Archive for the ‘Suicide Risk’ Category

Preventing Suicide Through Early and Universal Mental Health Training

Montana universities are taking steps to address suicide epidemic

Texas suicide lawyerAt the first ever Montana Suicide Prevention Summit last month, advocates for suicide prevention called for mental health and emotional education for the general public, starting at the grade school level.

Marny Lombard, the mother of a Montana State University student who died by suicide in 2013, and Karl Rosston, the suicide prevention coordinator for Montana’s Department of Health and Human Services, were among the key speakers at the summit. Both emphasized the need to prepare ordinary people to recognize and appropriately address suicide risk factors rather than relying exclusively on mental health professionals.

Montana has the nation’s highest suicide rate, nearly double the national average. Every other state in the Rocky Mountain region is close to the top as well. And while some suicide risk factors, such as altitude, are geographically fairly unique to the Rockies, most hold significance nationwide.

Rosston cited several suicide risk factors common in Montana and the surrounding states, including social isolation, easy access to firearms, high rates of alcohol consumption and a social stigma against mental illness. Many people in the West, particularly men, are uncomfortable seeking professional help for depression or emotional health – and that’s true in other parts of the country as well.

That means friends and family must play a key role in encouraging, supporting and protecting people at risk of suicide. Lombard pointed out that at-risk college students are much more likely to turn to their friends than professors or mental health professionals.

Friends and family members can help to prevent inpatient suicide

Even in cases where at-risk persons are already receiving professional help, friends and family play a hugely important role in preventing suicide. The unfortunate reality is that many mental health professionals lack the training and experience to recognize and appropriately address the warning signs that a person is at risk of death by suicide.

Friends and family members who know a person’s interests, background and personality are especially well-equipped to recognize early signs that a person may be at risk. Even when mental health professionals have the necessary training – and, again, many do not – there is no substitute for actually knowing the person.

Relatives and close friends of people in inpatient care need to be their advocates and their support system. Frequent visits and phone calls not only reduce the feeling of isolation that leads to many suicides, but also provide opportunities for loved ones to recognize those warning signs and work with caregivers to appropriately intervene.

Unfortunately, many mental health professionals fail to take appropriate steps to help patients at risk of suicide, even when they are warned of the danger. When that happens, friends and family members with some training in mental health are well-equipped to hold negligent caregivers accountable.

Skip Simpson has a couple of recommendations to understand what a friend or loved one can do to better understand how to help.  First, obtain training from the QPR Institute. There are three steps anyone can learn to help prevent suicide: Question, Persuade, and Refer.  See https://www.qprinstitute.com

Also, there is a quick read called “The Suicide Lawyers: Exposing Lethal Secrets” wherein Skip Simpson and his then partner were interviewed about what Skip Simpson had learned in his years of litigating suicide cases. Skip heard many clients say after starting litigation “if I had only known.” Skip Simpson wanted everyone to know what to look for and what to do before tragedy hit a friend, loved one, business colleague or anyone.

Protecting Your Patients and Yourself

Zero Suicide represents a commitment to identify, protect, and treat people who are at risk of suicide. Central to this commitment is the ability to record and properly share accurate information about a patient’s history and treatment. Without this information, each clinician that treats a patient must start from scratch — an inefficiency that will frustrate health care providers and patients, as well as affect the quality of care. Careful documentation also allows us to understand how health care systems can be improved and patient care made more effective.

The documentation essential to Zero Suicide has another benefit. It can protect clinicians and institutions from malpractice suits. Suicide is the most common cause of legal action against mental health care professionals. The central issues in most suicide malpractice cases are whether the clinician should have anticipated the risk of suicide and whether he or she provided care appropriate to this risk. Showing that a clinician met the standard of care appropriate for suicide risk can stop a malpractice suit in its tracks. Patient care should be documented in real time. Juries may suspect that medical records created after the fact rather than during treatment are inaccurate or self-serving.

