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Threats of Self-Harm Should Always Be Taken Seriously

This week the US Centers for Disease Control and Prevention's Morbidity and Mortality (CDC) reported that suicidal ideation among young people is higher than it was a year ago, with as many as one in four people ages 18 through 24 having seriously considered suicide in the 30 days. The CDC also reported that 11% of adults surveyed had seriously considered suicide in the past 30 days. Studies have demonstrated that suicide thoughts and attempts among transgender people are significantly higher than that of the general population of the United States.

Psychiatrists who see patients in the emergency department setting must be acutely aware of the risks of suicide. In some cases, involuntary admission is required to protect persons at risk of taking their lives. MCL 330.1401states, part: "Person requiring treatment" defined; exception. Sec. 401. (1) As used in this chapter, "person requiring treatment" means (a), (b), or (c): (a) An individual who has mental illness, and who as a result of that mental illness can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure himself, herself, or another individual, and who has engaged in an act or acts or made significant threats that are substantially supportive of the expectation. (b) An individual who has mental illness, and who as a result of that mental illness is unable to attend to those of his or her basic physical needs such as food, clothing, or shelter that must be attended to in order for the individual to avoid serious harm in the near future, and who has demonstrated that inability by failing to attend to those basic physical needs. (c) An individual who has mental illness, whose judgment is so impaired by that mental illness, and whose lack of understanding of the need for treatment has caused him or her to demonstrate an unwillingness to voluntarily participate in or adhere to treatment that is necessary, on the basis of competent clinical opinion, to prevent a relapse or harmful deterioration of his or her condition, and presents a substantial risk of significant physical or mental harm to the individual or others. "

Brian McKeen and John LaParl are presently litigating a case against psychiatrists who were employed by the University of Michigan Health System for discharging a transgender patient who presented to emergency department at the University of Michigan Hospital in severe emotional distress with suicidal ideation and a plan to take his life by jumping off a parking structure. The patient was unable to engage in crisis or safety planning given the acuity of his emotional distress, and attempted elopement from PES. He was at extremely high risk of suicide and warned staff that he planned to take his own life by jumping off a parking structure. In fact, staff were aware that only days earlier the patient had attempted to jump off a parking structure and had to be restrained from doing so by his roommate. After being told that Washtenaw Community Mental Health would not authorize and pay for hospital admission, the patient was discharged, and proceeded to do exactly what he had told them he was going to do - he jumped off the parking deck and suffered severe injuries which have resulted in lifetime disabilities. Mr. McKeen and Mr. LaParl are seeking to hold the University of Michigan accountable, and obtain justice for the patient.

If you are struggling with mental health issues, we encourage you to get professional help. The National Suicide Prevention Hotline is 1-800-273-8255. If you believe you or a loved one has been the victim of medical negligence, contact the law offices of Mckeen & Associates, P.C.

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