The suicide of a Sophmore undergraduate student prompted a legal investigation into her medical history and whether the school psychologist had followed proper suicide prevention procedure. Though she had no past mental illnesses and was physically healthy, the student had been placed on Effexor, an anti-depressant, and had called the university suicide hotline to speak with a school psychologist. She mentioned all her issues and stated she was beginning to feel suicidal. The psychologist asked her if she would be able to ‘hold off’ and not hurt herself until the psychologist could see her the following morning. The student was found dead the next day, and the ensuing court case against the psychologist sought expertise in counseling suicidal college students to better understand whether the tragedy was preventable.
Question(s) For Expert Witness
- 1. Do you have experience as a psychologist working with or treating suicidal college students?
- 2. Are you familiar with the proper steps to be taken when a student indicates suicidal tendencies?
- 3. Should a psychologists only action be to ask a student to hold off on committing suicide?
Expert Witness Response E-044965
I have experience as a psychologist working with college students, since approximately half of the patients at the clinic I direct are college students. I have seen and treated suicidal students, as suicidal behavior is my clinical subspecialty. I am very familiar with the proper steps that should be taken as soon as student indicates suicidal tendencies, which should be more than asking a student to hold off on committing suicide. Rigorous safety planning is the thing that should have been done in the case, and it appears it was not done or certainly not done sufficiently.
Expert Witness Response E-044983
Although I do not currently provide clinical services to college students, I am a licensed psychologist and have extensive clinical experience working with them, having previously worked in a university-based psychology clinic and with college students undergoing suicidal crises. I also have broad experience providing clinical services to adults in major psychiatric and medical hospitals. The bulk of my clinical training and experience has been in the assessment and treatment of patients experiencing suicidality. I’ve previously worked extensively with such individuals as a member of the Suicide Crisis Management Unit during my time at the Psychiatric Emergency Room of two universities and in the psychiatric crisis units of various hospitals. In addition, I regularly provide suicide risk assessment and intervention training to graduate student and medical trainees as a part of my teaching responsibilities as an Assistant Professor in the Psychology Department at a university.
I am very familiar with the proper, widely accepted procedures associated with assessing and treating suicidal crises. In addition to my extensive clinical expertise in the matter of suicidal crisis, I am also an internationally regarded expert and clinical researcher, having published extensively on the issue with over 70 peer reviewed publications and book chapters and having won multiple major research awards. Accordingly, I am intimately familiar with suicide assessment and intervention. Based solely on the brief description provided regarding the case, asking a suicidal patient to “hold off” till the next day or having the patient “promise not to hurt himself” would not be seen as sufficient risk protection procedures in the case of intervening with an individual exhibiting intense suicidal ideation. This is especially true if there was evidence of preparation, planning, and access to means for the attempt. In such cases, the provider has a legal and ethical responsibility to pursue more comprehensive intervention procedures, potentially including the pursuit of voluntary or involuntary hospitalization.