Assessments of suicide risk should be carefully documented. It is a fundamental principle of good practice that risk assessment is more than simply using a screening instrument—clinical observation and judgment are also essential. These observations should be documented in the patient’s medical record. Patient responses to questions about suicide and self-harm should be recorded in their own words, and quotation marks used to clearly distinguish which statements represent clinical judgments and which are verbatim reports of what a patient said.

Embarrassment and anxiety can make patients reluctant to admit they are thinking about suicide. They may want to protect family secrets about substance abuse, mental health disorders, sexual abuse, or family violence. They may be in denial or afraid of being institutionalized or feel that no one can help. Involving family members can be crucial to accurately assessing a patient’s risk and making care decisions. Family members can provide information that the patient can’t—or won’t—and this information should be carefully recorded. It should also be noted if family members cannot be reached or are uncooperative. If a suicide results in a malpractice suit, it is the family that will sue. Accurate information about the family’s involvement—or lack of involvement—in patient care can be critical to the outcome.

The clinician should also document the decisions made while developing a patient care plan, how this care plan was implemented, and the criteria used to decide the steps needed to preserve the patient’s safety (such as whether the patient admitted to actively planning his or her suicide and whether the patient has access to firearms).

It is also important for the clinician to document his or her review of medical records and consultations with other service providers. If medical records or prior providers are not available, all attempts to obtain records and reach providers should be documented.

Focusing on the possibility of malpractice lawsuits turns the clinician’s attention away from the patient to him- or herself. Thoroughly and accurately documenting the assessment and care of patients who may be at risk of suicide will help deter malpractice lawsuits as well as contribute to quality care, patient safety, and the ability of clinicians and the health care system to work toward the goal of zero suicides.

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Virginia’s Dysfunctional Mental Health System Puts Patients At Risk

Texas suicide lawyerVirginia governor Terry McAuliffe’s plan to close Catawba Hospital, a 110-bed psychiatric facility located near Roanoke, is the latest blow to the state’s underfunded and uncoordinated mental health system.

 

Over the past four decades, Virginia has already lost nearly 80 percent of its psychiatric hospital beds, leaving fewer than 1,500 statewide. Compounding the problem is the lack of community-based services, such as counseling, housing and treatment, needed for people struggling with mental illness to get the care they need outside an inpatient facility.

Due to the state’s failure to invest in those services, hundreds of discharge-ready patients are crowded into a limited number of beds, stuck at a hospital level of care because there is no plan for them to step down. This leaves little room for those who are most at risk.

As a result, people suffering from mental illness and substance disorders are left in a place that is ill-equipped to care for them: the criminal justice system. Nearly 7,000 Virginians with mental illness are currently incarcerated, more than four times the number in psychiatric hospitals.

Lack of Services Leads to Tragedy

Without the dedicated care they need, inmates with mental illnesses are at increased risk of abuse, neglect and suicide. In one recent tragedy, Jamycheal Mitchell, a mentally ill 24-year-old man, was arrested after shoplifting $5 worth of snacks from a convenience store. He wasted away and died after four months of neglect in jail.

A judge repeatedly ordered that Mitchell be transferred to a psychiatric hospital, but no beds were available. Meanwhile, at Eastern State Hospital, the nearest state psychiatric facility, some two dozen patients had been designated ready for discharge but remained in their beds due to a lack of community-based services.

Even when beds are available, failures to effectively coordinate care can be deadly. In November 2013, Austin “Gus” Deeds, a 24-year-old college student with bipolar disorder, stabbed and slashed his father, R. Creigh Deeds, 13 times before dying by suicide.

That night, the Deeds family had gotten a court order that gave the state six hours to place Gus in an inpatient treatment facility. Mental health evaluator Michael Gentry claimed he called 10 facilities that could care for Gus, but phone records show that he only called seven. Tragically, two of the three facilities that were not called had space available.

The elder Deeds, a Virginia state senator, survived the attack and has been a vocal advocate for mental health reform since. He is also pursuing a $6 million wrongful death suit against the state.

