Well I'm not necessarily saying more is always better. A low ratio is good but my point is to pay them well enough to motivate them to develop skills in Collaborative Problem Solving (CPS, a communication technique--I recommend the book "The Explosive Child") and stay for a while. To provide that training for free to the techs, with maybe like a scholarship upon completion, maybe in exchange for a certain commitment of time working.
But my other thought is in terms of externalizing and internalizing kids. Internalizing kids are less likely to end up on an inpatient psychiatric unit or at a long term psych care like setting (prominent exception being suicidality and eating disorders if you have an eating disorder speciality unit). You will mostly get kids who externalize. And you ask about medicating their aggression. It's a fair question because they might be out in the world physically hurting others and need to be sedated in those cases. But the cool thing about the controlled environment of inpatient psych is they can potentially have more freedom to express aggression in ways that could be made socially appropriate by an awesome medical director. What about a ping-pong table? A room with balls in the floor like McDonalds play place? Simply a layout to the unit where if one kid is yelling their head off and trying to throw around the immovable chairs, the other kids can easily be escorted through a hallway with a soundproof door to another hangout room? What about Tai Chi? And what about validating the dramatic unfairness of their situation when appropriate? Many of these kids have trauma that's left them feeling powerless, helpless, etc., and they've been placed in a position by society and their family as the identified patient. Not only do they feel powerless and helpless but in many ways they actually are. Probably DBT and then EMDR is also appropriate.
I'm not anti-medicating aggression. I have utmost faith you will figure out quickly which meds work for that. Typically we start with meds studied in kids like the antiepileptics and ones that are FDA approved for use in kids/adolescence and then in refractory cases you will see meds that look pretty much just like adult psych med lists. Less psych research is done on kids so the pool of info is smaller.
I guess the reason I respond this way is because a re-traumatizing experience (which is surprisingly easy to produce given how helpless it feels to be a kid on an inpatient psych unit sometimes) with psychiatry in the young years can turn people off to getting help forever, and I do meet adults who've avoided seeking care for years for this reason.
