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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5030
Experience:  Dr. Mark is a PhD in psychology in private practice
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I work with a 56 year old man that has a diagnosis of mental

Customer Question

Sexual abuse towards staff that work in MRDD field. I work with a 56 year old man that has a diagnosis of mental retardation, bipolar, and intermittent explosive disorder. He was sodomized when he was around 19-20 for a couple of years by another teenager. The abuser went to prison for the abuse. My question is now he is acting out sexually with his staff by telling them he's going to "f**k them is the a*s", etc. he has started physically touching them by grabbing at their genitals when they walk by him or trying to put his hands down the back of their pants, swiping the crack of their butt through their pants, etc. I don't know what to do. The staff are frustrated and ready to quit. He is very smart and knows that it's wrong to act this way but I don't know how to get him to stop. He may be sexually frustrated, is there something that can be bought to help? or what can we do?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 2 years ago.

Hi! I believe I can be of help with this issue.

First, let me say I can imagine how confusing and frustrating this situation must be for you. That you are making these efforts on his behalf is really a very wonderful thing and I appreciate very much that you are in our field. You are clearly one of the reasons this is a good field to be part of. I thank you for that.

And this is actually the key to my answer to you that you need to consider and think about. That you are a good person makes the alternatives you most likely have to choose between very difficult. Because they are unpleasant.

I think the psychiatrists and psychologists in charge are going to have to authorize some of this and I encourage you to not feel that the staff has failed when you bring up what will have to be done.

You need to deal with this on two fronts: protecting your staff is your first priority. Second is behavior modification for the patient. Therefore, you need to have the docs in charge order restraints for him or have him relocated to a higher security facility. This will not be pleasant for him either way. I mean having his hands in restraints, tied to his sides. This will work best with a psychologist in place to use it as part of the behavior modification work. But it is first and foremost to protect your staff.

If the docs in charge are worried about restraints being unethical, then you need to ask for the patient to be transferred to a ward or facility where the staff is trained to deal with "violent" patients. Because that is what he is. You need to orient your own thinking this way. Your staff is right to want to quit. This is violence being perpetrated on them. They do not deserve this. You need to orient your thinking in this way so that you can effectively communicate this to the docs in charge. Okay?

So this is what you are facing: #1 is supporting your staff: either restraints or transfer to a higher security facility. #2 is behavior modification. Restraints are good for this IF there is a psychologist available to work with the patient in conjunction with the restraints.

Again, thank you for being part of our field. I wish you the very best!

Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark

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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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