A Nationwide Trend

Virginia’s issues with mental health are far from unique. Rather, the lack of psychiatric beds is a result of a nationwide initiative in the 1970s to downsize psychiatric hospitals in favor of community-based care. While well-intentioned, this initiative ultimately led to cuts across the mental health system, as funding did not follow the patients into the community.

As such, people suffering from mental illness and their loved ones are left to deal with confusing bureaucracy, long wait times for services, overcrowded facilities and overworked care providers. In such environments, patients are commonly neglected and even abused, leaving them at elevated risk for inpatient suicide.

New Laws Aim to Prevent Suicide Among College Students

In 2014, a college student died by suicide following his first year at the University of Texas at Austin. Following his death, his parents began to advocate for legislation that would increase awareness of mental health resources on college campuses. College students are particularly vulnerable to the risk of suicidal ideation because they are often facing tremendous academic pressure and are away from family and support systems for the first time.

Texas suicide lawyer

 

While colleges have counselors available, students may be unaware of the mental health services that can be provided to them. Counselors may also fail to notice signs of suicidal ideation among their patients, which can result in accusations of clinician malpractice. Protecting young people during a vulnerable time in their life is of the utmost importance and two new laws have passed that could make a substantial difference in saving lives.

A closer look at Texas college suicide rates

In Texas, suicide is the second leading cause of death for college-aged kids. Around a third of all college students in Texas are reportedly dealing with depression.

Senate Bill 1624 was championed by the parents of the University of Texas at Austin student who died by suicide. The Bill was signed into law and took effect recently. The law requires universities to provide students with information on suicide prevention services and mental health services during their orientation period.

The bill mandates the information be provided to students during either a live presentation or a video. The information may not be provided in paper form. The purpose of requiring a video is to ensure students actually receive the information. Dallas News reports the director of the Counseling and Mental Health Center at UT-Austin is making a video that schools statewide can use in order to fulfill the new legal requirement.

Senate Bill 1624 was one of two laws that recently took effect to try to reduce the risk of death by suicide among college students. The other law requires local universities create a web page providing information to students about how to contact the local health authority in the university community.

The purpose of the new laws is to make it easier for students to access information they need and to reach out for help.  The lawmaker who authored the legislation stated: “College students in particular are at an age or an environment [where it’s] even more difficult for them, to seek out help.”  Now, by providing the information at orientation and on an easy-to-access website, hopefully more students will reach out.

The strong push should be “zero suicide.” This concept is realistic—several organizations have drastically reduced suicides and others have reached the goal of zero.  If zero is not the right number, what is?

Once students do seek mental health services, it is up to counselors to recognize signs of suicidal ideation and to take action to help vulnerable students. The counselor may be the only source of support a student who is far from home has, and the counselor must live up to the professional obligation he has to provide appropriate care and take action to help stop an attempted suicide or a suicide.

 

 

 

More Teens Losing Their Lives to Suicide by Firearm

Texas suicide lawyerIn 2013, there was a significant increase in the number of young people who used a firearm to die by suicide. Most of the instances in which a young person died by suicide using a gun involved a family member’s firearm.

A suicide attorney knows that many people who are considering death by suicide will use a firearm when available. This is one reason why it is so important for mental health counselors and professionals to be aware of the signs of suicide and to take action. Family members who are warned that a loved one is considering death by suicide can take extra precautions with any weapons in their home.

More Deaths By Suicide Involve Firearm Use

According to NBC News, the number of teens who died by suicide involving a firearm reached a 12 year high. An estimated 876 young people between the ages of 10 and 19 took their lives using firearms.

This is the third straight year in which the number of young people who chose this method to die by suicide has increased. In approximately 82 percent of situations where a young person died by suicide involving a firearm, the gun belonged to a parent or to another family member.

