Content warning: This story contains descriptions of workplace violence and its lasting impacts, including physical injury and trauma. The victim’s real name has been withheld for safety and privacy reasons. Her violent assault on a high-security forensic mental health unit is fueling renewed calls to strengthen Ontario’s violence prevention and training requirements.

Carly doesn’t remember most of what happened the day she was attacked at a high-security forensic mental health unit in Penetanguishene, Ontario.

The concussion she sustained took big chunks of time with it. But the moment right before it all went dark will forever be branded into her memory.

It was the kind of ordinary stretch in a shift that never makes the news. Lunch was being called. Patients were gathering in the common television area on the ward. Two patients were sprawled across the couches, leaving others with nowhere to sit. Carly, a patient care assistant, did what staff have done countless times: she asked the patients to sit up so the space could be shared with others.

One patient listened. The other looked at her and delivered a bone-chilling threat: “You’re gonna get your f------ face punched in.”

Carly didn’t immediately trust what she’d heard. She asked him to clarify his comment. He did.

She responded the way health care workers are taught to respond—steady voice, no escalation. She told him she was sorry he felt that way and suggested he return to his room if he was having those thoughts.

Most of what happened next is a blur. Carly doesn’t remember the assault unfolding—she only understood the sequence later, after watching surveillance video.

What the video showed: First she was sitting, then she was punched in the face and dropped to the floor. When she was on the floor, she was kicked in the head multiple times.

Things she does remember?

• The way the patient allegedly laughed as she cried.
• Coworkers piling in, trying to pull the patient off of her.
• Being dragged away by a colleague who was also injured during the rescue (in total, three workers were injured during the incident).

And she remembers the way it ended: not because staff overpowered the patient, but because he decided he was done. Once Carly was out of reach, the patient calmly walked back to his room like nothing had happened.

Carly was rushed to hospital where she was diagnosed with a concussion and a laceration under her eyebrow. Since then, she’s been in therapy weekly or biweekly. She returned to hospital when bruised ribs made breathing difficult. The severe headaches persist. So do the memory gaps. And long after the shift ended, the attack continues to haunt her.

“I’m never going to be the same,” Carly says.

She worries about her long-term safety if her attacker is released from custody. She also worries about the long-term effects of the attack on her physical wellbeing.

“The WSIB has declared my concussion healed,” she says. “(But I think about these) memory issues that I'm having. Maybe I'm going to be an Alzheimer's patient in 20 years. That's just something that sits in the back of my head.”

The patient has since been convicted and sentenced to five years in connection with the assaults. Review board records found he remained a significant threat to public safety.

$130,000 fine

Ultimately, the employer was fined $130,000 in the wake of the attack, plus a 25 per cent victim fine surcharge. The employer pleaded guilty to failing to provide proper information, instruction, and supervision to protect a worker’s health and safety, contrary to section 25(2)(a) of Ontario’s Occupational Health and Safety Act (OHSA).

The Ministry of Labour, Immigration, Training and Skills Development investigation found a crisis prevention plan was not up to date, staff were not given proper directions on how to use it, and staff had not received adequate training on how to respond to violence from a seated position.

Those are the public facts. But they don’t capture what Carly’s story makes impossible to ignore:

• how fast a spoken threat can become life-altering violence
• how lack of specific training standards and other safeguards leave workers vulnerable
• how the injuries you can’t see can last long after the visible ones fade.

What the training gap looked like on the ground

When it comes to training, Kurt Hehl, Vice President of OPSEU/SEFPO Local 329, says workers at the mental health unit receive a mix of onboarding elements: a theoretical component and a single-day, hands-on training component on hospital-approved Nonviolent Crisis Intervention (CPI) techniques.

Hehl describes CPI as a “one-size” system that’s been adapted over time but says it was not created for the unique hazards of a high-security forensic mental health environment.

“In [Carly’s] case… it’s not unique that people would be in a seated position and then be attacked while they’re in an observation area or in a common area,” he says. “This (type of incident) has happened for many years—but not to the extent to which (she) was harmed.”

Hehl says the critical incident is what finally triggered the employer to offer training specifically on how to respond to a violent attack from a seated position. The union questions why it took a life-altering assault for this kind of training to become available.

Why training standards matter

Carly’s story, however, also underscores a deeper gap. Sania Wadalia, Health and Safety Officer with OPSEU/SEFPO’s Worker Safety Unit, says the problem is bigger than a single incident or a single employer—and that workers pay the price when “training” becomes inconsistent, interpretive, or treated as optional until something goes wrong.

