Providing mental health services is one of the most important roles a healthcare institution can fulfill, especially if a person is experiencing suicidal ideation. The right mental health care can save a life and can help to stabilize people with serious illnesses such as depression.  Unfortunately, not all healthcare providers are capable of offering appropriate services to people experiencing mental illness.

Part of the problem stems from disagreements over appropriate provision of care and the right methods to use for treating mental illness. WQAD recently reported, for example, on fights between hospitals over who is best capable of providing inpatient care and where the care should be provided. As hospitals and other healthcare service providers go back and forth on what help should be offered to patients, it is victims who often suffer because there is no clear plan for inpatient treatment which has been proven effective.

Disputes Over Providing Inpatient Care Can Harm Vulnerable Patients

WQAD reports a company called Strategic Behavior Health (SBH) is seeking to open a new mental health facility. SBH is already operating two psychiatric hospitals which treat patients using both inpatient and outpatient services, including a hospital called Peak View Behavioral Health. When SBH tried to open its third facility, the two largest local health systems objected.

The local health systems, UnityPoint Health Trinity and Genesis Health System, argued SBH would cherry-pick patients who could pay the most and would make it harder for existing facilities to provide appropriate mental healthcare services.  Local hospitals also believe inpatient care is outdated, while SBH agrees and asserts the benefits of inpatient treatment.

In addition to concerns about the type of care and the cherry-picking of patients, there are also worries about whether there are enough doctors in the local area to provide staffing for all of the healthcare facilities who treat patients with mental illness.  One advocacy group, for example, indicated the problem with providing healthcare services locally is not a shortage of psychiatric beds but is instead a shortage of qualified psychiatric professionals.

Unfortunately, this disagreement means an inpatient facility which could provide important help in mental health care and suicide prevention may not be built or there may be a delay in building.  If there is a shortage of qualified caregivers, it also means facilities providing mental health services could be understaffed or unqualified staff members could be hired. When there is an inadequate level of staffing and/or staff members are not properly trained, patients will suffer.

This is an especially big risk for patients who are receiving treatment for suicidal ideation because it will be necessary for these patients to be carefully monitored. If an inpatient facility does not provide the supervision and help they need, the facility could be held accountable for malpractice if a patient is seriously injured or dies while receiving care.

A quarter of adults in the United States meet the criteria for a diagnosable mental illness. More than 1,069,000 people in the country attempted suicide in 2014 alone, according to the American Association of Suicidology.

Americans spent as much as $69 billion on mental healthcare services back in 1999 and while there is no current accurate data, experts suspect the spending is significantly higher today than it was almost two decades ago. Unfortunately, despite the massive spending and the significant need for effective inpatient and outpatient treatment, the system designed to treat people with mental health issues is fraught with problems in the United States.

Pacific Standard recently published an in-depth report of some of the issues with mental healthcare services in the United States. The report highlighted problems with inpatient care facilities in particular – and suggestions for positive change.

Until more effective solutions are identified, however, patients will continue to be at the mercy of care providers who  likely are not  equipped to actually fulfill their role at treating illness and preventing death by suicide. When a death occurs either under the care of an outpatient care provider or while a patient is receiving inpatient mental health services, family members of the victim should consider pursuing litigation  to hold the care providers accountable and, importantly help change conditions in the mental health industry

Problems in the U.S. Mental Healthcare System

Pacific Standard Magazine reported on one situation in which the mental health commissioner for the state of Virginia took a trip to an inpatient psychiatric care facility run by the state. The commissioner saw a facility which appeared very functional, as he saw impressive presentations and met with residents. However, the entire system seemed so perfect the commissioner suspected a Potemkin village had been constructed for his benefit.

He was proved right when he dropped by unannounced several weeks later. Residents suffering from behavioral problems smelled of unwashed clothing and urine. Patients requiring intensive treatment were alone in rooms as staff members chatted with each other in hallways. Overmedicated patients were also everywhere, slouched on the couch in front of the television.

