Comments on: Discharged patient commits murder-suicide — were her docs to blame?

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Tue, 04 Jan 2011 14:36:27 +0000

[...] Discharged patient commits murder-suicide — were her docs to blame? [...]

By: Ms. Responsivie

Ms. Responsivie — Fri, 30 Jul 2010 18:51:20 +0000

There is a lot to be said here, but at the end of the day, we need to look at the bigger picture.Yes, it’s heartbreaking that lives were lost; but these types of incidents are increasing across the country and blame will not remedy of of the end results. Persistent heighten of awareness and more education on mental illness is the key to recognizing the signs that a person needs help. Yes, the doctors have a responsibility and so does the siblings that lives with the patient and understands what is abnormal about his/her actions. At that point, any person with a known mental illness should be assigned a “caregiver” by the courts to assist with their care and psychiatric follow ups. I would agree that some doctors may be neglegent, but others just don’t have enough treatment time to get all the necessary details and they can’t force it if the patients is not agreeable to the suggested mental health prescriptions or counseling. We need to pose this very important feedback to our Courts to push this issue further. Now more and more Children are being abused stemming from these same ailments in addition to DRUG ABUSE (the same should apply). LETS SAVE OUR CHILDREN!

By: Judy Buckley

Judy Buckley — Wed, 24 Feb 2010 18:06:37 +0000

S Denny and Ted: I’m so sorry for your loss. I agree, Ted, in your son’s case it looks like the caregivers could have seen that coming and his meds don’t seem to have been balanced just right. I’m not a doctor, though I work in a outpatient mental health clinic and I’ve learned that the effectiveness of meds can be cyclical. They work well for a time and then may have to be adjusted. This case is so tragic. It would be, it seems to me, near impossible to predict this patient’s behavior with the timeline given. Ted, I don’t agree that treating patients with meds is not a sound treatment. Some illnesses are what they call “chronic and persistent” – a person usually cannot recover with “talk therapy” alone – especially with schizophrenia. Bipolar illness can be tough to treat, too, and a lot of people, especially young males, I understand, are really resistant to taking meds. Hence, the “dually-diagnosed” – mental illness and drug addiction because of self-medicating. Also, the statistics I’ve heard recently indicate a percentage in the range of 60% of people with mental illness being non-compliant with their meds. The thing that surprised me was that the same percentage of people with illnesses other than mental illnesses are also non-compliant. In California, the law is very specific that one has to be a danger to him/herself or others to be involuntarily committed – and then it’s for a 3-day hold for observation. And, “danger to oneself” doesn’t necessarily include that a person is not eating or keeping him/herself clean. We have a long way to go in the mental health and law enforcement fields in dealing with this.

By: Sue

Sue — Wed, 24 Feb 2010 15:35:29 +0000

Since it was 4 months out; the physician has no way of knowing if the patient is compliant with his/her treatment. Even under court ordered treatment it is difficult to enforce the use of the medications unless it is a court ordered injectible drug. Most patients can refuse treatment; and even if it was court ordered that usually is only for a period of 3 months and this patient probably would not still be under the court jurisdiction. When a tragic situation happens it is a normal human response to want to blame someone for the incident; but in this case I don’t see there was a duty to warn which does preclude HIPAA; and the article did not say this person was homicidal which would fall under the duty to warn.

By: Gupta

Gupta — Fri, 19 Feb 2010 01:00:06 +0000

MD shouldnot be blamed. He has done best. There may be other factors he may not know. Pt. or Family will share what they think is important for them. Even best psychiatrist cannot predict aabout pt.’s future behaviour.

By: Jim

Jim — Thu, 18 Feb 2010 23:17:36 +0000

I think this tragedy is being compounded by the impression provided by lawyers, that everything bad that happens, has a legal remedy. Who were the doctors supposed to tell? The parents and the siblings? Suppose the patient’s sister in law had sent the kids by herself, would there still be a suit (which implies that the in laws must be told as well). Of course then it would not have been the relatives that were suing the physicians, but the federal government for violations of HIPPA. So who are the potential losers here? The Hospital, the doctors, and any subsequent patients with short term or long term mental illnesses who wish privacy are potential losers. Who are the potential winners here? Well the family of the dead children….maybe…..if having money matters when your children are still dead. Who are the inevitable winners here regardless of the outcome? The lawyers are. The more I see of this kind of behavior the more I think Shakespeare was right “first, kill all the lawyers.”

