Mental Health Awareness Month 2021
It is estimated 1,500 patients die each year by suicide in our hospitals and many thousands more make non-fatal attempts. Among other factors, investigations have shown these injuries and deaths can be attributed to inadequate staff training in a) how to detect, assess, and communicate suicide risk, and b) how to properly monitor known at-risk patients in the emergency room or hospital.
As mental health issues come more into our nation’s forefront, we are more aware than ever of the widespread nature of depression, anxiety, and other mental health conditions that can lead to suicide. Many of us have known someone who was admitted to a hospital or other medical care facility in order to protect them and treat them in a safe environment. Unfortunately, deaths during inpatient psychiatric care or due to premature release from psychiatric care are far too common.
When someone is in the care of a psychiatrist or psychologist, the medical professional is responsible for taking appropriate measures to monitor the patient’s safety. Although “appropriate measures” can vary from one situation to the next, it is clear when those measures have not been taken. With competent care and appropriate psychological treatment, all mental health facilities should be able to keep their patients alive and well
How Mental Health Facilities Fail Those Who Need Them Most
Families believe their suicidal loved ones are safe once they are seen at a hospital emergency room, psychiatric facility, mental health center, or mental health professional’s private practice. However, many licensed mental health professionals are poorly trained – if trained at all – in the detection, assessment, protection and treatment of suicidal people. Although you might expect your loved ones to receive proper care in a psychiatric facility, they might actually be in harm’s way due to poor training of facility staff.
A spouse, parent, child, sibling, or a close friend should take steps to help their loved one. Family members may have found a hospital or a medical professional they thought would help. Tragically, people sometimes take their own lives while under the care of professionals who failed to meet applicable standards of care.
Unfortunately, in most situations, by the time psychiatric negligence is apparent, it is too late to change the situation. If your loved one committed suicide while under the care of a psychologist or psychiatrist, or while a patient inside of a mental health facility, it is important to hold the negligent party responsible.
Examples of Psychiatric Malpractice:
- Failure to take an independent and complete psychiatric and medical history of the patient
- Failure to thoroughly review what can be voluminous medical and psychiatric records
- Negligent psychiatric hospital care
- Physical, emotional, or sexual abuse
- Failure to obtain informed consent
- Failing to notice signs the patient may be a risk to themselves or others
- Failing to monitor a suicidal patient
- Failure to protect patients from harming themselves
- Failure to refer to an appropriate specialist
- Failure to prescribe the proper medication
- Failure to prevent the elopement of a psychiatric patient from a locked facility
While approximately 1 of 4 outpatient suicides will result in a claim, about 1 of 2 inpatient suicides will result in a claim. Courts and juries generally perceive inpatient units as having a greater degree of control over the patient and, thus, a greater responsibility to prevent suicides. Inpatient suicide is the most common sentinel event reported to the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) over a 10-year period (1995 to 2005). According to JCAHO, the greatest clinical root cause of inpatient suicide is a failure in clinical assessment. Risk was not adequately assessed in about 60% of suicides, or else the risk level was not accorded appropriate precautions.
Inpatient suicides are viewed as the most avoidable and preventable because they occur in close proximity to staff. Early in the admission is a clear high-risk period, but risk declines more slowly for patients with schizophrenia. Other risk factors include absence of support and presence of family conflict. Findings of a systematic review of inpatient suicides included10:
•Inpatient suicide rates correlate strongly with the admission rate
•78% had at least 1 previous admission
•20% to 62% of suicides occurred on intermittent observation
•2% to 9% of suicides occurred on constant observation (staff informally cease observation to undertake other activities)
•Inpatients who commit suicide are not a homogeneous group
•Immediate post discharge is a high-risk period because of the increased stress it poses
•Reduced staff supervision increases risk, especially at nights, during hand-offs, and in unsupervised areas
It is important for the inpatient psychiatrist to understand the perspective of the newly admitted patient. Many patients will find the experience depersonalizing, threatening, and socially alienating and may perceive it as a personal failure.
Civil Liability Involving Inpatient Suicide
In most civil cases involving liability for someone’s death, it’s usually pretty easy to link the defendant (the person who is allegedly at fault) with the actions that caused the death (e.g., a driver runs a red light and strikes a pedestrian, killing them; a surgeon makes an obvious error during a routine procedure and the patient dies).
This is also true in civil cases in which family members or other loved ones try to hold someone else (in most cases, an institution such as a hospital or treatment center) liable for a suicide of their loved ones.
According to the Psychiatric Times, of the 35,000 or more suicides per year in the US, about 1,800 (6%) are inpatient suicides. This statistic is too high.
Determining Civil Liability
By definition, someone who commits suicide directly causes of his or her own death. As such, in the case of a personal injury lawsuit against a defendant who allegedly caused someone else’s suicide, the onus that falls on the prosecution is proving the defendant’s actions (or inaction, in most cases) were a substantial factor in the deceased person’s suicide. This is usually easy to prove. Most, if not all inpatient suicides are preventable if the standard of care is followed by the healthcare providers entrusted to care for the suicidal patient.
Another major element in a case of suicide is “foreseeability.” That is, was it reasonably foreseeable that the deceased person would commit suicide as a result of the defendant’s action or inaction? For instance, psychiatrists have a duty to protect their patients by properly assessing their potential risk of suicide. Reasonable precautions, such as one to one monitoring of the patient, need to be taken after the risk is identified and maintained until the risk is deemed low enough or the patient is discharged.
“Inpatient suicides are viewed as the most avoidable and preventable because they occur in close proximity to staff. Additionally, courts and juries generally perceive inpatient units as having a greater degree of control over the patient and, thus, a greater responsibility to prevent suicides.1″
Proving Liability in Suicide Cases
When it comes to proving an institution is liable for the patient’s suicide or injury, the plaintiff (the person bringing the lawsuit) must first prove that the provider was negligent in their care for the patient.
Negligence occurs when a health provider (including physicians, psychologists, social workers, counselors, therapists, or hospital employees) fails to comply with the standard of practice for providers with similar training and experience. In some cases, the provider may have done something a reasonably prudent provider would not have done in the same/similar situation. In other cases, the provider has failed to do something that a reasonably prudent provider would have done.
If the plaintiff can prove negligence on the part of the provider, they must then prove that the defendant’s negligence caused the suicide or other injury. At this point, it becomes important to determine if the health provider could have or should have anticipated the suicide attempt or some other injury (this goes back to foreseeability).
Because no mental health provider can guarantee a successful result, they will not be held liable simply because the treatment failed. The care must have been negligence, or the provider will not be liable.
At GreeningLaw P.C., we see too many Americans losing family members to suicide because they assumed their loved ones were receiving competent, professional care. That’s why we feel that reducing the suicide rate in America’s healthcare institutions starts with holding mental health professionals accountable.
GreeningLaw P.C. is one of the most recognized personal injury law firms in the state because we know how to make sure you are properly compensated for your suffering. Our experienced attorneys care about you and your outcome, and we will treat your case with the same respect and thoroughness with which we would our own families. We work on a contingency basis, meaning you don’t pay for anything unless you receive compensation for your case.
Contact us today for a free consultation. We will review the elements of your case, discuss the possible compensation you may receive, and suggest the best course of action.
We fight the legal battle so you have time for healing and renewal. We will get you through this
Call (972) 934-8900 or visit our contact page today.