When the commissioner tried to take steps to fix conditions, he discovered quickly there was little he could do to improve things and he also discovered similar problems existed nationwide in care facilities. He has since written a book focused on the problems with the mental healthcare system in America as well as focused on suggestions for making positive changes.

Unfortunately, the problems he identified with inpatient care are only the tip of the iceberg when it comes to nationwide issues with mental health services. Some of the many issues include psychologists and psychiatrists relying on outdated treatments and insurers who refuse to pay for the care patients need.

Less than 15 percent of mental health care consumers actually receive care based on evidence, and those who don’t can suffer greatly from ineffective treatments.  When this poor care is provided to patients and suicide or other serious consequences result, it is important to pursue claims against those responsible to ensure there is at least accountability within the ineffective patchwork system for providing care.

As the San Diego Tribune recently reported, suicide rates are high among veterans who have served in combat since the attacks on 9/11/01. Unfortunately, research into veteran suicides reveals that both the VA and civilian health institutions are not doing enough to help when veterans appear to be giving up on treatment or experiencing despair. In some cases, veterans in inpatient care are not even being provided with the minimum level of assistance they need.

When someone is in a VA hospital or other treatment facility and there is a risk of death by suicide, steps need to be taken to ensure the person is properly monitored and an effective treatment plan is in place. When this does not happen and inpatient suicide occurs, the family members of the victim need to hold the institution and mental health professionals working at the institution accountable for their failures. This is especially true in situations where professionals who work with veterans regularly should be aware of signs of suicidal ideation and should ensure the proper healthcare is provided for patients who are receiving inpatient psychiatric care.

Veterans at Risk of Inpatient Suicide

According to the San Diego Tribune, one case which has spurred the VA to try to make some changes involved a 37-year-old Air Force Veteran who died by suicide at a local hospital within days of being released from a lockdown psychiatric hold. He had been released from lockdown even though he clearly was not yet ready for release, as he was still experiencing suicidal ideation. He was admitted to a drug rehabilitation program at the same hospital with the belief he would get further help in the rehab program. Unfortunately, he hanged himself in his room.

Following this veteran’s death, the hospital decided to formalize the process of handoffs among inpatient units so staff members in different units would document that they had reviewed the patient’s case together and were aware of the risks. This is certainly a positive change: If veterans are to be released from one inpatient program to a different one when still at risk of suicide, extra precautions will need to be taken by new care providers to be watchful for continuing signs of suicidal ideation.

Unfortunately, changing the process of handoffs may not be enough to stop the epidemic of veteran suicides. Paul Rieckhoff, the executive director of Iraq and Afghanistan Veterans of America believes the government is downplaying the severity of the suicide crisis, which is a major public health issue more resources are needed to address. He compared the failures to provide appropriate care to suicidal veterans to the lack of response in the early days of the AIDS crisis.

The government has a responsibility to veterans, and the VA in particular has an obligation to make sure veterans are getting the care they need. Most importantly, facilities treating veterans must take seriously their duties to monitor and protect those who served, especially as suicide rates remain high.

Mental health facilities have obligations to psychiatric patients to keep them safe, particularly when patients are on suicide watch and there is a risk of death by suicide.  One of the duties in most facilities is simply to monitor patients who are at great risk to ensure they do not try to self-harm.  If a hospital has failed in any of its obligations to patients and inpatient suicide occurs as a result of this failure, it is possible to take legal action against the facility.

Hospitals can be held responsible for negligence in policies which lead to patients dying by suicide. If staff members fail to fulfill the obligations imposed upon them by their jobs, mental health facilities can also be held accountable due to these on-duty errors or the negligence of staff members in fulfilling work tasks.

Hospital records and other internal evidence from mental health facilities can prove invaluable in determining if the facility has lived up to its obligations or not.  An experienced inpatient suicide lawyer can assist family members of patients who died by suicide in obtaining necessary records to help prove negligence.

