We recently shared the link to a Seattle Times investigation that found staff in medical settings have used spit hoods over the past decade to subdue or control psychiatric patients and risk psychological distress, suffocation, and even death in the process. The comments poured in. Many came from healthcare workers describing being bitten, kicked, and repeatedly spit on, insisting the tools they use are harmless and an “absolute necessity.” Others, including people with lived experience in psychiatric care, described those same practices as terrifying, misused, and sometimes part of abusive environments that were later shut down.

It would be easy to dismiss the thread as “just the internet.” But it shines a bright light on something much bigger: compassionate people who choose helping professions, working within systems so broken that they gradually normalize, and then defend, practices that cause trauma.

This isn’t just about psychiatric care. It is about educators restraining and secluding students. It is about staff in group homes, juvenile justice, residential treatment, emergency departments, and psychiatric units who believe in care, and yet find themselves strapping, isolating, masking, and sometimes holding down the very people they came to help.

If you’ve heard me speak before, you’ve probably heard me share one of my favorite quotes from Maya Angelou: “Do the best you can until you know better. Then when you know better, do better.” The challenge is that our systems rarely pause long enough to ask whether we actually know better, or to make it safe for those inside the system to admit that what they are doing is causing harm to them and those that they serve. Very often, it is the systems that are broken, not the dedicated professionals who want to make a positive difference.

Helpers in Broken Systems

Most people who enter nursing, teaching, counseling, or direct care do not wake up in the morning intending to harm anyone. They enter these fields because they care about children, families, and people in crisis. They choose demanding jobs, often with low pay, irregular hours, and high emotional load. Thy chooses these jobs because they want to make a positive difference in the world.

Yet the comment thread on this post gives example after example of what happens over time. Staff describe being punched, scratched, bitten, and spit on so often that they begin to see patients as “demons,” “brats,” or simply by their most dysregulated behaviors, rather than as human beings in distress. Many insisted certain practices are safe, even when investigations document deaths and injuries associated with those practices, especially when combined with the use of restraint, prone positions, or poor monitoring. Unfortunately, criticism of a practice is sometimes heard as a personal moral attack, leading to responses like “You have no idea what we go through,” “You’d never last in my job,” “This page is a slap in the face to the risks we already take.” I understand what it feels like to be attacked, especially when you are there to help.

We often see similar responses in discussions about seclusion and restraint in schools. Teachers and aides describe being overwhelmed and unsupported, feeling blamed for behaviors they did not create and cannot control, and fearing for their own safety. Under those conditions, it becomes easier to see a child primarily as a “biter,” a “runner,” or a “violent kid,” and to view restraint or seclusion as inevitable, sometimes as the only thing standing between staff and serious injury. This is hard.

When people are already carrying an incredibly high level of stress and experiencing trauma and injuries while trying to do their jobs, any suggestion that a familiar practice is harmful can feel like an attack. They likely feel they are doing their best in a difficult environment. They may defend the practices as necessary, sometimes fiercely.

Moral Injury, not Moral Failure

It is tempting to frame this as individual failure: “Those nurses are cruel,” “Those teachers don’t care.” While there are always exceptions, this is generally not the case. The reality is more complicated and, in many ways, more troubling.

Staff in hospitals, schools, and residential settings are often working in chronically understaffed environments and are asked to manage more individuals than is safe. They may receive minimal training in de‑escalation, trauma, neurodiversity, or alternatives to restraint, yet be held responsible for safety and behavior without the real authority to change the conditions that drive crises. When something goes wrong, leadership and the public frequently look for someone to blame. The blame often falls on the individual, not the system.

This is the recipe for moral injury, the pain of being part of, or witnessing, actions that conflict with one’s own deeply held values. Over time, that pain has to go somewhere. Often, it is redirected outward as anger at “noncompliant” patients or “out‑of‑control” students, at parents, and at anyone who questions the tools staff have been told are necessary. Defensiveness in the comment thread is not just evidence of the pain; it is evidence of a system that has placed good, caring people in impossible positions for too long. The anger is real. So is the trauma. But neither justifies ignoring the trauma of the people on the other side of the door, the mask, or the restraint.