The increase comes at the same time as a general spike in the suicide rate for teens. Death by suicide is now the second leading cause of teen fatalities, with only motor vehicle accidents causing more fatalities. From 2007 to 2013, the overall rate of suicide among young people between the ages of 10 and 19 increased by as much as 34 percent.

Some advocates of stricter weapons laws argue that guns in the home increase the chances that a child will be shot and killed. A study published in the Annals of Internal Medicine also asserts that having access to guns increases the risk of death by suicide and Fox News indicated that guns in the home could cause as much as a three-fold increase in the risk of death by suicide.

Access to firearms may result in a high number of deaths by suicide not just because people who are considering suicide may find it easier if a gun is available, but also because guns tend to be a speedy method of suicide as compared to other things like taking pills. There is less opportunity for help to come or for a young person to change his mind when a gun is used in an attempt to die by suicide.

Health care professionals need to carefully monitor young people, and people of all ages, for risks of suicidal tendencies. If a young person seems especially at risk of suicide, it becomes important to discuss options with family about restricting access to weapons as well as about getting appropriate care.

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.

Researchers Find ‘Talk Therapy’ May Reduce Deaths By Suicide

Texas suicide lawyerNearly  everyone has heard about the importance of talking about your problems and not keeping feelings bottled up. A new study in Lancet Psychiatry finds that talking to others – specifically, therapists – can actually save lives. People who have attempted suicide can benefit from “talk therapy,” another name for psychotherapy. Repeat suicide attempts and deaths by suicide were about 25 percent lower among a group of Danish people who underwent voluntary short-term psychosocial counseling after a suicide attempt, according to the study.

Researchers from Johns Hopkins Bloomberg School of Public Health examined Danish health data from about 65,000 people who attempted suicide between Jan. 1, 1992, and Dec. 31, 2010. They looked at 5,678 people from that group who received sessions of talk therapy at one of Denmark’s eight suicide prevention clinics. Then they compared their outcomes over time with more than 17,000 other people who attempted suicide and who looked similar on other factors but had not gone for treatment afterward. Analyzing the data after a 20-year follow-up, researchers found the people who received talk therapy  were less likely to attempt suicide than people who did not receive the therapy.  Those who received psychotherapy repeated acts of self-harm less frequently and had a lower risk of death by suicide (or any cause) than those in the study who did not receive the therapy.

First-Of-Its-Kind Study Supports Benefits of Psychotherapy in Suicide Prevention

Suicide attorneys understand that it’s no surprise that counseling people with suicidal thoughts will help save lives.  But up until now, there has not been a lot of research to support whether a specific treatment is working. It’s a difficult subject to analyze, according to the study’s authors, because it’s not ethical to conduct a randomized study where some people get suicide prevention therapy while others don’t. In Denmark, the suicide prevention clinics were rolled out slowly and participation in the study was voluntary. Researchers say the large-scale study is the first of its kind to offer evidence that talk therapy can decrease the number of deaths by suicide.

Unfortunately, we know that many licensed mental health professionals in the United States lack proper training to help people who are at risk. They sometimes fail to offer the talk therapy – or other types of treatment – that can save lives. That’s why families whose loved ones died by suicide need the help of experienced attorneys who know what’s required to hold mental health providers accountable.

The new study was detailed in many publications, including a report in Time on Nov. 24, 2014. Quoting researchers, Time stated: “People who present with deliberate self-harm constitute a high-risk group for later suicidal behavior and fatal outcomes, so preventive efforts are important; yet, implemented specialized support after self-harm is rare.”

In  Johns Hopkins Bloomberg School of Public Health news release about the findings, Annette Erlangsen, DPH, an adjunct associate professor in the Department of Mental Health, stated: “We know that people who have attempted suicide are a high-risk population and that we need to help them. However, we did not know what would be effective in terms of treatment. Now we have evidence that psychosocial treatment – which provides support, not medication – is able to prevent suicide in a group at high risk of dying by suicide.”

According to the news release, researchers suggest broadly implementing therapy programs for people who have attempted suicide in the past.

