Inpatient Suicide

Abstract

Suicides that occur while a patient is hospitalized are tragic events causing immense distress to relatives, peers, and professional caregivers. The prevalence of this infrequent occurrence is between 0.1% and 0.4% of all psychiatric admissions. This article reviews the literature to see if such events can be predicted and prevented; attempts to identify high-risk patients through demographics, diagnoses, medication treatments, and patient social situations; and examines the care-delivery environment such as length of stay and physical surroundings. This article also examines the means patients used to end their lives and when in their hospital course they did so. The authors ask if standard predictors are applicable to hospitalized patients, speculate on potential preventive measures, examine the effect on care providers, and explore what might ease the aftermath. Affective disorders or schizophrenia are most frequently associated with inpatient suicide. Most occur while patients are off the psychiatric unit. Suicides on-ward are usually accomplished by hanging; off-ward suicides are also often violent. Most patients denied suicidal ideation prior to the act. Factors associated with suicide in the general population are not consistently associated with inpatient suicides. Patient monitoring is not always effective. The first week of hospitalization and the days immediately after discharge are when patients are most vulnerable to end their lives. The authors conclude that the potential for suicide may be present from the initiation of hospitalization, but the ability to determine individuals at risk is, at best, poor.

Malignant Depression Takes Marie Osmond's Adopted Son

Sometimes, depression is so deep, suicide is a logical choice. The remedies include 1) electroconvulsive treatment, 2) tranquilizers to tone down the intense distress, and the really delusional idea required to commit suicide.

Singer Marie Osmond was said to be ‘devastated and in pieces’ last night after her troubled adopted son committed suicide by jumping from the roof of his Los Angeles apartment.

Michael Blosil, 18, left a suicide note for his family saying he had decided to end his life because of the ‘torment’ of his long battle against depression and drug and alcohol abuse.

The note was also reported to contain the words: ‘I feel like I have no friends and will never fit in.’

A police source said Blosil, who had been adopted as a baby by Osmond and her ex-husband Brian, jumped off the roof of the ten-storey apartment block in central LA where he rented a £1,500-a-month flat.

Read more: http://www.dailymail.co.uk/tvshowbiz/article-1254282/Marie-Osmonds-teenage-son-Michael-Blosil-commits-suicide.html#ixzz0goVjGA7s

Patient Murders 2 Children and Kills Self 4 Months After Release

There are several problems with the plaintiff case. They wanted to be warned, even though they were not the immediate family.

1. Tarasoff Warning. That is required when a credible threat of immediate harm is made against a named individual. This is a review of the current state of that warning requirement. The Illinois has rejected this bad case law. (Tedrick v. Community Resources Center, Inc., Nos. 104861, 104876 (Ill. Sept. 24, 2009)


2. Several unforeseen intervening causes. These include the traffic stop, the batteries of strangers. The biggest is the irresponsible entrustment of the children to the care of a psychotic patient. Unless, it can be shown otherwise, the parents knew of the severity of the patient's psychosis. These failures to prevent the catastrophe break the legal chain of any causation by the doctors or hospital.

3) Garbage Science. Any expert asserting an ability to foresee the suicide 4 months in advance is asserting a supernatural power, in violation of the Establishment Clause. I would appreciate the name of the plaintiff expert, so that I may act upon him.

Enraged Murderer-Suicider Flies into IRS Building

One can sympathize. But one hopes he targeted high officials who made policy decisions. These are armed federal functionaries with the humanity of Mafia loan shark collectors. It is unclear if his wife and daughter are dead, after being pulled from the flames engulfing his house. Here is his suicide note.

" A pilot furious with the Internal Revenue Service crashed his small plane into an office building in Austin, Texas, that houses federal tax employees, setting off a raging fire.

Officials are investigating whether the pilot, identified by authorities as Joseph Andrew Stack, a 53-year-old software engineer who lived in Texas, crashed the plane intentionally. Stack was confirmed dead.

An Internal Revenue Service office is located inside the building.

IRS Agent William Winnie said he was on the third floor of the building when he saw a light-colored, single engine plane coming towards the building, TheStatesman.com reported.

“It looked like it was coming right in my window,” Winnie said, according to the Web site.

Winnie said the plane veered down and smashed into the lower floors. “I didn’t lose my footing, but it was enough to knock people who were sitting to the floor.”

Stack posted a suicide note to a social media Web site, ranting against the IRS, officials confirmed.

"If you’re reading this, you’re no doubt asking yourself, “Why did this have to happen?'" the note read. "The simple truth is that it is complicated and has been coming for a long time."

Guard Fired After Noting but not Intervening in Youth Hanging

"An Ohio youth prison guard has been fired and two others disciplined after a teen offender's attempt to hang himself in a juvenile detention cell was ignored.

A state investigative report obtained by The Associated Press says the guard saw the youth with a blanket around his neck, noted the suicide attempt on a log and walked away without intervening.

The report says two other guards who were later suspended knew the youth may have been attempting to try to kill himself but failed to check on the teen, who survived."

More Garbage Assessment of Suicide

If Dr. Shawn Christopher Shea ever serves as a plaintiff expert, I would appreciate being told about it. I would intervene in the case, and seek to have a mistrial, with costs assessed to the assets of this peddler of garbage science.

"A sound suicide assessment approach or protocol is made up of 3 components:

• Gathering information related to risk factors, protective factors, and warning signs of suicide.

• Collecting information related to the patient’s suicidal ideation, planning, behaviors, desire, and intent.

• Making a clinical formulation of risk based on these 2 databases.

Practical approaches to integrating these 3 aspects of a suicide assessment have been well delineated for adults and adolescents.^1-8 Innovative systematic approaches, such as the Collaborative Assessment and Management of Suicidality (CAMS) approach created by David Jobes,⁹ have also been developed for integrating all 3 tasks while providing collaborative intervention, which may help lay the foundation for a more evidence-based protocol for suicide assessment. Recently, Joiner and colleagues¹⁰ have delineated a promising approach based on the interpersonal theory of suicide, which gracefully integrates all 3 components necessary for a suicide assessment."

Garbage.

Court: Prison Responsible for Suicide Two Days after Threat

The court wants prison guards to have training and to report suicidal gestures and threats.

The court wants to enrich tort lawyers. About a third of the beds in prison are filled by straight mental patients. So this decision will generate a lot of lawyer fees.

The dissent should be read as a checklist of defenses for the government entity.