A Difficult Narrative Story

Another pattern emerges clearly: staff describing themselves as the primary, and sometimes only, victims. In the recent thread, many ask, “So I’m supposed to let them spit on me?” Some say that if they are spit on, the person responsible might “meet their maker,” or suggest that mechanical devices are what keep them from physically retaliating against a patient. Educators echo similar themes when they say, “What about teacher safety?” or “What about my right to go home uninjured?” These are legitimate concerns. Safety matters. No one wants to see a teacher or medical staff member hurt while doing their job.

The trouble begins when the victim story becomes the only story. The person in crisis is reduced to their most dysregulated behavior. Their fear, history, disability, and trauma fall out of the frame. The harm caused by restraint, seclusion, and mechanical devices is minimized, denied, or reframed as “necessary consequences.” Systemic problems, understaffing, lack of training, unsafe environments, inequitable funding, and a lack of accountability fade into the background. The “problem” becomes the behavior of the patient or student, not the structure or broken system around them.

This narrative can protect individuals from feeling shame, but it also leaves them stuck. If the story is “there is nothing else we can do,” then there is no meaningful pressure on systems to change. Maya Angelou’s invitation is different. It assumes we are doing the best we can with what we know and that we are capable of growth. It recognizes our humanity without making it the center of the story. It encourages us to lean into curiosity and ask, how can we improve outcomes for students or patients while at the same time improving outcomes for the professionals supporting them.

Staff, Students, and Patients Deserve Better

The core truth we must hold is simple: staff deserve to be safe from assault, infection, and the trauma of working with people in crisis, and people in crisis deserve care and support that does not rely on fear, coercion, compliance, or practices that routinely cause trauma, injuries, and sometimes death. These are not competing values. When systems invest in trauma‑informed, neuroscience-aligned, neurodiversity‑affirming approaches, safety can be prioritized for everyone.

That kind of investment looks like adequate staffing so that teachers, nurses, and aides are not asked to do the impossible without appropriate support and strategies. It looks like robust training in de‑escalation, co‑regulation, sensory needs, and an understanding of behavior based on our neurobiology. It looks like environmental changes: quieter spaces, predictable routines, options for movement and sensory regulation, and crisis plans developed with the person and their family. It looks like clear limits on restraint, seclusion, and mechanical devices, including independent review of every incident and real accountability when policies are violated. And it looks like emotional and clinical support for staff who have been injured or traumatized, so they do not have to armor themselves with dehumanization to cope.

For educators and healthcare workers reading this, the goal is not to blame you for doing what your system has told you is the only option. The goal is to say: you should not have been put in that position in the first place, and together, we can and should demand better.

Bridging the Gap

So how do we move from anger and defensiveness to curiosity and change?

You should not have to choose between your own safety and someone else’s humanity. If you feel defensive, that may be a sign of how deeply you care and how much you have already given. The question is not whether you are a good nurse, teacher, or direct support professional; the question is what support and changes you would need so that your daily work could reflect the reasons you chose this field in the first place.

Two things can be true at the same time. We can name the harm and the hurt. We can say out loud that being hit, kicked, or spit on at work is traumatic, and that being restrained, secluded, covered, or held while in crisis is also traumatic. One does not cancel out the other. We can shift blame upward, framing concern not as “you are abusive” but as “the tools and policies you have been handed are causing harm; let’s work together to change them.”

We must create spaces for honest reflection, where staff can safely say, “I did what I was told to do, but it does not feel right to me,” without fear of consequences, and where people with lived experience can share their stories without being dismissed as exaggerating or lying. We can use Angelou’s words as a compassionate challenge: if we now know more about the risks of certain practices, what would “doing better” look like in your setting, and what support would you need to make that possible?

Most of all, we can center dignity. Whether we are talking about a child in a classroom, a teenager in a residential facility, or an adult in a psychiatric unit, the question should never be only “how do we stop this behavior?” It should be “how do we respect everyone’s safety and well-being while preserving this person’s humanity?”

The reactions to this social media post are not an anomaly. They are a mirror. They show us good people trying to survive in systems that are failing everyone: staff, patients, students, and families. The work of the Alliance Against Seclusion and Restraint is not to shame those people, but to stand with them in saying: we all deserve better than this. We deserve systems that do not force us to choose between our own safety and the humanity of those we serve. We should stay curious and strive to know better, and once we do, we deserve the support we need to get there.

We can and must do better for everyone.