We have no doubt that there’s room for improvement when it comes to helping people who have made attempts at suicide or who have suicidal thoughts. We hope this new study will lead to some meaningful changes.

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.

Justice System Neglecting Prisoners with Suicidal Tendencies

Texas suicide lawyerWhen a person is incarcerated, he or she is still entitled to receive necessary medical care for health conditions. This includes not just physical symptoms but also mental problems that may be causing someone to have thoughts of suicide or to consider dying by suicide. Unfortunately, a recent article on AOL.com suggested that safeguards designed to prevent inmates from harming themselves are not being followed.

Anyone considering dying by suicide deserves to get help and have a chance to recover, even if that person is in jail or prison. This “prisoner,” by the way, may be a teen locked up in jail for a DWI; a teen who is ashamed for the arrest and thinking he or she has ruined their life.  Of course they haven’t but they think so.

Those responsible for providing help can be held accountable if they negligently fail. An experienced suicide attorney can represent victims or family members who suffer as a result of a failure of healthcare providers or other professionals.

Inmates at Risk of Death by Suicide

According to AOL.com, an inmate in New York city who was experiencing mental illness died by suicide. He had attempted to die by suicide three times within a three day period of time before his ultimate death. As a result, he was put on 24-hour watch in an attempt to protect him. This was ignored. Also ignored was a screening form in which he had indicated that he was “thinking about killing himself.”

This is not an isolated incident. Another inmate also died by suicide in a solitary confinement cell after telling the guards that he was suicidal. When he said this to one of the guards shortly before his death, the reply was to “go ahead and do it,” if you have the courage to do so. A third story involved another inmate dying by suicide using a metal bed that he stood on its end to create a scaffold. The beds were supposed to be welded to the floor to prevent this, since another inmate had previously done the same thing.

AOL reported that records show at least 11 suicides in New York City jails in the past five years. In at least nine of the incidents, there was a failure to follow safeguards designed to prevent inmates from death by suicide.

Problems include:

  • Communications breakdowns between guards and mental health staff, which can sometimes result in inmates not getting necessary medications or precautions not being taken to protect those considering death by suicide.
  • Improper distribution of medication.
  • Inadequate mental health treatment.

There is no excuse for these types of problems, but they happen all the time. As a result, after cancer and heart disease, suicide is the third leading cause of death in jails nationwide. Throughout the country, there are 41 deaths by suicide among inmates for every 100,000 people incarcerated.

It is often possible to prevent death by suicide and a failure to take reasonable precautions to protect inmates can be considered negligent. When someone’s negligence directly contributes to a death by suicide, it is important to hold that individual or company accountable in order to change behavior going forward in the future and provide broader protections to those who need them.

A suicide attorney at the Law Offices of Skip Simpson can help. Call (214) 618-8222 to schedule a free case consultation.

Domestic Violence Elevates Suicide Risks

Texas suicide lawyerThere are many risk factors for suicide and both individuals and mental health professionals need to be aware of some of the likely reasons why people will consider death by suicide. One factor that can play a role in increasing the risk of suicide is domestic violence.

Mental health professionals should know that a person who has experienced domestic violence or intimate partner violence is at greater risk of death by suicide. If a counselor or care professional fails to recognize risk factors of suicide, a suicide attorney should be consulted for assistance in pursuing a claim for compensation.

The Link Between Domestic Violence and Suicide

As Overcoming the Darkness reports, victims of domestic violence have a higher risk of suicide not only while the violence is occurring but over the course of the rest of their lives. For example, a woman who experiences violence at the hands of an intimate partner is 12 times as likely to die by suicide as compared with someone who is not a victim of domestic violence. The increased risk of suicide is so strong that more domestic violence victims actually die by suicide than are killed by the person who is committing the abuse.

People who are themselves victimized by domestic violence are not the only ones who face an increased risk of suicide. Children who are exposed to domestic violence in the home are more likely to have suicidal tendencies and to die from suicide.

