Mental Health First Aid: A Proactive Approach to Workplace Violence

Summary

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Advancing Health Podcast Summary

Episode Title: Mental Health First Aid: A Proactive Approach to Workplace Violence
Date: February 16, 2026
Host: Jordan Steiger, Director of Behavioral Health and Violence Prevention, AHA
Guest: Tom Richard, Senior Vice President & Chief Human Resources Officer, Hospital Sisters Health System (HSHS); Member, AHA's Hospitals Against Violence Advisory Group

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Episode Overview

This episode explores how Hospital Sisters Health System (HSHS) has adapted and implemented elements of the National Hospitals Against Violence initiative, prioritizing a safer environment for healthcare workers, patients, and families. Tom Richard discusses the system's proactive strategies—particularly around training, prevention, and post-incident support—and shares actionable insights for other health organizations.

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Key Discussion Points & Insights

1. HSHS and Tom Richard’s Role

• HSHS Background: Catholic healthcare system with 13 hospitals in Illinois and Wisconsin (01:19).
• Tom Richard’s Role: As CHRO, focuses on workforce experience and safety, recognizing workplace violence as a barrier to providing compassionate care (02:06).

2. Systemic vs. Individual Solutions to Workplace Violence

• Need for Systemic Change:
  • Recognized “individual solutions weren’t enough” and committed to comprehensive, systemic approaches about 18 months ago (03:38).
  • Assembled a leadership team to address this as an organization-wide issue.

3. Prevention, Training, and the Trauma-Informed Approach

• Mental Health First Aid Training:

  • Made mandatory for all leaders; offered to all staff and external partners (05:17, 05:50).
  • Focuses on recognizing signs of trauma and providing immediate support, not long-term treatment.
  • “It’s not often that you get to offer a class or program and you have wait lists. We do.” (08:13, Tom Richard)

• Trauma-Informed Care:

  • Emphasizes recognizing both acute incidents and the underlying trauma individuals may bring into the workplace (05:17-05:50).
  • Encourages staff to pause and consider “what is going on here,” helping to de-escalate situations (07:22).
  • “Things can escalate very quickly...this adds another layer...that we think has been very beneficial for us.” (07:22, Tom Richard)

4. Post-Incident Support

• Healing Time Away:

  • Innovative policy allowing affected staff to take immediate, paid time off after an incident, outside of standard leave like vacation or bereavement (09:18-10:22).
  • “If you are slapped or punched... asking you to come right back to work probably isn’t the best care solution that we could deliver.” (09:41, Tom Richard)
  • Well-received, judiciously used, and helps with re-acclimation and showing respect for employees’ well-being.

• Additional Support Tools:

  • Care kits, toolkits for leaders, and check-ins to ensure ongoing support.

5. Data Collection, Reporting, and Using Insights

• Encouraging Reporting:

  • Emphasizes importance of incident reporting to drive systemic improvements, noting that increased reporting is a positive step (13:02).
  • Data used for action planning: “which units, at which time of day, which circumstance...for some reason, it's Thursdays...” (13:35, Tom Richard).
  • Insights inform staffing, resource deployment, and broader advocacy efforts.

• Monthly Cross-Disciplinary Meetings:

  • Regular review by security, quality, risk, and leadership teams to identify patterns and adapt interventions (13:55).
  • Data also shapes advocacy with lawmakers and law enforcement (14:45).

