints.

"That can create, obviously, aggravation on the part of the client and of course it ranges from that sort of verbal abuse right up to physical where they may get slapped or hit. I’ve anecdotally heard of people having things thrown at them.”

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During the five-year period the Interior Health data covered about twice as many incidents were physical as opposed to verbal or psychological.

“When personal services are being provided, whether it’s bathing or changing of medical equipment, that brings our members up into close proximity, there can be times when a client just takes out their aggravation or frustration or, because of dementia or other mental health challenges, they don’t always see our members as being helpful,” Smith said. “They take that frustration and aggravation out. There isn’t on site security. These workers are working alone more often as not.”

The level of violence is much lower in acute care settings at 3.5 reports per 100 full-time equivalents. Community care and public health have rates of 1.9 each. Assisted living and corporate reports of violence were close to zero.

One positive change for home support workers happened before COVID when all such workers were brought under the control of provincial health authorities, Smith said.

“Previously it was provided by third party agencies and there wasn’t the same oversight or responsiveness of the employers when we raised concerns,” she said. “Now that they are back under the health authorities it’s a much more cohesive system and we’re able to work much more proactively with the individual health authorities.”

It's up to the employer to provide safe work sites, Smith said, but it’s also important that workers report problems so they can be addressed.

“I come from community social service. That’s a sector that works with adults with developmental disabilities or children and youth in crisis," she said.

"I would say just from my own personal experiences and the conversations I have with members in these sectors there is that bit of an attitude that: ‘Well, you know, they spat in my direction or I got called really horrific names on this visit but that’s just because so and so is struggling with this particular disability or mental health challenge.’

"Our point is you cannot manage what you cannot measure. This is not a part of the job. We need the reporting to help mitigate some that.”

She also stressed there’s a cumulative impact of the attacks so more has to be done to support the mental health and psychological well being of workers.

“You can mitigate risk and put in place all the best safety measures but you’re never going to have zero risk.”

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