VA closes psychiatric after 4th patient kills himself

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VA closes psychiatric after 4th patient kills himself

12:00 AM CDT on Tuesday, April 15, 2008

By SCOTT FARWELL / The Dallas Morning News
sfarwell@dallasnews .com

The Dallas VA Medical Center has effectively closed its psychiatric wing after a fourth mentally ill patient this year committed suicide.

On April 4, a man fastened a bed sheet to the bottom corner of a door frame, draped a noose over the top, and hanged himself. Before that, a veteran hanged himself on a frame attached to his wheelchair. And in January, two men who met in the psychiatric ward committed suicide in Collin County days after being released.

Officials said the government hospital, which was rated the nation's worst Veterans Affairs facility in a 1995 study, stopped admitting patients the day after the most recent suicide.

Ten veterans remain on the north wing on the 51-bed psychiatric unit. The south wing is closed.

Joseph Dalpiaz, director of the VA North Texas Health Care System, ordered the shutdown a day after the latest suicide.

"He decided he wanted to ... give us some time to assess the environment of care and make sure things were as safe as possible in our patient unit," said Dr. Catherine Orsak, head of mental health for the VA's North Texas health system. "It's a horrible tragedy and it may not have been preventable, but we wanted to look again to see if anything can be done to increase safety."

Investigators from the national Veterans Affairs office will be in Dallas next week to assess the safety of the Dallas psychiatric ward. Doctors sent patient records and other documents to Washington last week for review.

Dr. Orsak said VA hospitals around the nation have been examining their care and treatment of veterans after a Washington Post investigation last year found wounded Iraq war veterans living in ramshackle housing at Walter Reed Army Medical Center.

At the Dallas VA, she said, more than $250,000 has been spent during the last six months to eliminate suicide risks at the 68-year-old hospital in southeast Oak Cliff. Door knobs have been replaced, shower curtains and plumbing retrofitted, and light fixtures modified in an effort to remove rigid outcroppings that veterans could use to hang themselves.

"That's what makes this even more shocking and painful," said Dr. Orsak. "No one was ignoring this, and everyone was working hard on the fixes. And then you have a tragedy and you realize there's more you can do, and some patients have such a will to end their lives, it's hard to protect them."

Dr. Orsak said she did not know when the psychiatric ward would begin admitting patients again. In the meantime, veterans are being treated at government hospitals in Waco and Temple, as well as Parkland Memorial Hospital in Dallas and private treatment centers such as Green Oaks and Timberlawn.

She did not know how much the outsourcing of psychiatric care is costing the hospital.

Dr. Orsak acknowledged that mistakes have been made.

The wheelchair used by one veteran to commit suicide was not supposed to be allowed on the third-floor unit. After his death, wheelchairs of that type were disassembled and removed from the hospital.

Doors like the one the veteran used to take his own life this month will be removed or retrofitted. To avoid hanging suicides, many psychiatric hospitals use doors with a half-moon shaped top, or buy spring-loaded doors that collapse under weight.

Dr. Orsak said the 10 veterans remaining in the psychiatric unit should be safe.

"What we've done is increased the staffing and increased the checks," she said. "We're as confident as we possibly can be to say they are safe."

The Dallas VA is building a 29-bed psychiatric floor near the eastern entrance to the hospital. The $6.5 million project should be finished about this time next year. Three years later, another floor is scheduled to be built.

Shirley Bemps, who said her husband, Larry Johnson, committed suicide in the psychiatric ward on Feb. 5, said the Dallas VA's work is too little, too late.

"I blame the doctors," the Arlington woman said. "If he was a high-risk patient like they said, he should have been watched and monitored. They haven't called me to offer condolences. They won't even respond to me. I just feel cheated."

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