This case involves a young woman who had attempted to commit suicide several times and was admitted for inpatient psychiatric treatment. She was discharged without a plan or regimen to keep her safe; instead, discharge instructions recommended the patient seek outpatient treatment means on her own. The woman killed herself several days later. It was alleged that the follow-up ordered by the physicians, as well as the decision to discharge the woman, were negligent.
Question(s) For Expert Witness
- 1. Do you routinely treat patients like the one described above?
- 2. What steps/safety precautions are recommended to ensure the welfare of a patient who has previously exhibited suicidal tendencies?
Expert Witness Response E-009157
I work in a general medical hospital which has an active psychiatric ER, inpatient units and outpatient clinic; I routinely assess suicidal patients who require psychiatric hospitalization and those who are referred to the mental health clinic with an appointment. I actively teach medical students and residents; topics have included substance abuse and suicidality as well. I assess and manage over 2000 patients yearly across multiple institutions. I regularly psychiatrically hospitalize suicidal patients as well as perform risk assessments for those who either report suicidality or who have attempted self-harm. I am board-certified in psychiatry and forensic psychiatry. Prior to discharge, either from a medical or psychiatric until, patients who have exhibited suicidal tendencies require some form of suicidal risk assessment; those who were recently suicidal and are being discharged from a unit will usually be prioritized to have an arranged follow-up within a short period of time; if they don’t make the appointment, phone or even mobile crisis follow-up is done to assess the situation.