Video Surveillance Footage Helps to Show Staff Failure in Mental Health Facility

Naples News reported on one tragic case which illustrates how information a hospital collects can be used to help prove negligence after inpatient suicide occurs.  The case involved the suicide of a 51-year-old man who was in a psychiatric inpatient hospital. The man had been admitted because of feelings of paranoia, hopelessness, and depression. His admissions paperwork indicated he had been having suicidal thoughts.

During the time he was in the 103-bed facility, the 51-year-old man was quiet and didn’t participate in any activities or therapy sessions. Two days prior to his death, he asked to talk to a social worker and requested forms for a living will. The social worker didn’t ask the reason for this request, and did not report the request to anyone.   The patient’s doctor indicates he would have put the patient on immediate suicide watch if he had been aware a request for a living will was made.

Even though the patient was not on suicide watch, he was still supposed to be checked on every 15-minutes.  Unfortunately, though written paperwork indicated these checks had happened, surveillance footage from the hospital shows there were two checks missed in a row. Neither a 9:15 and a 9:30 check happened. By 9:45, when the 51-year-old patient was finally checked on, the patient had gone into the bathroom and hanged himself with a tied-up hospital gown.

There were numerous situations in this case where the hospital facility dropped the ball, from the social worker not reporting the living will to the 15-minute checks not being made. The surveillance evidence and the patient records including the living will help to show how the hospital facility fell short of its obligations.  A suicide lawyer can help family members to obtain this type of evidence to prove a mental health facility should be held accountable for lapses.

Facilities that provide inpatient care to patients experiencing mental health issues have a strong obligation to make sure patients are carefully monitored and appropriately treated to prevent an attempted suicide. When patients are depressed and experiencing suicidal ideation, it is especially imperative the institutions in charge of them take active steps to protect them.

Sometimes, however, institutions fall short. One such institution, which tells patients to “expect a miracle” is considered one of the foremost rehabilitation centers in the country. The strong reputation and appealing promises made by the institution led one family to pay $64,800 to get care for a 55-year-old man who had been struggling with chronic depression. The man’s admission to the rehabilitation facility was his first time in a residential treatment center, although he had previously been hospitalized for mental health issues. Unfortunately, Tucson.com reports the man died by suicide while under the care of the rehabilitation center.

In cases like this one, serious questions arise regarding whether the inpatient treatment center did enough to protect the residential patient or whether the center fell short. In this case, a lawsuit has been filed in response to the inpatient suicide, with family members claiming they were misled into thinking the patient would be safe and arguing the facility was negligent because staff members failed to notice the patient had not shown up for scheduled activities.

Responsibility for Inpatient Suicides

Despite its promises of miracle cures, the facility has faced trouble in the past with actually living up to its promises.  Five patients have died in the care of the facility since 2011, all of whom were men between the ages of 20 and 71. Three of the patients died of suicide, two hanging themselves with a shoelace and one hanging himself with a belt.

Because of problems with the provision of patient care, the state Department of Health Services has been heavily monitoring its operations. The monitoring requirement was imposed because the rehab center was not following its own policies on keeping track of where its patients were. In the case of the 55-year-old suicide victim, for example, the man did not show up for any of the five activities he was scheduled to attend. He also missed appointments.

When patients are 15 minutes late for an activity, staff members are supposed to look for them.  Interviews with staff members, however, revealed no one looked for this man for hours, until it was too late. Staff members also confirmed they did not know who was responsible for taking attendance of patients, reporting when a patient was absent, and calling for the initiation of a search to locate the patient.

It was especially important for the facility to take action here, as records show the suicide victim had described feelings of total helplessness and thoughts of suicide.  Inpatient facilities are supposed to be operated specifically to protect patients like this when they offer care to those experiencing thoughts of suicide and they need to be held accountable when they fail in fulfilling obligations.

In 2012, the National Action Alliance for Suicide Prevention and the Suicide Prevention Resource Center (SPRC) came together to develop a plan called “Zero Suicide.”

