Workplace Violence & Physical Harm

Workplace violence refers to any act of aggression, threat, or harm that occurs at a place of work or is directed at employees and employers. It spans a broad spectrum from verbal harassment and intimidation up to physical assaults and even homicide. Alarmingly, it has become a significant occupational hazard across many sectors. According to the U.S. Bureau of Labor Statistics, 740 workplace fatalities in 2023 were due to violence (including 458 homicides), making it the third-leading cause of work-related deaths in the United States. Moreover, non-fatal incidents like assaults, threats, and stalking are far more common – nearly half (48%) of HR professionals report that their organization has experienced at least one instance of workplace violence in recent years. These incidents affect a wide range of workplaces: corporate offices, hospitals, retail stores, factories, schools, and government agencies have all seen violence perpetrated by current or former employees, customers, patients, or others.

Contexts and Examples

No industry is immune, but the nature of workplace violence can differ by setting. In corporate and office environments, the most catastrophic events have often been insider-perpetrated shootings. For example, on April 10, 2023, an employee of Old National Bank in Louisville, KY who was about to be terminated opened fire during a morning staff meeting, killing five co-workers and wounding others. This tragedy highlighted how a disgruntled individual in a professional office can escalate to deadly violence seemingly without much warning. In another case from 2021, a VTA transit employee in San Jose fatally shot nine colleagues at a railyard after long-standing workplace frustrations. These “going postal” incidents (a term originating from postal facility shootings in the 1980s-90s) underscore that extreme anger or despair can lead an employee to target their own workplace as an outlet.

In the healthcare sector, workplace violence often involves patients or their families assaulting medical staff. Hospitals, emergency rooms, and mental health facilities report high rates of verbal and physical attacks on nurses, doctors, and support staff. For instance, nurses in emergency departments frequently face punches, bites, or threats from patients under the influence or in distress. In one case, a psychiatric patient stabbed a social worker to death during a home visit, leading OSHA to cite the employer for inadequate protections. Healthcare and social service workers are particularly at risk due to factors like caring for volatile or delirious individuals, and hospitals have had to increase security presence and training as a result. OSHA has even published specific guidelines for preventing violence in healthcare settings, acknowledging the elevated hazard.

Retail and customer-facing businesses also see violence, often related to robberies or angry customers. Late-night retail (convenience stores, gas stations) are well known to be targets for armed robbery – clerks have been threatened or killed for cash in the register. Retail workers also encounter irate customers; for example, retail employees have been attacked over mask mandates or simply denying a refund.

The public sector and government offices have likewise seen rising violence. There have been incidents of citizens attacking public servants – such as a city council meeting where a disgruntled citizen opened fire, or the 2019 Virginia Beach municipal building shooting by a former employee that killed 12. In recent years, threats against government officials have surged. A 2024 analysis recorded over 320 threats or harassment events aimed at local officials in just seven months, a 30% increase from the prior year. School board members, health inspectors, election workers and others have reported an uptick in menacing communications and stalking, fueled in part by political or ideological anger.

Prominent business leaders and executives are not exempt either. One high-profile example was the targeted killing of UnitedHealthcare’s CEO Brian Thompson in December 2024: a gunman ambushed him outside a Manhattan office, in what prosecutors labeled an act of terrorism. The suspect, a 26-year-old customer of the company, allegedly harbored a grievance against the health insurance industry. Investigators discovered he had expressed intense anger at corporate “greed” and even considered using a bomb before opting for a firearm to single out the executive. This shocking assassination of a CEO on the street sent ripples through corporate boardrooms, highlighting that disgruntled individuals can and will aim violence at business leaders over corporate decisions or societal issues.

Contributing Factors

Workplace violence usually doesn’t erupt out of nowhere; there are often underlying causes and stressors. A common factor is insider frustration or grievance – employees who feel wronged, humiliated, or desperate (due to job loss, demotion, disciplinary action, etc.) and seek revenge. The Louisville bank shooter, for instance, was reportedly depressed about his impending firing and had a history of mental health struggles alongside resentment towards his employer. Layoffs, terminations, or even a poor performance review can become flashpoints for someone already at a breaking point.