UMN reports on additional research showing a link between suicide and domestic violence. One study showed that 29 percent of all women in the United States who attempted suicide had been battered by an intimate partner. Reports prompted UNICEF to state that “a close correlation between domestic violence and suicide has been established based on studies in the United States” as well as in at least seven other countries.

Victims of domestic violence may feel trapped in a situation they cannot get out of and may feel as if they have no choice but to escape by taking their own life. Unfortunately, both suicide and domestic violence are also stigmatized in society. People avoid talking about domestic violence and they avoid talking about the fact that they are having thoughts of suicide because they are ashamed or because they fear social stigma.

Open communication is the key to preventing deaths by suicide among domestic violence victims. A change in public perception could help to make it easier for people who are being victimized and considering suicide to get the help that they need. Healthcare professionals need to be better trained and better informed on the link between domestic violence and suicide, and screening should be encouraged so that intervention is more likely to occur.

A large-scale study conducted by the United States Air Force shows that integrating suicide prevention policies and de-stigmatizing the process of seeking help can make a major difference in reducing the suicide rate. Not only that, but homicide and family-violence rates also decreased along with the number of people who died by suicide.

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.

The Link Between Teen Head Injuries and Death by Suicide

Texas suicide lawyerMany different risk factors can increase the likelihood of a young person having suicidal thoughts or attempting to die by suicide. While most parents and counselors are familiar with the potential impact that bullying and depression can have on the likelihood of a teen attempting death by suicide, there is also another danger that may not be so apparent. Emerging research indicates that a teenager who has suffered a traumatic brain injury (TBI) may have a greater risk of taking his or her own life.

Mental health professionals need to be aware of factors that increase a teen’s likelihood of death by suicide and must act to protect their patients. A suicide attorney should be consulted in situations where a mental health counselor has potentially failed to live up to his obligations with teens.

The Link Between TBI and Suicidal Thoughts or Attempts

According to Psych Central, a traumatic brain injury can result in “significantly greater odds” that a teenager will make an attempt. This is true even if the TBI was a simple concussion. Teens with a TBI had three times the chances of attempting suicide, and twice the chances of being bullied either at school or online.

Researchers identified this link by reviewing data collected as part of the 2011 Ontario Student Drug Use and Health Survey. The survey initially began as a method of studying drug use but has been broadened to ask questions about adolescent well-being and health. It is one of the longest ongoing school studies worldwide and almost 9,000 students participate. The students range from grade seven to grade 12.

In 2011, questions about traumatic brain injury were added to the study for the first time. Prior research shows that as many as 20 percent of adolescents in Ontario had experienced a TBI over the course of their lives.

The comprehensive nature of the new study allowed for connections to be drawn between a history of TBI and an attempt to die by suicide.  Mental health experts know that TBIs can exacerbate both mental health and behavioral problems, so it is important to understand this link.

Research revealed that a teenager who had a prior TBI was more likely to become a bully or to be bullied; and was also more likely to have been prescribed medication for anxiety, for depression or both. Teens with a prior TBI also had greater odds of breaking and entering; selling drugs; running away from home; damaging property; getting into fights at school; carrying weapons and setting fires.

Because of the far-reaching consequences of a TBI, prevention should always be the top goal, especially as many traumatic brain injuries are suffered during recreational or athletic activities and could be prevented by the use of helmets.

Unfortunately, once a brain injury has occurred, the only option is to watch carefully for signs of problems. It is essential for “primary physicians, schools, parents, and coaches” to be vigilant in monitoring adolescents who have suffered a brain injury.  Counselors should also provide the assistance these teens need to cope and avoid behavioral problems or thoughts of suicide.

A suicide attorney at the Law Offices of Skip Simpson can help. Call (214) 618-8222 to schedule a free case consultation.

What Can You Do to Make a Loved One’s Hospital Stay and Discharge Safer?