Zero Suicide was outlined in the 2012 National Strategy for Suicide Prevention, and the website for Zero Suicide indicates the “foundational belief” of the project is: “that suicide deaths for individuals under care within health and behavioral health systems are preventable.” Essentially, this means individuals should not be falling through the cracks and the healthcare system should take a systematic approach to patient care to prevent death by suicide – all of them.

Mental health care providers play a key role in Zero Suicide, because as National Council magazine indicates: “serious mental illnesses and addictions elevate suicide risk by 6-12 times over the general population’s.”

When people with mental health issues seek treatment, care providers must recognize the dangers, be alert to signs of suicidal ideation, and take necessary steps to offer services designed to eliminate risk. If a mental health care provider fails in obligations and a patient dies by suicide, the care provider may be held legally liable for mental health malpractice for deciding not to follow the standard of care which contributed directly to the patient’s attempted suicide and/or death.

Zero Suicide Can Be Effective at Reducing Suicide Risks

States throughout the country are embracing the systematic approach of Zero Suicide, including New York. New York’s view is when suicide deaths occur, the fatalities are because of systemic failures- which are precisely the type of failures Zero Suicide is intended to stop from occurring. As part of a Suicide Prevention Initiative in NY, a plan has been put in place to improve the quality of behavioral healthcare and put an end to these systemic failures.

New York is putting a systems approach into place in higher risk communities and among higher risk demographic groups. Steps being taken include:

• Improving inpatient and outpatient care to reduce or eliminate suicide deaths in state-operated psychiatric service systems.
• Involving multiple parties and institutions, including local county leadership, residential care providers, inpatient and outpatient care providers, mental health professionals, and substance use care providers, in developing a comprehensive care and support network.
• Embedding suicide care in the major organizations serving youth across the state.
• Raising levels of staff support and surveying staff members in mental health facilities on their readiness to provide effective suicide prevention care.
• Assisting organizations in creating effective management practices aimed at achieving Zero Suicides through team-based care.

In Zero Suicide approaches, suicide protocols should be incorporated within policies and procedures of healthcare facilities, and the suicide risk of all patients should be assessed. Suicide should be treated not as a symptom of a mental health disorder or substance abuse disorder but instead as a condition for which a patient receives direct treatment.

When a suicide risk is identified in patients, a safety plan should be developed and regularly reviewed to reduce the risk of death by suicide and to ensure patients are provided with necessary support.

Above all, clinical staff must be appropriately trained, must follow up with patients, and must ensure they are providing the level of care patients need to reduce risks.

Over the past 18-months, there have been reports of a dozen cases involving suicide of white-collar workers who were employed by high profile financial firms at the time of their death. Overall, rates of death by suicide are generally lower among those with attained higher levels of education. However, depression can affect anyone no matter what his or her education levels and income bracket. Often, it is more difficult to recognize or respond to signs of suicidal ideation in those who appear, on paper, to have it all. This can make it more difficult to spot and prevent suicide risks among white collar workers and people in privileged positions.

Mental health counselors should know of all signs of suicide in all patients, including those with good jobs and advanced levels of education—the so called VIP patient. When a mental health professional misses signs of suicidal behavior and death by suicide occurs, a suicide attorney should be consulted by surviving family members for assistance. The death of a white collar professional can have serious financial reverberations on family financial stability and mental health professionals should provide compensation to dependents if the negligence of mental health professionals played a role in causing the death by suicide. If clinicians are not familiar with the VIP risk factor, they need to get familiar ASAP.

Why are More White Collar Workers at Risk of Death by Suicide?

Market Watch discussed the recent spate of suicides among financial professionals and considered why suicide rates are rising among white collar workers. Studies have demonstrated doctors, dentists, financial workers, veterinarians, lawyers, and engineers are among the professions with suicide rates at least 1.5 times the suicide rates among the rest of the population .  Physicians have a suicide rate 1.87 times higher than the rest of the population, and dentists have a suicide rate 1.67 times higher than average. A part of this may be explained by easier access to dangerous pharmaceuticals that could be used in a suicide attempt.

