When registered nurse Stephanie Ambrose was attacked by a female patient at McFarland Mental Health Center in February 2021, short staffing in other parts of the building delayed workers from coming to her aid, she says.
"The patient jumped on top of me, and she grabbed me and slammed my head into the floor 10 times," Ambrose told Illinois Times. "I ended up with a concussion, as well as neck and back injuries, and I needed to take a month off before returning to work."
Chronic understaffing, which has reached record levels at the state-operated psychiatric hospital, prompted Ambrose and other unionized McFarland employees to hold an informational picket for two hours Nov. 16 outside the facility at 901 Southwind Drive in Springfield.
Members of the Illinois Nurses Association and American Federation of State, County and Municipal Employees Council 31 said they want the Illinois Department of Human Services to be more attentive and aggressive to resolve a longstanding staffing problem that has gotten worse during the COVID-19 pandemic.
"People in the administration have gotten used to working with skeleton crews," said Gene Mitchell, an AFSCME official who represents most McFarland employees, other than registered nurses. "We are at a critical mass where we are very concerned about providing quality care for patients. We need the state to do its job and hire people and retain people."
Ambrose, a Springfield resident and INA member who helped to coordinate the picketing, joined AFSCME officials in saying McFarland's staffing is 20% below what is provided for in the state budget.
The situation puts staff members at risk of being physically harmed by the facility's mentally ill patients, and it puts patients at risk of being assaulted by other patients, workers said.
"Something has to happen. We can't go on like this," said Ambrose, 47, who has worked at McFarland 11 years and been assaulted by patients twice during her tenure. "Nobody should be anybody's punching bag."
Staff members are exhausted working both mandatory and voluntary overtime to fill in gaps – often 40 to 120 hours of overtime per month per worker – and they are facing burnout, Mitchell said.
DHS spokeswoman Marisa Kolias said in a written statement in response to union members' complaints: "IDHS is deeply committed to safe, healthy work environments for staff and quality care for patients. Working closely with the Department of Central Management Services, we have taken many measures to retain, recruit and hire a strong workforce during a nationwide staffing shortage. We will continue working closely with our labor partners and are committed to ensuring appropriate staffing."
DHS did agree to one of the workers' demands after the picketing – a jobs fair scheduled Dec. 7, according to Ambrose. But other demands remain, including continuous postings online at work.illinois.gov for open positions at McFarland, she said.
Mitchell said the staff shortage is a problem throughout state government and especially at 24-hour facilities.
A total of 98 positions for AFSCME-represented mental-health technicians and security therapist aides are budgeted for McFarland, but there are 22 vacancies, AFSCME spokesman Anders Lindall said. The technicians can earn between $35,000 and $53,000 per year, while the therapy aides can make between $47,000 and $67,000 annually, not counting overtime, and fringe benefits include the state's pension program and health insurance.
The state tells AFSCME that no one is applying for the openings, but openings often aren't posted online, Mitchell said.
He also faulted the state for an overly bureaucratic hiring process that can take up to nine months to complete. Many applicants get jobs elsewhere while waiting, and so the openings remain unfilled, he said.
Mitchell said workers want Gov. JB Pritzker, whose administration controls DHS, to make good on promises he made before the Nov. 8 election to address staffing shortages.
The democratic governor said Nov. 14 in a news release that five-year budget forecasts show Illinois in "its best fiscal shape in decades." But Mitchell said that situation is partly the result of sacrifices made by state workers in "blood, sweat and tears" as they watch state officials "dragging their feet on hiring staff."
Ambrose said 61 registered nurse positions are budgeted for McFarland, and there are 11 openings – the highest number since she began working there. Nurses at the facility earn between $71,124 and $96,708 per year, not including overtime.
Shalik Rhynes, 47, a therapy aide who has worked at McFarland almost 10 years, said morale is down because patients aren't getting the care they need and workers are missing family events because of required overtime.
"No one wants to fix the problem," he said. "None of the higher-ups are doing anything. They go home at 4 p.m., so they don't care. They just sweep it under the rug."
Ambrose said she, like other workers, has had to scramble on short notice to arrange for rides for her three children and arrange for childcare to deal with short staffing.
"I just don't feel that I have the work-life balance I need to have," she said. "I don't want to feel like I'm neglecting my family to work all the time. A lot of the staff feels the same way."
Ambrose said nurses have told management they want the option of working 12-and-a-half-hour shifts, rather than the current seven-and-a-half-hour shifts, so they can have more days off.
McFarland routinely cares for about 125 patients at a time, even though its capacity is 140 patients, because there aren't enough doctors on staff to expand the number of slots, she said.
The limited number of slots related to understaffing is contributing to the problem of mentally ill defendants sitting in county jails around the state after they have been ruled unfit for trial while they wait for a bed in a DHS facility to restore their fitness.
Sangamon County Sheriff Jack Campbell and sheriffs from Macon, McLain, Madison, Knox and Rock Island have sued Gov. JB Pritzker, whose administration controls DHS, and DHS Secretary Grace Hou because of the months-long delays.
The sheriffs contend that state law requires defendants to be admitted to DHS facilities within about 20 days of being notified of a judge's finding of unfitness. The state has asked the Illinois Appellate Court to decide the case, originally filed in Sangamon County Circuit Court.
Pritzker and Hou have been found in contempt of court twice for failing to transfer two Sangamon County defendants to DHS facilities on a timely basis.
The first finding of contempt later was overturned over the objection of State's Attorney Dan Wright. The most recent contempt finding came Nov. 17 from Circuit Judge Adam Giganti in the case of Breawna Miller, 33, of Auburn, who was found unfit Sept. 8 and remained in the Sangamon County Jail as of Nov. 21.
Miller faces charges of domestic battery and methamphetamine possession.