Mental health issues and emotional crises frequently play a role; untreated depression, paranoia or rage can explode in the workplace if not recognized and helped in time. Another factor is ideological or hate-based motives, which can target workplaces symbolically. Some extremists might target a government office or a company because they see it as representing something they oppose (e.g. anti-government ideology, or anger at a particular industry). The murder of the healthcare CEO appears to have been motivated by hatred of the insurance company’s policies and a broader anti-corporate sentiment. Similarly, in 2015 a county employee in California committed a mass shooting at an office holiday party apparently fueled by extremist ideology mixed with workplace grievances (San Bernardino attack).

Personal relationship issues can spill into work as well – an estranged spouse or stalker might come to the victim’s workplace to commit violence, as tragically happens in some domestic violence cases. Robbery or crime is a factor for retail: the perpetrator’s goal might simply be theft (as seen in robberies that turn violent). Finally, organizational climate and warning sign negligence can contribute. Often after an incident, colleagues report the perpetrator exhibited red flags: threatening comments (“I’ll make them pay”), fascination with weapons, severe mood swings, or conflicts with others. If these warning signs are ignored by management or co-workers, the risk can escalate unchecked.

Risk Indicators and Warning Signs

There are several behaviors that can signal an individual is at risk of committing violence. Direct threats or talk of violence is the clearest warning – any employee making overt or veiled threats (“One day someone’s going to get hurt” or joking about bringing a gun) should be taken seriously and assessed immediately. Extreme anger and outbursts beyond normal upset – such as screaming at colleagues, punching walls, or throwing objects – indicate loss of control that could turn to physical harm.

Other red flags include obsessive grievance or paranoia, like an employee who constantly blames others for their problems, talks about revenge, or has an irrational fixation on a supervisor. Dramatic behavior changes can be telling: someone who was calm becomes erratic or socially withdrawn, or whose work performance collapses alongside talk of personal crises. Signs of severe stress, depression, or substance abuse in an employee should also raise concern, as these can impair judgment.

Another subtle indicator is when an individual violates policies or social norms deliberately – for example, showing up in off-limits areas, or deliberately provoking conflicts – as if “testing” boundaries (this might mean they are fantasizing about an act of violence and probing what they can get away with). It’s important to note that no single profile fits all attackers, but any combination of these warning signs should prompt intervention. Many attackers leak their intent in advance via comments on social media or to co-workers – known as “leakage” of violent intent – which is why having a mechanism for employees to report concerning behavior is vital.

Preventive Measures and Response Planning

To protect employees and executives from workplace violence, organizations should implement comprehensive prevention and preparedness programs. A first step is to establish a clear anti-violence policy. This policy must spell out zero tolerance for threats or abuse, encourage reporting of any concerns, and outline how such reports will be handled. Crucially, it should include a confidential reporting channel or hotline so employees can report warning signs or threats without fear of retaliation. Many companies have set up employee assistance lines or use third-party reporting apps for this purpose.

Alongside the policy, employers should form a Threat Assessment Team – a cross-functional group (HR, security, legal, and management) trained to evaluate reports of concerning behavior and take action. This team can investigate threats, decide when to involve law enforcement, and recommend support or discipline for the troubled individual. In fact, some jurisdictions now mandate formal Workplace Violence Prevention Plans: in 2024 California required virtually all employers to implement such plans, including processes to encourage reporting and a defined response team for violence risks.

For senior leaders and at-risk individuals, specialized executive protection (EP) measures might be appropriate. Companies are increasingly conducting risk assessments for their C-suite and providing security resources if warranted – such as security guards for a CEO during a high-profile termination or controversial corporate action, secure transport, or residential security upgrades. The need for EP is usually determined by the presence of credible threats against that person or their industry. In the wake of the UnitedHealthcare CEO shooting, security consultants have urged firms to evaluate threat intelligence (like online hate or threats aimed at executives) and not dismiss violent rhetoric as “just talk.” High-profile executives, public officials, and any employee who has a restraining order against someone should have tailored protection plans. Sometimes this means coordinating with local police for extra patrols or using badge access systems to flag if a known threat enters a facility.