Workers within these and other white collar professions may feel significant amount of career pressure. Many of the professions are highly competitive and workers within certain fields may have a particularly negative response to stress or to a crisis. While there has not been a clearly-established causal link between work pressure and higher risks of suicide for white collar professionals, it is possible the high levels of stress coupled with the intensive work environment are a contributing factor to more white collar workers taking their lives.  Careers that are all-consuming may also isolate workers from family and friends, thus increasing the risk of death by suicide.

A spokeswoman for the Centers for Disease Control and Prevention indicated the increased rate of suicide among individuals in these higher-profile and higher-paying careers is something which should be researched further. If a causal link is discovered between certain careers and an added risk of death by suicide, more actions can be taken to protect workers within that field.

Suicide – a global problem – is one of the leading causes of death worldwide. As Quartz reports, more than 800,000 people throughout the world die by suicide each year and many millions more people attempt suicide.

An experienced suicide attorney knows understanding the risk factors that can lead to suicide is vitally important to try to bring the death rate down. One of these risk factors relates to gender. In every country throughout the world, men are much more likely to die by suicide than women.

Men are at Greater Risk of Dying by Suicide in Every Country in the World

In the United States, 32,055 males died by suicide in 2013, the last official figures. 9,094 females died by suicide for same time period. There were 3.5 deaths by suicide for each female death by suicide. This discrepancy of male versus female suicide rates is even larger in some countries. For example, in Lithuania, 49.5 men out of every 100,000 die by suicide compared to 8.4 females.

There are many different factors that could help to explain why men are so much more likely to die by suicide. However, one medical professional from the University of Glasgow believes that a major contributing factor to the higher rates of male suicides is the phenomenon of social perfectionism.

Despite an increased focus on equality of genders, the majority of men still believe that they must provide for their families and will consider themselves failures if they cannot do so. The perceived pressure to provide for a family is outside of a man’s control – he believes – and may be a conscious or subconscious pressure, but it is present even in societies where significant progress has been made toward making the genders more equal. Studies as recent as 2014 show that men still think that others will view them negatively if they are not able to make a good living.

Women can also be social perfectionists, but evidence suggests that the phenomenon is not as pervasive among women and that the social perfectionism that men feel pressured to live up to is much more harmful. One expert from the University of Florida, for instance, indicates that while women generally think of themselves as women even if they do not live up to feminine ideals, a man who cannot provide may consider himself no longer to be a “man.”

Understanding this intuitive phenomenon can help prevent death by suicide among men. When men are experiencing periods of unemployment or are facing financial struggles, it will become even more important for family members and mental health professionals to be watchful for any signs of suicidal thoughts or behaviors. Men can and should be able to get help from mental health professionals in overcoming fear they will lose their manhood if they cannot earn a living as successfully as they had hoped. There is a catch: men are not as likely to seek any healthcare, let along mental health care because of stigma and macho attitudes.

A suicide attorney at the Law Offices of Skip Simpson can help. Call (214) 618-8222 or visit www.skipsimpson.com to schedule a free case consultation. Serving clients throughout the United States. 

After a young Texas teen died by suicide and his parents revealed he had been bullied, hundreds of supporters came out for a peaceful demonstration. The teen’s parents indicated that the bullying had gone on for weeks before the young man killed himself. The teen had obtained a gun from a friend, allegedly to protect himself and his family from the bullying occurring. His friend has now been arrested according to CBS Local, but the teen’s parents want the school to face accountability.

A suicide attorney knows that bullying is one top reason for teens to consider death by suicide. School officials claim that the district where the Texas teen had attended school is adamantly opposed to bullying. However, the supporters of the family of the teen who died want bullying to be discussed more openly and want stricter policies in place to protect young people.