6. Organizational Culture and Policy Changes

• Widespread Buy-in:

  • Pandemic-era focus led to deep, system-wide engagement—multiple leadership meetings dedicated to these topics (15:42).
  • Deemed less a “program” and more “a way in which we work and that everyone’s involved in it.” (17:47, Tom Richard)

• Patient & Visitor Code of Conduct:

  • Updated and implemented by frontline colleagues, providing staff a concrete tool to address disruptive behaviors (16:24).
  • “It gave them a tool in the moment they could use to change behaviors as they’re occurring.” (16:27, Tom Richard)

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Notable Quotes & Memorable Moments

On Training and Culture:

• "It's not often that you get to offer a class or program and you have wait lists. We do...they're sharing with others."
  —Tom Richard, 08:13

• "Things can escalate very quickly. We, as do many other organizations, have de-escalation training... but this adds another layer."
  —Tom Richard, 07:22

On Healing Time Away:

• "If you are slapped or punched... asking you to come right back to work probably isn’t the best care solution that we could deliver... So if someone needs the afternoon or the evening... they can take advantage of that without having to take time off for their vacation or their holiday."
  —Tom Richard, 09:41–10:54

On Reporting and Data Use:

• "It's kind of hard to manage something that you don't understand how frequently they're occurring... The more that you ask for reporting, the more that you get. This is always a good thing. We'd rather know than not know."
  —Tom Richard, 13:02–14:18

On Organizational Commitment:

• "I'm most proud of the way that the entire organization has leaned into it...it's reinforced with regularity...we are focused on it for the long term."
  —Tom Richard, 15:42

• "It's less of a program and more of a way in which we work and that everyone's involved in it."
  —Tom Richard, 17:47

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Timestamps for Important Segments

• HSHS Background & Tom’s Role — 01:19–02:06
• Systemic Approach to Violence Prevention — 03:38
• Focus on Prevention & Trauma-Informed Training — 05:17–08:13
• Healing Time Away Policy — 09:18–10:54
• Incident Reporting & Data Use — 13:02–14:45
• Organizational Commitment & Code of Conduct — 15:42–16:27
• Final Reflections: From Program to Culture — 17:26–17:47

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Takeaways for Listeners

• HSHS’s model blends trauma-informed training (“mental health first aid”), strong post-incident supports (“healing time away”), and aggressive data-driven reporting/response to workplace violence.
• Their proactive, system-wide commitment transforms violence prevention from a checklist program into an embedded part of organizational culture.
• Practical tools—like updated codes of conduct and scheduled leadership check-ins—empower frontline staff and reinforce safety as a shared value.
• Continuous data review enables targeted systemic action, both internally and in advocacy.

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For deeper detail, see the case study companion referenced by the host.

Transcript

[A]

Welcome to Advancing Health. Today we hear about how One Health System has adapted elements of the National Hospitals Against Violence initiative to achieve a safer environment for both its workforce and for patients and families.

[B]

Welcome to Advancing Health. My name is Jordan Steiger and I'm the Director of Behavioral Health and Violence Prevention at the aha. I'm joined today by Tom Richard, the Senior Vice President and Chief Human Resources Officer at Hospital Sisters Health System, and he is a member of the AHA's hospitals against violence Advisory Group as of this year. So, Tom, welcome.

[C]

Thank you.

[B]

Tom and his organization have been really instrumental in advancing safety and preventing workplace violence across the entire system. He and his team have done some incredible work, especially over the last few years that the AHA has been privileged to kind of learn about and see grow. And we thought this was a great opportunity today to share this with our membership because I think there's a lot of really, really good lessons learned, especially around things about coordinating violence prevention efforts across an entire system, improving outcomes for the workforce, and then, of course, for patients and families. So, Tom, to get us started today, can you just tell us a little bit about Hospital Sisters Health System and your role in the organization?

[C]

Thank you, Jordan. Hospital Sisters Health System is a Catholic healthcare organization. We're based in Springfield, Illinois. We have three primary locations. One is on the Illinois side of St. Louis, one is in Greater central Illinois area. And then we also have hospitals and other care delivery settings in the Green Bay, Wisconsin area. We have 13 hospitals. And I am the Chief Human Resources Officer, HSHS.

[B]

Great. And I think coming at this problem of workplace violence from that Chief Human Resources Officer position really positions you well to make impact across the entire system. And a lot of times we see clinicians taking on that role. And I think, you know, having you especially come onto our advisory group as a chro is really, we're really excited about that.