If your loved one is about to be admitted to a psychiatric hospital because he or she is suicidal, this is a blog you should print out and take with you to the hospital. It could save your loved one’s life.

Texas suicide lawyerWhen a loved one is in the hospital, we assume that the care is high quality and, most of all, safe. We feel relieved that our loved one is finally being properly protected while he or she is enduring a suicidal crisis.  We expect constant and safe round-the-clock trained nurses or psychiatric techs properly watching our loved ones to make sure all is well. We expect a properly trained psychiatrist giving hospital staff proper orders to protect our loved ones. We expect hospital leadership working hard to make the hospital safe.

Sadly, inpatient suicide—when a person takes his own life in a hospital or kills herself in a healthcare facility—is all too common. In fact, inpatient suicides occur six times a day every day of the year.

This is particularly egregious because the reason the patient is hospitalized is to keep the patient safe from suicide.

Sadly, unless hospitals abide by proper safety rules, the psychiatric hospital can be dangerous for suicidal patients … not as dangerous as not being hospitalized, but the hospital danger is a needless danger.  The mental health literature has clearly set forth safety rules for psychiatric hospitals for over 20 years, but many hospitals are turning a blind eye to the lessons of the literature primarily because of greed. There are obvious exceptions like Johns Hopkins in Baltimore, but the exceptions are rare.  The hospitals do not want to spend money on properly training staff or making sure the hospital is environmentally safe for a suicidal patient.  In addition, hospitals are understaffed so that the nurses and techs cannot keep up with properly protecting their patients.

What Families Can Do to Foster Suicide Prevention Awareness

Texas suicide lawyer Skip Simpson knows how vulnerable certain patients can be during their stay in a healthcare facility due to improper suicide watch and broken safety rules. He believes it is important for families to be aware of the statistics in order to foster as much suicide prevention awareness as possible.

Suicidality is the most common reason for inpatient psychiatric hospitalization. When a patient is admitted to the hospital because of thoughts of suicide, the clinician and hospital is on notice that the patient is at an increased risk for suicidal behavior. To be extra clear, the hospital knows it is likely a suicidal patient will attempt suicide in the hospital if the patient is not properly protected.

When hospital staff members are aware of a patient’s suicidal risks, the hospital assumes the duty to take reasonable steps to prevent the patient from inflicting harm. Obviously if the hospital staff does not know the proper safety rules or does not want to spend the money to learn them, the “reasonable steps” concept is ditched and the chief executive and finance officer just hopes for the best … just rolls the dice with patient safety.

An inpatient suicide may occur under varying types of circumstances. These circumstances all relate to violations of safety rules from inadequate suicide assessment, negligent suicide watch, an unsafe environment, inadequate policies and procedures regarding dangerous contraband like shoe laces or belts (to mention only a few).

What can the loved one do when their loved one is being admitted to a hospital for protection from suicide?

1) Make sure hospital staff knows exactly what your loved one has said about suicide or what steps your loved one has taken towards ending his or her life. You can ask your loved one before getting to hospital if he or she has thought about suicide. If yes, ask how he thought about doing it. Ask what steps he or she has taken, like buying a gun, getting a rope, hoarding pills, thinking of jumping from a bridge, or jumping in front of a car.

Make sure the hospital staff knows the answers to these questions.  Why? Because you cannot be sure hospital staff will ask them!

Make sure you see staff document what you say.

2) Ask who will be assessing your loved one for suicide and what their qualifications are to do so.  Don’t be embarrassed to be proactive. Be nice but be firm. You want your loved one protected…the more you are showing your concern the more concern your loved one will receive hopefully.

3) Tell the staff you want to be a part of the treatment team.  If there is a decision about your loved one’s care you want to be a part of that decision.

4) Encourage your loved one to sign a waiver of confidentiality so you can be kept informed by the staff of what your loved one is saying about suicide.  Patients often demand to be released and claim they are not suicidal so they can get out of the hospital…frequently so they can attempt suicide. Pressing for discharge can be a risk factor for suicide.

