Virginia 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.

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.

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.

In 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.

Nearly  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.

When 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.

There 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.

Many 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.

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.

When 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.

How many times, when you were extremely anxious, depressed, overwhelmed, and suicidal, did you call your primary care physician after hours? Remember the recording, “If this is an emergency, call 911 or go to your nearest emergency room?”  You muster up the courage to go to the Emergency Room, only to endure a wait, perhaps for hours. You might conclude the wait is making you more stressed and leave (wrong choice) or you might wait to be seen by the ER staff. Is the ER staff competent to help?  Maybe not. If you are overwhelmed will you need a family member or a friend to help you negotiate the ER? Absolutely.

Emergency rooms are recognized as an important component of suicide prevention … if the ER is competently staffed. Studies indicate that on average 412,000 ER visits per year are related to intentional self-harm or suicide attempts. Thousands more go the ER seeking help for mental health concerns including increased anxiety, depression, and thoughts of suicide. Many visits to the ER are by folks who have not yet attempted suicide but are in a suicidal crisis and need an intervention to prevent an attempted suicide. Now for the rub.

For effective treatment to occur in the ER, the ER staff must detect, assess, and manage the suicide risk before suicidal individuals choose that most desperate and final act. In those situations in which suicidal people have made it to the emergency room, most of us believe they are safe and will be protected.  Not so! Most emergency room staff, including the doctors, are poorly trained – or not trained at all – in the detection, assessment, management, and treatment of suicidal persons.

Steps to Take to Get the Help You Need

A recent report in Academic Emergency Medicine, the official journal for the Society for Academic Emergency Medicine, concludes “…suicide screening for adults in the [emergency department] (ED) is far from universal, which is concerning as many individuals at risk for suicidal behavior seek treatment in the ED.” The report states that many patients presenting with suicide risk factors were not screened for suicide. In a nutshell, a suicidal patient is going to need assistance from a friend or loved one in the ER to enhance the chances of the patient getting better help.

What can you do to get the help you need?

1. First understand that the ER may not be as good as we would like it in assessing and treating suicidal patients, but it is clearly the best choice when there is a suicidal crisis.  The likelihood is that if you, and your loved one or friend follows these steps, the ER, with your help, will make better decisions.
2. If you are suicidal, tell a family member or friend you are having suicidal thoughts and need help. Tell the family member or friend you would like them to take you to the emergency room. Trying to handle a suicide crisis without professional help is like flying a plane without a license.
3. After you arrive at the ER tell the first person working at the ER you see that you are suicidal and need help and now.
4. If you are a friend or family member helping the suicidal patient, make sure the ER staff knows your friend or loved one is suicidal and needs help now.
5. Make sure you see the intake person write in the records that the presenting patient is stating they are suicidal and needs help. If they don’t write it in the charts, ask them to do so. ER staff will have second thoughts on prematurely discharging a patient when the records state the patient is suicidal and thinking of killing themselves if not helped.
6. Make sure the intake nurse knows clearly the last time you thought about suicide and what it is you thought. If you thought about shooting yourself, say so. If overdosing, say so. If hanging yourself, say so. If you are helping the suicidal patient make sure you understand the answers to these questions and tell the intake nurse if the patient does not.
7. Understand that the point of this exercise is to get the protection you need. If protected and the underlying reasons for the suicidal thinking are properly treated with the correct counseling and medication, things WILL get better.
8. If the ER staff makes the suicidal patient wait in the ER, make sure you don’t let them leave the waiting room if possible. Don’t be afraid to speak out loud and clear if the suicidal patient is leaving. Silence or being embarrassed to speak out could be a deadly decision.  Remember you are with your spouse, child, or friend for a reason: getting them help & keeping them safe.
9. If the ER staff makes a decision to discharge the suicidal patient, ask the staff if they assessed the patient for suicide.
10. Ask the staff why they think the patient is safe?
11. Ask the staff if the patient can safely be left alone?  If the answer is no, ask why not?  Get the name of the ER staff member who says your loved one or friend is safe. Ask the staff member for a safety plan. Insist on the safety plan.
12. If you don’t get a safety plan ask to speak to the ER physician for an explanation of why no plan?
13. Ask the staff for the specific reason your loved one is not being admitted inpatient. If admitted they will likely only be in the hospital for 3-5 days … a small price in time to have many more years of life.
14. Listen to the reasons for not admitting inpatient. If you believe your loved one or friend is in danger for hurting themselves if not helped, tell the staff why you think that. Again, tell the staff to record in the patient’s records your concern.
15. Remember the squeaky wheel gets the oil.
16. Patients and their loved ones and friends can’t count on the ER to get it right.  You must make it clear, even to the untrained, that your loved one and friend need to be properly assessed and managed.

At the Law Offices of Skip Simpson, we understand how devastating it is to lose a family member or friend to suicide. If you lost a loved one, you will need a compassionate lawyer who works hard to hold mental health professionals accountable. Contact a Dallas attorney with a highly successful track record who represents clients nationally. Call 214-618-8222 or fill out our online contact form.

The link between bullying and suicidal thoughts among teenagers has long been established, with early medical journals dating back as far as 1910 addressing the impact of harassment or teasing behavior on suicidal ideation.

Now, a new study published in the medical journal JAMA Pediatrics takes a closer look at how bullying can affect young people in today’s world. The study confirmed that victims of all types of bullying had an increased risk of suicidal thoughts, but that new forms of bullying in a digital age have exacerbated the problem.

Understanding the risk factors for suicidal thoughts among teens is important as parents, family members and other caregivers can be more alert for potential signs of problems at times when the teen is at the greatest risk. When a professional is providing therapy or treatment to a teen who is the victim of cyber bullying or other denigrating behavior, it is essential that the teen has adequate support. A suicide attorney can help families affected by a death by suicide to take legal action against a mental health counselor or other party who failed to provide appropriate treatment and/or who failed to provide a correct diagnosis for a teen experiencing suicidal thoughts.

Risk Factors for Suicidal Thoughts Among Teens

Suicide is one of the leading causes of teen deaths worldwide, and between five and eight percent of teenagers in the U.S. attempt to die by suicide annually. Bullying is also common among young people. As many as one out of every five teens is involved in some type of bullying.

Researchers decided to take a closer look at how this widespread bullying is affecting rates of death by suicide. A total of 34 different studies on suicidal ideation and peer victimization were reviewed. In total, the studies provided data on 284,375 young people between the ages of nine and 21.

The researchers found that children who had experienced bullying were 2.23 times as likely to have suicidal thoughts as those children who had not been victimized by abusive or aggressive behavior. In situations where the children had both been a bully and been bullied by others, there was a slightly greater risk of suicidal thoughts. These children were 2.35 times as likely to consider death by suicide than young people who had not had any involvement with bullying at all.

The greatest risk-factor, however, was cyber-bullying, or bullying that takes place on the Internet. A young person who had been bullied via text message, via email or via an online video was 3.12 more likely to consider death by suicide than someone who had not been victimized.

There were many possible reasons why online cyber bulling is a bigger risk factor than traditional bullying. For one thing, material may be stored online and accessed repeatedly, resulting in the victim relieving the denigrating experience more frequently. Being bullied on the Internet could also cause a young person to feel as if he or she had been humiliated in front of a wider audience. The added risk factor existed across all age groups as well as for both boys and girls. Parents, teachers and mental health professionals should be aware of the risks and help to prevent teen bullying online and off.

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