[C]

I tell you, I. First of all, I'm very glad to be on the advisory group, but it's really interesting to see all the different roles and expertises that are involved in this really complex topic. And I think it speaks to the complexity of the issue at hand. As an HR professional for my career, we spend a great deal of time looking at what the experience of our employees and colleagues are and how we can optimize that. What we recognize as have many organizations, particularly healthcare organizations, violence at work is becoming too prevalent and it was really harming our people and harming their ability to do what they came to healthcare to do, which is to provide care for others. We see it part and parcel with the work that we do to try to create positive work environments for everyone who is working here. And so naturally in our organization fits into the HR space. But I can see where it fits into safety, security, nursing, other clinical areas just as easily, just happened to be one that really gained traction for us at hshs.

[B]

No, that makes a lot of sense. And I think you mentioned it takes that interdisciplinary approach to really make this work and to enhance safety. I know that you and your organization have been doing a ton of work over the last few years especially, and that's not to say you weren't doing this before, but you've really made huge strides on improving safety and kind of enhancing your programming around workplace violence. So tell us a little bit just about how you got started on this path and what was important to you as you were thinking about expanding some of your work.

[C]

What was important to us was individual safety at work. And then we recognized that coming up with kind of individual solutions wasn't going to solve the problem because it's so big and we're all feeling it okay? And so we recognize the need for kind of systemic solutions, for a dedicated effort to it. We had no shortage of individuals working very hard, teams working very, very hard in response to it, to these situations. But we recognize we need more than that as a leadership team. We're observing this, we're witnessing what was happening. We just recognized the need for a more comprehensive solution, which really happened about 18 months ago for us. It's really when we decided to get serious around what we're going to do, and that initiated a number of activities that have led us to where we are today.

[B]

So just to mention and build on what Tom was just talking about, we do have a case study coming out, the companion to this podcast, that is going to go into a lot more detail about some of the programs and approaches that Tom is discussing today. So if you're curious about anything he's mentioning, that's a really good place to start. But thank you for telling us a little bit more about kind of what your thinking was around that. One thing that has really stuck out to me, I think in all the work you've done, especially in the last 18 or so months, is your focus on prevention and training. So not just waiting for an event to happen, but really trying to empower your workforce to mitigate those events before they actually occur. What have you been doing to help your staff recognize signs of trauma, maybe identify behavioral health needs, things like that?

[C]

The instances of violence are occurring every day and they're easy to see. And we do respond to those. And those are what kind of gets the headlines in there. But what we've also recognized is that folks are living through trauma in other ways. And we need to spend the time to understand what it means to provide care in an environment where you may be someone who is in other violent environments or is carrying other trauma with them. We look at it on both lenses, both that acute and the instant moment, but also what someone may be bringing to work. We think around just some of the core elements of trauma informed care, but really recognizing and responding when we see these things occurring. How do we actually do that? It's easy to say we're big proponents here of a concept called mental health first aid. And actually, as we started this year, while we've had hundreds of leaders and colleagues take that certification, we have made that mandatory for all leaders within our ministry. We want our leadership team and we make available to all of our colleagues and our external colleague partners as well. We want them to be able to recognize when someone may be suffering. It could be work related, but I'll tell you, it's also home related and community related. And we want them to recognize that so they can help that person get to kind of on a healing path, whatever that might be for them. Certainly mental health first aid isn't around providing that long term treatment, but at least recognizing when there may be a situation that can be addressed by addressing it makes the colleague, it makes the work environment stronger is something that we want to give to all of our leaders so that as part of their role in managing others, they're looking out for their welfare.

[B]

I think that makes a lot of sense. And just like you said, that empowerment to understand that you are seeing someone on their worst day, at their worst time, and that doesn't excuse violence, but it certainly helps you understand where they're coming from, maybe a little bit more. And that leads to prevention. I think in some cases, at least.