Under OHSA, employers have a general duty to provide “information, instruction and supervision to a worker to protect the health or safety of the worker” (S. 25 (2)(a)). Further, unlike other sector regulations under OHSA, under Ontario’s Health Care regulation (O. Reg 67/93) the employer is charged with providing “training and educational programs in health and safety measures and procedures for workers” and in the doing consulting with the joint health and safety committee or worker health and safety representative if any (S. 9 (4)).

This additional provision establishes a higher bar, as training has been defined by the Canadian Standards Association as a structured activity with measurable outcomes—knowledge, skills, and abilities learners can actually demonstrate. Just the same, without a more specific, mandatory training standard, employers are left without guidance, and workers are left vulnerable—especially in high-hazard situations.

This gap was identified by the Expert Advisory Panel on occupational health and safety in their 2010 report to the then-Ministry of Labour. They recommended the establishment of a Prevention Office within the Ministry and the creation of a training standard for Working at Heights (WAH) to be implemented within 12 months of their report. But they also recommended additional training standards meant to address all “high” hazards in construction and indeed all sectors. These standards were to be developed in consultation with stakeholders in each sector. Of course, in health care, workplace violence is widely recognized as a high-priority hazard.

Ontario’s training standard for Working at Heights, eventually launched in 2015, is widely regarded as a success, establishing Ontario as a Canadian leader in the field. Unfortunately, the work to develop other envisioned training standards has stalled.

Could better security have changed Carly's outcome?

Training is one piece of prevention. Another is what happens in the seconds after an incident begins, including whether help can reach a worker fast enough to limit harm.

Wadalia says security can be a meaningful control in high-risk settings, but only if it is properly resourced and able to respond quickly.

“It’s great to have security, but if they’re across the hospital… a matter of a few minutes can make a huge difference,” she says.

Hehl also points to specialized practices used in extreme situations, including planned room extractions—work that requires staff to be fitted for protective gear. He estimates only a portion of the workforce has been fitted. The takeaway, he says, is that prevention cannot depend on informal responses. It requires clear roles, consistent team protocols, and training that reflects the conditions workers are actually in—including situations where staff may be seated for one-to-one observation, in common areas, or during routine ward activity.

Wadalia also points to broader approaches unions have been pushing in health care, including better screening for weapons at entry points. To date, hospitals in Windsor and London have installed weapons detection systems at Emergency department entrances. While Lakeridge Health at their Oshawa and Ajax hospitals and the Peterborough Regional Hospitals have implemented pilot projects.

Lasting psychological impacts

Finally, Wadalia raises an issue that rarely gets attention: namely, the psychological impact of workplace violence.

“The psychological aspect around the harm that comes out of these violent incidences is lacking from health and safety legislation,” she says, noting that workers can be left carrying the fear, stress, and aftermath long after the physical injury is addressed.

Currently, the Workplace Safety and Insurance board accepts claims for stress (albeit with some limitations). Their data show acceptance of workplace stress claims has doubled in the last 10 years. But nowhere in OHSA are psychological harms, or the psychosocial hazards that cause them mentioned.
 
In Quebec, section 51(5) of the Act Respecting Occupational Health and Safety requires employers to take the necessary measures to protect the physical and mental well-being of workers by using methods and techniques intended for the identification, control and elimination of risk factors that threaten the safety or health of the worker.
 
Further afield, Australia has joined many other international jurisdictions also defining worker health as meaning physical and mental health. All five states have also legislated employer duties to assess the workplace for psychosocial hazards and implement control measures accordingly. In carrying out these duties the employer must consult worker health and safety representatives.

As a first step here in Ontario, some are calling for the definition of “occupational illness” in OSHA to at least include an acknowledgement of mental injuries.

Carly's future?

While stakeholders work for change, Carly’s future remains uncertain. There are still too many unanswered questions regarding her physical and mental health, she says. But when it comes to one question—whether she would ever feel safe returning to her workplace—she has perfect clarity. “No,” she says. “Absolutely not.”

Join Us on April 28!

Want to register your concern for worker physical and mental health issues? Be sure and attend a Day of Mourning event nearest to you. This year’s WHSC theme, “Ensuring Workers Survive AND Thrive” aligns with the 2026 theme of psychological health established by the International Labour Organization. As early as 1950 the ILO and World Health Organization adopted a comprehensive definition of the aim of occupational health that has stood the test of time: “The promotion and maintenance of physical, mental and social well-being of workers in all occupations.”

Need more information?
Contact a WHSC Training Services Representative in your area.
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