Preventing Teen Death by Suicide Can Be Challenging

The school district insists that it did nothing wrong. The District stated that many interviews with students, counselors, and staff members had been conducted but that no prior reported incidents of bullying had preceded the teen’s death. Some bullying goes unreported or school officials may see bullying occur but not take formal steps to stop it.

School districts have a responsibility to their students, but there may be limited things the district can do to get kids to stop being mean or exclusionary to others. Young people should learn about the dangers of bullying from a young age and should be taught the behavior is unacceptable. These lessons must explained in a way that causes teens to understand and to respect their peers instead of subjecting anyone to bullying behavior.

An article on Palo Alto online describes how some California areas are responding to the risk of teen death by suicide following several recent deaths on Caltrain tracks. A Mental Health Association held a round-table discussion on ways to prevent death by suicide among youth, recognizing there are no easy fixes to the problem.

One pilot program being used is called Fire Within. Fire Within uses entrepreneurship and the support of teen peers to help students be more open about how they are feeling and to get a better understanding of the root causes of depression and teen suicide. The program involves peers talking to each other about depression and encourages teens to seek emotional support from each other in high stress environments.

The pilot program is being tried because of a belief that what schools have done so far to address the issues of bullying and teen death by suicide have not been working. There is no quick or easy solution to help kids cope with their depression or to stop bullying behaviors, but hopefully programs like this could be a step in the right direction.

A suicide attorney at the Law Offices of Skip Simpson can help. Call (214) 618-8222 or visit http://www.skipsimpson.com to schedule a free case consultation.

Suicide attorney Skip Simpson has provided legal representation to many families whose loved ones have died by suicide because of the failures of mental health professionals to provide appropriate care. Simpson believes – relating to suicide prevention – the mental health care system is broken and that implementing best practices  for suicide risk assessment would help to save thousands of lives every year. His goal is not to threaten care providers with lawsuits, but instead is to help secure compensation for victims and to help ensure that mental health professionals are as effective in preventing unnecessary deaths.

As one of the leading experts nationwide on the legal aspects of suicide resulting from the negligence of mental health providers, Simpson was recently asked to speak at a training seminar for mental health service professionals. The seminar was held in late February at the University of Denver. Mr. Simpson was invited to speak about how best practices for suicide prevention treatment can be implemented by health care providers to reduce risk and provide legal protections.

Simpson Talks to Mental Health Professionals About Treating At-Risk patients

The training seminar was attended by psychology students, psychiatrists, and psychologists, all of whom could treat patients who are at risk for an attempted suicide. The conference was called the Elevating the Conversation Conference. Simpson was asked to speak to the attendees about how to avoid suicide malpractice lawsuits while better caring for the suicidal patient.

Simpson cautioned providers that their care decisions should not be made based on a fear of being sued, as focusing on lawsuits could end up taking the attention off the patient. Providers must devote their full energy to focusing on meeting the needs of at-risk clients and identifying when someone may consider death by suicide.

Simpson also encouraged providers to avoid a “checklist mentality,” and to really hear what patients are saying. Insincere attitudes can be recognized by patients and doctors who focus on ticking off boxes of things they need to do to prevent lawsuits will not be effective at getting through to people who need help.

Over 100 people die by suicide daily in the United States, so any failure of the psychiatric care system can be very dangerous. Simpson believes there is a need for meaningful systematic change, especially since every suicide in a system should be preventable with the right mental health care. During the training seminar, Simpson discussed some of the best practices that could be followed for medical professionals to ensure they are following the recommended guidelines for suicide prevention.

Simpson also advised therapists and counselors to ensure they are documenting everything. The quality of documentation can mean the difference between being sued when a patient dies by suicide and not being sued.

If providers follow these recommendations and try to effectively manage suicide risk assessment, perhaps more deaths by suicide will be prevented.

A suicide attorney at the Law Offices of Skip Simpson can help. Call (214) 618-8222 or visit http://www.skipsimpson.com to schedule a free case consultation.