By: MSW

MSW — Thu, 18 Feb 2010 19:25:33 +0000

The parents of the children should have been more resposnible about who they left thier children with. As I parent with a mentally ill sibling, I would never leave my children alone with my sibling. It is absurd to think that an MD or MSW is responsible for this. The parents are focusing thier grief in the wrong area and need to examine themselves. Focusing thier anger on the providers who tried to help will only prevent a healthy resolution to thier grief.

By: Bewildered

Bewildered — Thu, 18 Feb 2010 16:17:50 +0000

The fact that this suit has even been filed is nothing short of ridiculous. There is absolutely no way that the treating physicians could have predicted this outcome from a single admission, or even multiple admissions, for that matter. I realize that the treatment of mental disorders is poorly understood by the average member of society, and that the etiology of mental disorders is poorly understood even in the scientific community. However, the assertion that psychiatrists only “dope up” their patients is nothing short of ignorant and, frankly, dangerous. For every bad outcome, there are litererally hundreds, if not thousands of individuals whose lives are saved by mental health treatment that is validated and supported by quality randomized, placebo-controlled evidence published in peer-reviewed academic journals.

The outcome in this case is truly tragic, and I feel deeply for those who have lost so much. But demonizing the caregivers for lacking the extra-sonsory perception that would be required to literally predict the future (obviously impossible), will result in nothing more that reduction of access to necessary and potentially life-saving care in the future.

By: Sharon Davis

Sharon Davis — Thu, 18 Feb 2010 14:57:26 +0000

I am a Psychiatric CNS. Just recently we had an female individual return to our facility early (midnight) and floridly psychotic after a therapeutic leave. Upon her return she pulled out a very large hunting knife (about 9 inches) on the staff. All went well and no one was injured but the RN took a couple of punches in the interim. I point blank asked our CEO pf Administrative Services, the CEO of Nursing Services, and the Human Resource Director (AKA Labor Relations Coordinator) at our monthly Labor/Management meeting if the State Police were notified, per our policy, that she was in the possession of a weapon and were charges filed. I had the three (all men), look at each other, rather stupidly, and state “I’m not sure”. At this reponse I pointed out several facts to them: 1. I am concerned that you do not know the answer considering your level of management, 2. It happens throughout this country that critical information of this nature is not put on patient’s discharge summaries or histories, as then no outside alternate living arrangements/agencies will accept them, and 3. We (the healthcare provider) have a responsibility to note this information and press charges (so it is documented), to prevent or at least make our collegues aware and prepared, both in healthcare and law enforcement if she decompensates in the future. I received no response. However, the information is documented on our (the unions) minutes.

I am truly sorry for the loss of these 3 persons. However, after 4 months I cannot see how the physicians or facility is accoutable. Where was community counseling services? Was she following up? Was she in day programming? There are a lot of questions to follow up with, but this much I can tell you for sure…it is almost a guarentee that she was going to decompensate. The empirical data shows that patients stop medicating for various reason’s; they don’t like the way they feel, it interferes with thier sexual performance, side effects, they don’t need it, stressor’s, or just biological changes within thier bodies after time.

This is a field that constantly intrigues me and yet, with all my knowledge that I constantly keep current with, there continues to be no concrete answers.

By: linda hooks

linda hooks — Thu, 18 Feb 2010 13:15:29 +0000

Confidentiality has gone too far. The family should be made aware of a condition that could be harmful to the patient or to others. Bipolar!!!–Hmmm–as most people who deal with patients who have mental illness know, they are not compliant with taking their meds. I would never have let a 4 and 5 year old go on an ‘overnighter’ with a known bipolar patient. I was married to a person with a mental illness (didn’t know it when I married him). They do not ‘get better’ on their own. If they don’t take their meds and continue on follw up care (with family involved) they are extremely dangerous. I’ve been in the health care profession for over 30 years and I am sick and tired of HIPPA! No one ‘advertises’ a patients condition. However, sometimes it is important to discuss their problems with others, OBVIOUSLY!!!!!