5) Tell staff you want to know what was learned in the suicide risk assessment. You may be able to shed light on what your loved one is telling the psychiatrist or nurse.  There are many reasons why your loved one may not “tell all” and your knowledge can make a big difference.

6) Determine how often the psychiatrist will visit with your loved one in the hospital.  Tell the psychiatrist you would like a brief call updating you on your loved one’s condition and the plans for your loved one.

7) Determine what level of observation your loved one will be on. In other words, will he or she be watched constantly? If not, how often? If you are told your loved one will be watched every 15 minutes, remind the staff that if your loved one attempts suicide by hanging, it only takes 2-3 minutes to have irreversible brain damage and 6-7 minutes to be dead.  Then ask, “How 15 minutes is protective?” Again, be firm and be an advocate for your loved one. The hospital patient’s advocate is employed by the hospital. You are the only true advocate for your loved one.

8) Ask if there is a bathroom door inside the patient’s room. If so this is where patients hang themselves using a sheet or clothing to hang over the door wrapped as a noose.

9) Ask how often your loved one will be properly assessed for suicidal thinking.

10) Ask how the staff monitors for behavioral signs and symptoms of suicide.

11)  If the staff or psychiatrist wants to relax suicide precautions to less than constant tell the staff you want to be notified to discuss this with staff.  You will want to know if there has been significant, stable, and reliable change in your loved one to warrant a step down in protection. Remind the staff that hanging is the number one way patients die by suicide in a hospital. Remind staff that ordinarily this is done in the privacy of the patient’s room or bathroom.

12) If a staff member acts rude with you or to your loved one, insist to see the staff member’s supervisor and explain you concern. Suboptimal staff-patient relationships are a risk factor for suicide. You want your loved one to have hope and not to feel like he is a burden or no one cares.

13)  When it comes time for discharge from the hospital, again make sure you are part of the discharge process. If you don’t feel like your loved one is ready for discharge say so and tell staff why. Again, make sure you see staff document your disapproval in the chart.

If staff insists on discharging your loved one ask to speak to the CEO of the hospital. If all else fails, call 911 and report that your loved one who you believe is still suicidal is being discharged from a psychiatric unit.

14) If you feel your loved one is safe for discharge make sure your loved one’s transition to outpatient care is smooth and immediate. Why? Post discharge of psychiatric patients admitted to a hospital for suicidal protection, is a very dangerous high risk time for a suicide attempt.

15) Very important: Make sure all guns are removed from your home, your car (check carefully under the seats, glove compartment, trunk… think like a police officer who is checking for drugs), your relatives and friends homes and cars, and anywhere in sheds or other hiding places around the home or apartment.   Skip Simpson, in making this list, has handled cases where guns were hidden and used post discharge.

16) Ask hospital staff how many suicides have occurred in the hospital in the last 5 years. Get an answer from someone.

17)  Ask staff what they do to ensure the hospital is safe for your loved one.  Do they have suicide prevention committee meetings? Do they utilize a Failure Mode and Effect Analysis? This analysis thinks of ways that patients could suicide in a hospital and fixes what needs to be fixed before a suicide occurs.

Patients, Families Suffer When Safety Rules Are Ignored by Hospitals

The hospital has lots of patients. You have one loved one who needs protecting. Make sure your loved one is on the top of the hospital’s list to protect.

The suicide prevention literature makes the who, what, where, why and how of inpatient suicide very clear. There is no guess work in making psychiatric hospitals safe.  When the safety rules are not followed, only the patients and their loved ones suffer the consequences.  Not the financial statement of the hospitals or the hospital leaders.

If you lost a loved one due to inpatient suicide, you may be able to pursue insufficient suicide watch compensation or recover damages for suicide in a hospital. For a free and confidential consultation, contact a tough yet understanding lawyer who can help you seek the justice you deserve. Contact Skip Simpson Attorneys and Counselors by calling 214-618-8222 or completing online contact form.