October 9, 2006

Psychiatrists On The Wrong Side of Civil Rights, Again

Hunter college caves to lawyers.

A student takes a bunch of Tylenol in an OD attempt, and after 4 days inpatient returns to her dorm to find she has been evicted.

The article makes it sound as if Hunter College kicks you out of school if you attempt suicide, which wouldn't necessarily be improper, but it's also not true.  Hunter College's housing contract says you can't live in the dorms if you have a suicide attempt.  That's a little different.

So the student sues, and Hunter decides to settle.  Her lawyer gloats:

“We’re pleased that Jane has been compensated for the college’s discriminatory treatment based on the stigma attached to a mental illness,” said David Goldfarb, one of the law firm’s attorneys representing her. “If Jane had been hospitalized for mononucleosis or pneumonia, I am confident that she would have been welcomed back to her dorm,” he added.

Well, gee, maybe a suicide attempt made volitionally, with a good chance of happening again, is a little different than pneumonia?  Stigma of mental illness?  So she was evicted for being on Zoloft?

The lawyer for the Bazelon Center for Mental Health Law , who should know better, says,

"Schools that exclude students who seek help discourage them from getting the help they need, isolate the students from friends and support at a time when support is most needed, and send students the message that they have done something wrong.”

Hmm.  I thought Hunter was a college, not a daycare?  Since when is it a school's responsibility to ensure adequate access to friends?  Is it responsible for finding them mates as well?  The problem with this statement is its logical conclusion: when can a school exclude students who seek help?  Never? Let's say the next time she tries suicide by turning the gas on, and she blows the dorm up.  Oops?

The most dangerous quote of all is from someone who really, really should know better, but obviously doesn't:

[Rachel] Glick, who is also associate chair for clinical and administrative affairs and a clinical associate professor in the Department of Psychiatry at the University of Michigan, emphasized that "universities should be open to being informed by psychiatrists and other mental health professionals about what to do to enhance the care of the students, rather than just thinking about protecting themselves from lawsuits."  

So let me get this straight: the university should ask the psychiatrist about whether the person could stay on campus or not?   Any psychiatrist out there who wants that liability football?

College:  So now that you've evaluated her, should she be allowed to return to the dorm?
Psychiatrist:  Huh?
College: Is she going to kill herself again?
Psychiatrist: How the hell would I know that?  I can't predict the future.
College: But you all told us we needed to seek your advice.
Psychiatrist: Hey man, don't try to pin this on me.  I'm going to lunch. 

Interestingly, the Psychiatric News article doesn't mention last month's case  where the parents of  Charles Mahoney sued Allegheny University because Charles was not put on mandatory leave of absence while he battled depression for two and a half years.

Everyone wants it their way; sue when you don't get your way, logical consistency be damned.  Has it now become outrageous to say that  the liability for a suicide attempt and its prevention lies  entirely with the person attempting it? 

(Addendum: many angry at my post, so I refer to the specifics of the case itself.) 







Comments

I'm working on a post in re... (Below threshold)

October 10, 2006 7:53 AM | Posted by dinah: | Reply

I'm working on a post in response to this.

Vote up Vote down Report this comment Score: 0 (0 votes cast)
And I've responded to your ... (Below threshold)

October 10, 2006 9:39 AM | Posted by Alone: | Reply

And I've responded to your comment.

Vote up Vote down Report this comment Score: 1 (1 votes cast)
If college is "daycare" whe... (Below threshold)

October 11, 2006 8:07 PM | Posted by Roy: | Reply

If college is "daycare" when they have to maintain access to friends, then what do you call it when they have to protect nihilistic students from themselves? Does this mean that dorm students with stiff necks and headaches who refuse to be evaluated for meningitis should be kicked out? What about people with seizures who are non-compliant with their meds?

I say let's put 'em in jail at the first potentially harmful thought, with 24-hour camera supervision and an e-meter.
http://psychiatrist-blog.blogspot.com/2006/10/suicidal-students.html

Vote up Vote down Report this comment Score: 0 (0 votes cast)
I very much enjoy your writ... (Below threshold)

October 12, 2006 7:33 PM | Posted by Anonymous: | Reply

I very much enjoy your writing. Please consider a different background so those of us with difficulty reading white text on black can continue to read your thoughts!

Vote up Vote down Report this comment Score: 1 (1 votes cast)
"dorm students with stiff n... (Below threshold)

October 12, 2006 9:07 PM | Posted by Trimble: | Reply

"dorm students with stiff necks and headaches who refuse to be evaluated for meningitis should be kicked out?"

Actually, they get forced into an evaluation-- it's a public health hazard. But the non-compliant seizure patient is on his own, unless he puts others at risk.

Vote up Vote down Report this comment Score: 0 (0 votes cast)
The issue of liability belo... (Below threshold)

October 12, 2006 10:51 PM | Posted by Anonymous: | Reply

The issue of liability belonging directly to the individual who is suicidal contradicts what psychiatrists do in an emergency room setting all the time. So yes, I think this society deems that it is outrageous to "blame" the individual who is suicidal for their actions. This is why courts prosecute a psychiatrist when a person is discharged from their care and then goes home and kills themselves a week later. The psychiatrist is considered at fault.

Although the "how long after being seen" is up for debate, an individual is loosely thought to not be responsible for their own decisions if they present themselves to a psychiatrist. It then becomes the responsibility of the psychiatrist to evaluate for the often even more arbitrary criteria for "mental illness" and some criteria are met to indicate that a person has a foreseeable risk to themselves, then the obligation falls on the psychiatrist to provide them with a millieu that will prevent that.

Active suicidality is essentially an indication of mental illness. The burden of proof lies on proving that the suicidality is not mental illness. In addition, the notion is, and often rightfully so in the case of depression, that when a person gets their mental illness treated, they return to their "baseline" level of rational thinking which allows them to then "not be suicidal" and function as the non-ill function. The logic being that they had a transient correctable "attack" of an illness.

Therefore, from a civil rights perspective, it does to me logically follow that a person should not be discriminated against (ie kicked out of school) because of an attack of a disease process when their baseline is functional and not disruptive to an educational environment. If they are kicked out of a dorm, I actually think that this is a bit more gray, because dorms are not essential to education, although they are owned by the university.

Vote up Vote down Report this comment Score: -2 (2 votes cast)
The article makes ... (Below threshold)

October 19, 2006 1:45 PM | Posted by Lindsay Beyerstein: | Reply

The article makes it sound as if Hunter College kicks you out of school if you attempt suicide, which wouldn't even be a bad thing, but it's also not true. Hunter College's housing contract says you can't live in the dorms if you have a suicide attempt. That's a little different.

Thelast, are you seriously suggesting that it wouldn't be a bad thing for colleges to expell students who attempt suicide?

Keeping suicidal kids out of dorms makes sense, but expelling them?

Vote up Vote down Report this comment Score: 0 (0 votes cast)