Safety and Security Protocols at Montana State Hospital - FMHF Inspections

FMHF Health and Welfare Inspections Montana State Hospital Forensic Mental Health Facility 6/10/2025 1

Safety Principles MSH FMHF-21 Review Agenda: Patient Searches Contraband Identification and Control 2 6/10/2025

Safety Principles Staff knowledge of safety is of major importance to facility operations: Identify or spot potential problems Staff enforce rules, regulations and policies Direct care staff can more readily identify potential changes or improvements to the overall safety. All staff need to create and reinforce a climate that supports the safety of the facility 3 6/10/2025

Property, Facility, and Body Searches Policy: MSH FMHF-21 I. POLICY: The FMHF of MSH primarily serves individuals on forensic commitments, or persons transferred from state correctional facilities. A higher level of security will be maintained in this facility in order to provide appropriate safety for patients, employees, contractors, and the public, and to reduce the risk of unauthorized leave. 6/10/2025 4

Policy Definitions Contraband or having in their possession. This is an item that constitutes a safety or security concern, which can be denied or confiscated. These items pose a serious threat to the facility; are never approved for possession or admission to the facility; or present a health, fire or safety hazard. Items patients are prohibited from owning, purchasing by the Hospital Administrator or their designee. Please see Contraband and Searches policy SF-02 for additional information and lists of contraband items. Any exceptions to contraband items must be approved 6/10/2025 5

Policy Definitions Clothed Body Search Commonly referred to as a pat down . A patient is searched while wearing undergarments and only one layer of clothing from head to lower body by strategically patting down the collar and neck area down the front and back trunk, around the waist, and down each leg. Body Cavity For the purposes of body cavity searches, the body cavity is considered the vaginal or anal cavity. Body cavity searches require a Licensed Independent Practitioner s order. Body cavity searches will be completed in a private room by a physician with a nurse present. 6/10/2025 6

RESPONSIBILITIES: Forensic Mental Health Technicians ( FMHT s) Ensure safety and security in the FMHF by: 1. Monitoring safety and security of the FMHF. 2. Encouraging compliance with safety policies. 3. Implementing clothed body searches, room searches, pod searches, yard searches, and facility searches. 4. Limiting the type and amount of items in a patient s possession or room in accordance with FMHF policies and procedures. 6/10/2025 7

PROCEDURES Property Searches: 1. FMHT s or nurses will search all property a patient brings to the hospital upon admission. They may withhold any item identified as a potential threat to the safety and security of the unit. They may also withhold property that is considered in excess of that allowed each patient. The Treatment Team will review the withheld items and decide whether to return them to the patient, hold them until the patient discharges, send them to someone in the community, donate, or dispose of them. 6/10/2025 8

PROCEDURES FMHT s will monitor the type and amount of property in each patient s possession or room during routine and random searches. Random searches of patient s rooms will occur on day and afternoon shift. All patients rooms will be searched at a minimum one time a month. FMHT s will perform a clothed body search on each room occupant before beginning the room search and will document on one Room Search Sheet per patient in each room. The results of the room search will be reported to the nurse. Common areas such as pods, individual rooms, or yard searches may occur at any time that staff believe there may be a safety or security issue. No items may be stored on the floor. 6/10/2025 9

General advice on searches Do searches in a systematic manner/front to back Check areas that could offer concealment Review security devices for tampering or alteration Perform searches on a random and routine basis Communicate with staff and patient what is going on Never use a search as a means of patient harassment or punishment If contraband is found, continue the search until the entire area is covered. Patient Searches 10 6/10/2025

Security staff is responsible for clothed body searches, pod searches, yard searches, and facility searches. Pod searches will be assigned by security management on a random basis. Pod searches will be conducted continually throughout the shift. Post Orders (FMHF) Clothed Body Searches 1. 2. 3. 4. When pods are leaving the mess hall When leaving the recreation yard When leaving the gym or cardio lab When leaving or returning from a transport 5. When leaving contact visitation 11 6/10/2025

Types of body searches Pat down or frisk search - an external inspection of a fully clothed person Used primarily to control the movement of contraband within the facility Utilize your hands to feel for contraband Wear protective gloves Have patients remove items from pockets Patient has feet and arms extended Systematically cover all parts of the patient s body from top to waist to feet Key Points on Patient Searches 12 6/10/2025

Other types of searches Patient rooms or living quarters Key Common areas (day rooms, classrooms, dining areas) Points on Patient Searches Perimeters Visitors/Volunteers Staff General security inspections Recreation yards or gyms 13 6/10/2025

Contraband Control and Identification In simple terms contraband is any unauthorized article Any item that has been altered from its original form Contraband cannot be completely eliminated but it can be controlled 6/10/2025 14

Identification and control of contraband is critical to facility security What is contraband? Any item, article, etc. in the possession of patients that has not been: Issued to the patient by the facility Purchased through the commissary Purchased or allowed through approved channels Approved for issue by appropriate staff Authorized by policy, rule or procedure Key Points on Contraband Control and Identification 15 6/10/2025

Authorized items or articles that are in excessive quantities may also be considered as contraband. These are referred to as nuisance contraband which create security, safety, sanitation, or fire hazards Nuisance contraband is usually: Food Magazines and newspapers Books Clothes Photos, letters, artwork Key Points on Contraband Control and Identification 16 6/10/2025

Other types of contraband include Approved items that have been altered Items that a facility has forbidden a particular patient to have Any item that is being used for a purpose other than what is was intended Contraband control is critical to facility security Sign of power for patients/bulldogging Used as weapons Used for escape or disturbances Violation of facility rules and policies Key Points on Contraband Control and Identification 17 6/10/2025

Contraband sources are: Visitors Staff Fabrication or alteration of items found within the facility Received through the mail or property Canteen Other patients Key Points on Contraband Control and Identification 18 6/10/2025

Remember to be specific in your notes to justify your observations. When examining patients for injuries & weapons inspect the insides of their mouths, eyes, scalp, hands & navel. Make note of injuries of those involved .

For additional information or clarification on the topics discussed here, please take your concerns to FMHF supervisor or manager.