“Who is in charge of my own safety?”

It is a question Matthew Thomas has participants ask of themselves during an armed intruder training. Though an armed intruder event – defined as someone or someones trying to cause the most amount of carnage in the least amount of time – is least likely to occur in a health care environment, the threat is not zero, so preparedness is key, says Thomas.

“We have to be prepared. Regardless of where we are, we have to take ownership of our own safety in that moment until law enforcement arrives to neutralize the threat.”

Thomas, a Training, Development and Communications specialist in MGH Police, Security and Outside Services, has more than two decades of experience as a security officer and supervisor, and has taught hundreds of classes to help people be prepared in difficult and worst-case scenario situations.

“I’m not here to scare anyone, I’m here to remove any complacency,” says Thomas. “Most of these incidents happen quickly and end quickly, and our goal is to prevent as many casualties as possible. So we want to be aware, we want to be focused and know what to do if a situation does arise.”

Know the Signs

To date, Mass General has had no armed intruder incidents, but because the hospital often sees aggressive behavior, knowing what motivates an armed intruder is important.

“Hospital shootings tend to be targeted and personal,” says Thomas. “Typically, there is only one victim, and some sort of personal relationship. These are not just random acts.”

Hospital staff can learn to recognize the signs of someone – be it a patient, visitor or even colleague – who may be displaying potentially violent behavior. When these behaviors are recognized, Thomas says, they can be managed or treated, and violence prevented.

Verbal and expressive indicators of potentially violent behavior may include:

  • Expression of suicidal tendencies
  • Talking about previous incidents
  • A focus on dangerous weapons
  • Paranoid thinking
  • An overreaction to workplace changes
  • Depression or withdrawal
  • Unstable emotional responses
  • Intense arrogance, powerlessness, anger or hostility
  • Sudden excessive drinking or drug use
  • Increased absenteeism
  • Blaming others

“We don’t want to be the people who saw something and didn’t say something,” he says. “We want to be the people who see something and say something.”

Run, Hide, Fight

What should you do if faced with an armed individual?

Run. Hide. Fight.

This is what the Department of Homeland Security has suggested for years, and it’s the same approach adopted at MGH. The common goal for all these approaches is survival.

“The farther away you are, the better off you’re going to be,” Thomas says. “Know your escape paths here at work and outside of MGH. Get somewhere safe as quickly and efficiently as possible.”

Should you choose to hide, get to a place where the intruder is least likely to find you. Be out of view, lock or barricade a door, silence phones and stay quiet. Put as much stuff as possible between you and the intruder, Thomas says.

As a last resort, and only if in imminent danger, be ready to fight to try to take out the intruder. “At that point it’s either ‘them or us’, and we need to protect ourselves,” says Thomas. “Use anything you can locate in your immediate area. We need to take actions to keep ourselves safe and walk out of the situation unharmed.”

“Respect that everyone has different experiences that cause people to respond in different ways. How we respond is a personal choice,” Thomas says. “If you are an employee of Mass General, you will be supported in your decision, whether that decision is to run, to hide, or to fight.”

Preparedness is Key

Typically, an armed intruder event ends with law enforcement’s response and actions. However, before law enforcement’s arrival, staff should feel capable and confident. This is where training and preparedness are crucial.

“You may be the first responders before they arrive. Bystander intervention can be the difference between life and death,” says Thomas. “People who train or know what to do in the unlikely event that an incident occurs are more likely to take positive action for their own safety or the safety of others.”

Untrained people tend to be afraid, panic, or fall into disbelief and deny the situation, he adds, whereas trained people – who also will be afraid and anxious – won’t panic and will be able to function.

“We revert to training when all else fails. When we do things consciously at first, they turn into unconscious habits that allow us to react effectively when needed.”

MGH Police and Security offers a number of trainings in person and through HealthStream, to help staff be prepared, including:

  • AVADE Workplace Violence Prevention
  • Strategies to Prevent Workplace Conflict & Violence
  • Armed Intruder/Active Shooter Training
  • Workplace Conflict, Violence Prevention Training
  • Security Awareness & Vigilance for Everyone (SAVE)
  • Safety Before, During and After Home Visits
  • Missing Child-Infant Security Response Training

These trainings are free. All MGH staff are strongly encouraged to complete them, and all managers are strongly encouraged to allow their staff the time to do so.

“This is a tough topic to talk about and think about,” says Thomas, “but knowing the tools and skills to use in a crisis can mean the most positive outcome possible.”

MGH Police and Security Contact Numbers

  • Main Campus: 617-726-2121
  • Charlestown Navy Yard: 617-726-5400
  • Charlestown HealthCare Center: 617-724-8151
  • Chelsea HealthCare Center: 617-887-4300
  • Revere HealthCare Center: 781-485-6464
  • Mass General/North Shore (Danvers): 978-882-6444
  • Mass General Waltham: 781-487-6999
  • Assembly Row: 857-282-6000

Main Campus, CNY and Assembly Row sites provide 24-hour coverage. All other sites provide coverage during operating hours only.

For questions or training inquiries, Matthew Thomas can be reached at mdthomas@partners.org.