Healthcare Security: When a Disabled Person is Involved in an Incident

When a security incident includes a person with disabilities, things can get complicated. Imagine you’re a security officer responding to a report of a combative individual. You don’t know when you get the call, but the person is both nonverbal and autistic. How do you respond correctly to this call? How can you identify the person as disabled? 

You can’t allow the person to continue being combative, but using force may not be the right decision. What do you do? 

Responding to people with disabilities has always been tricky. It’s a well-documented dilemma when it comes to law enforcement; studies find that between one third and one half of use-of-force incidents involve a disabled civilian. If police, who often have access to more training and resources than security officers, have trouble responding to disability, how should private security prepare its officers for an incident involving a disabled person? 

How can security officers respond to a disabled perpetrator? 

There are several types of disability, including: 

• Mental illness
• Addiction
• Physical disability
• Intellectual disability
• Chronic illness

Some of these disabilities are apparent, but others may not be visible. Security officers have to observe the individual closely to better understand how to respond. 

De-escalation

De-escalation, decreasing the possibility or intensity of a potential violent encounter, should be the end goal of most security responses. It’s even more important to de-escalate a confrontation with a person who is disabled; they may not respond the way you are expecting, for example, or they may be particularly vulnerable to escalation. 

There are many strategies for de-escalation: 

• Stay calm: Remaining calm is a key strategy for defusing a situation. There is no benefit to adding your own heightened emotions to an already tense situation.
• Assess the situation: Don’t just rush in. Observe the individual. In the case of a nonverbal autistic person, are they rocking or fidgeting to self-soothe? If that’s the case, they are already attempting to deescalate themselves. 
• Change the setting: If possible, remove the person from the area to minimize conflict. This may help calm the individual. 
• Listen with empathy: Present genuine concern, ask questions if possible, and demonstrate that you are taking the situation seriously.
• Respect personal space: Unless it can’t be avoided, do not put your hands on the individual. Touching them is often the worst strategy. It creates a vicious circle; they get more upset, you have to use more and more force, and someone may eventually get injured. 
• Get help: Contact a caseworker, family member, or healthcare worker with the skills to respond to the situation. Don’t try to handle everything yourself.

These are just some basic strategies. It’s important to make sure that security personnel receive training in de-escalation to prevent incidents from worsening. 

Disabilities and healthcare security

While security personnel in many industries are likely to respond to incidents involving disabilities, such incidents occur disproportionately in the healthcare field. The healthcare industry has some of the highest workplace violence on record, because the sector works with a vulnerable and at risk population. 

Disabled patients may become angry or frustrated, patients may be in crisis, and patients with mental illnesses may become combative.

While medical experts are on hand to help de-escalate patients, there are special concerns for security officers working in healthcare. For example, healthcare is a highly regulated field. When writing an incident report about your response to a combative person with disabilities, you must be careful of what you disclose, or risk violating HIPAA (The Healthcare Insurance Portability and Accountability Act)

It’s critical for security officers working in healthcare to be trained so that they are able to respond appropriately, and keep everyone — including possible perpetrators — safe. 

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