[C]

I think it does. And you try to think through, not only is it around recognizing it in someone on your team, but maybe even recognize it on that family member who's coming in. It causes a different set of initial reactions there. And we think that's valuable that you have that. Even if it's just a momentary pause to think about what is going on here that's so preventative. Things can escalate very quickly. We, as do many other organizations, have de escalation training and things of those rights. But this adds another layer to that that we think has been very beneficial for us.

[B]

Absolutely. And I mean, mental health first aid is something that is out there in every community and I think a really smart approach for your system to take. It's accessible and it's evidence based and we know it works. So I think that's an awesome example to share with other members.

[C]

And I'll add to it, which is from an HR guy here. It's not often that you get to offer a class or program and you have wait lists. We do. And so we don't have to promote it. It's being filled every time that we offer it. Matter of fact, we were just going through what our schedule is for the rest of the first six months of the year and we're full. We're thrilled for that. But it's one of the few things where people are asking to sign up and when they walk out, they're sharing with others. So I encourage people to consider this as a great alternative and a great vehicle for this type of learning and for the support you may want to provide within your hospitals.

[B]

Absolutely. I think that's great advice to share. We know, though, that as much as we want to focus on prevention and everything, that there are still going to be incidents, unfortunately, that happen. But I think the way that you and your team have kind of put some supports in place for your staff after incidents of violence is pretty incredible. So I was wondering if you could share a little bit about some of the work you've done to really support your staff after they experience violence.

[C]

Yeah, I think the first and foremost thing that we have to do is to make sure that we're recognizing it when it happens. And so we put in a number of different processes and tools to make sure that it's initiating the next level of process, next level action that occurs there. Those are very exciting, what we're doing. I'll share those with you in just a moment now. But we need to make sure that that's getting entered into our systems and so that we can take action there. The thing that is kind of the most heartwarming of it all for us is recognizing that particularly when violence happens at work, we do not want to re traumatize that individual. And sometimes they need a little time away and makes sense if you are slapped or punched or something of that nature, ask you to come right back to work. Probably isn't the best care solution that we could deliver in the moment and certainly isn't respectful of the conditions that that colleague is facing. We instituted last Year a different classification of time off, healing time away. Much like many of you may have bereavement models or other these short term periods of time where folks can take time away we have funded and made available at this classification. So if someone needs the afternoon or the evening to reground themselves, or perhaps they need the next day off before they're ready to come back in there, they can take advantage of that without having to take time off for their vacation or their holiday or otherwise. I believe that we had an example right before the holidays that it would have been a choice between taking holiday time away with their family or coming back to work and not being ready to do so. This was a fantastic bridge for them. We had a concern that it might be overused and it really is. Not that it's been pretty judiciously used, but we've had a number. I'll say it's more than I can count on my 10 fingers of times of which we've used it. And it's been of great value to those individuals. It's a terrific thing that we've done for them and it really sets the stage better for their re acclimation to work and for them to recognize for colleagues to recognize that we do value and respect them. And knowing that this can be difficult now we do other things as well. I mean we have kind of care kits and toolkits for leaders on how to check in with others. Already mentioned the mental health first aid to see if there's any lingering topics related to that. Care for colleagues is super important and that's where we spend a lot of our time in the event these things occur and we're not naive to believe that they're not occurring.

[B]

I love this example and I'm so glad you brought it up. If you didn't, I was going to ask you about it because I think this is something that other systems can really emulate. Like you said, everyone has a bereavement policy. You know, others have maybe volunteer time away, things like that. You know, this is, I think putting something in place really sends such a strong message to your workforce that you respect them as professionals, you respect their mental health and their well being and you want them to be at their best so they can provide the best care to your patients too. I have not heard of other hospital systems doing this. They might be out there, but I think this is a really, really shareable model. I'm so excited that you brought it up so others can learn from it. You mentioned a few things like you're wanting to make sure that things are being reported and recorded as quickly as possible, like events. How are you using that data and reporting and maybe even enhancing the amount of reporting? Because we hear from members a lot that these events are kind of going unreported.