Employee Training and Drills

All staff should be educated on recognizing and reporting warning signs of violence. Regular training sessions can review scenarios (e.g. an employee overhears a co-worker making violent jokes – what should they do?) and emphasize that “if you see something, say something.” Training should also cover de-escalation techniques for customer-facing roles: e.g. how to handle an enraged customer without inflaming the situation, and when to disengage and seek help.

Many workplaces now also train employees in active shooter response options – commonly the “Run, Hide, Fight” protocol promoted by the Department of Homeland Security. Knowing how to react quickly (evacuate if safe, hide and barricade if not, and as a last resort be prepared to defend oneself) can save lives during the unthinkable. Drills or exercises can be conducted for emergency lockdowns. Admittedly, these drills must be done sensitively to avoid causing alarm, but practicing a response can greatly improve outcomes in a real event.

Physical Security Measures

Just as with external intruders, controlling the environment helps mitigate violence. Workplaces should enforce access controls – for instance, former employees or outsiders should not be able to stroll in unchecked. Badge systems, reception check-ins, and security officers at entrances can deter a violent outsider or at least slow them down.

Some offices install silent alarms or panic buttons at front desks and in vulnerable areas (like cash handling points or hospital reception) to summon help quickly. Surveillance cameras not only deter misconduct but also help monitor developing situations and provide evidence after an incident. Facilities open to the public (e.g. retail stores, government buildings) should ensure good lighting, clear sightlines, and possibly employ on-site security guards, especially if they have a history of violent incidents. Certain high-risk locations (like an emergency department or a high-value retail store) may use metal detectors or bag checks to prevent weapons from being brought in.

Emergency Response Planning

Even with prevention, employers must be prepared to react swiftly if violence occurs. A written Emergency Action Plan for workplace violence or an active shooter scenario is critical. This plan should designate who in management or security will call 911 and initiate lockdown or evacuation procedures. It should include internal communication methods (PA announcements, text alerts) to warn employees of danger. Floorplans can be marked with safe hiding areas or exit routes. Employees should be informed of these plans as part of their training. Regular drills (at least tabletop exercises if not full evacuations) will help identify gaps.

Companies should also establish beforehand a relationship with local law enforcement – inviting police to do walkthroughs and give advice can greatly improve response if an incident happens. After any threat or incident, having a post-incident protocol is important too: this might involve activating an employee assistance program for counseling, conducting a root-cause investigation, and reviewing security weaknesses that were exposed.

Fostering a Supportive Culture

Lastly, a long-term preventive approach is to foster a workplace culture where respect and communication are paramount. Many violent acts by insiders stem from feelings of being unheard or mistreated. Employers should ensure fair employment practices and provide resources for employees in crisis (such as counseling services). Encourage supervisors to take note of employees’ mental well-being and intervene early (e.g. refer to counseling or adjust workloads if someone is showing signs of extreme stress). Terminations, in particular, should be handled with dignity and, if the individual is volatile, with security present and perhaps timing it when fewer people are around.

Workplace violence is a multifaceted threat requiring vigilance from HR, security, and every employee. The good news is that many incidents are preventable if warning signs are acted upon and if robust systems are in place. As an employment law bulletin noted, nearly every major workplace shooting had red flags that, in hindsight, indicated the upcoming eruption. By creating a climate where employees freely report concerns, by implementing physical and procedural safeguards, and by planning for emergencies, organizations can greatly reduce the likelihood of violence and ensure a safer workplace for all.

References

[9] OSHA – Workplace Violence Overview and Statistics (3rd leading cause of occupational fatalities; 458 homicides in 2023)

[10] SHRM / Inova Payroll – Workplace Violence Prevalence (48% of organizations have experienced workplace violence)

[11] Epstein Becker Green – Recent Workplace Shootings and Context (Louisville bank shooting April 2023; San Jose VTA 2021 shooting)

[12] Bridging Divides Initiative – Threats Against Local Officials Rising (30% increase in threats/harassment of local public officials vs 2023)

[13] CBS News – UHC CEO Brian Thompson Assassination Case (motive of shooter Luigi Mangione included hatred of healthcare industry; charged with terrorism)

[14] Epstein Becker Green – Workplace Violence Prevention Strategies (anti-violence policy with hotline; emergency plan with violence prevention team)

[15] Littler Law – Executive Protection Considerations (importance of exec protection for high-profile leaders facing threats)