[C]

Yeah. It's kind of hard to manage something that you don't understand how frequently they're occurring. And we know they're occurring. We know that they're occurring twice a day. Okay. And we would not have known that otherwise. Now, this is the spectrum of different types of ways in which violence is lived. Okay. And so it's not always just the punch in the face. It could be other things as well. It could be harassment, bullying, lots of other different types of activities that really harm the individual. We do ask and we reinforce with our colleagues, with our leaders reported. We need to know. And it's given us some great insights into certain things like which units, at which type of day, which circumstance. For some reason, it's Thursdays, you know, what are these things that are happening which allow us then to do other things with that? Like, well, do we need to do different types of resource deployment? Are there certain conditions in place that are causing this to occur? How do we address those? We do meet monthly on this at a global level to say, what are we seeing and what should we do based on that? And that's with our security team, that's with our care delivery teams. Just different groups across organizations. We say, now that we know this, our quality teams, our risks teams, now that we know this, what should we do differently to try to prevent, to try to mitigate and try to address what is going to be going on in our buildings? The more that we found, as you do with many kind of quality events, the more that you ask for reporting, the more that you get. This is always a good thing. We'd rather know than not know. And so we follow that same path. As you'd see as many. I'm sure we have some quality folks in the phone where you want to get more of those so you can have good information to use to decide what do we need to do. And what we need to do could be some of those examples I just shared, but also bigger picture things like advocacy and speaking with lawmakers and otherwise, law enforcement officials. How can we make changes that can support the care delivery that we want to support in our buildings?

[B]

Absolutely. I'm glad you brought up thinking about partnerships and advocacy. I think that's such a key part of all of this. And you know, one hospital or hospital system can't fix this problem alone. But it sounds like you're using the information you have to really make some positive changes. It's interesting how you say, you know, Thursdays for some reason, I don't know why, but I mean, that's good that you know that and you can, you know, look at your work, you know, your staffing, and understand how you can keep people safer. So that's. That's awesome. As we're kind of winding down here, what is something that you're really proud of in all this work that you've done?

[C]

I'm most proud of the way that the entire organization has leaned into it. And we have monthly, all leadership meetings. Last calendar year, three of those meetings were dedicated to this topic. And usually there's two or three topics in those meetings. So it wasn't a one time. Here's an important initiative. Let's everyone get on board. It is reinforced with regularity. I'm proud of our whole organization for saying this is a real concern and we are focused on it for the long term. I'll say secondly, the work that was done by our colleagues to help to rework our patient visitor code of conduct was transformational for us. It gave them a tool in the moment that they could use to change behaviors as they're occurring. And so I'm really proud that we were able to do that and to see it when I round I go and look for that. Is it visible? Is it viewable? Do the staff know where to find that? Have they had conversations with folks when they need to use it? Inevitably, I do hear stories of it being used. So that's. That shows that it's less of someone from the HR team in a corporate office doing something to. It is a tool that is practiced and is having effect in there. So it's very satisfying to see that occurring and knowing that's contributing to kind of de escalating some of the issues that we're facing.

[B]

I mean, it sounds like your whole system and workforce has really embraced this idea of safety. And I mean, that sounds like it's really coming from you and your team and your leadership and going throughout the whole organization. So that's something I think to be extremely proud of.

[C]

We have work to do. Violence is at epidemic levels in our society, and that's unfortunate. So we have to remain vigilant in it. I would say that we've got it all right. We still continue to work on many different aspects of it, but we're proud to kind of turn the corner to say it's less of a program and more of a way in which we work and that everyone's involved in it.

[B]

I love that. That's exactly what we should all be aiming for. Tom, thank you so much for being here with us today. It was a joy to learn a little bit more about your work, and I'm sure our membership is going to feel the same.

[C]

Thank you, Jordan. Good luck to everyone.

[A]

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