AN ANALYSIS ON 211 DEATH REPORTS TO LARA FROM PRIVATE PSYCHIATRIC HOSPITALS AND COMMUNITY HOSPITALS WITH PSYCHIATRIC BEDS, 2015-19

From Mental Health Association of Michigan: For Complete Post, Click Here…

The Mental Health Association in Michigan (MHAM) is the state’s oldest advocacy organization concerned with individuals of all ages with mental health conditions.  Incorporated in 1936, one of the primary activities for the Association over the past 84 years has been to influence mental health public policy at the state level. As such, this report, representing a compilation of death reports in inpatient psychiatric units and psychiatric hospitals, has been completed for the sole purpose of bringing to the attention of policymakers the necessity of providing greater oversight and accountability regarding the care that is given when an individual receives inpatient psychiatric treatment. MHAM is not only concerned about the availability of appropriate mental health treatment but of greater importance is the quality of care that is provided.

Please note that this is a preliminary report about the reported deaths that occur re d between 2015 and 2019. MHAM will be releasing a more in-depth analysis of the data later this year and will include data from 2020 – 2021.

The information contained in this report was obtained under the Michigan Freedom of Information Act (Act 442 of 1976). In 2020, MHAM requested all reports of deaths in inpatient psychiatric units and free-standing psychiatric hospitals from 2015-2019 from the state’s Licensing and Regulatory Affairs Department (LARA). Our analysis was limited by LARA redacting several critical pieces of information; providing no referenced attachments; and not asking for patient’s1    medication regimens in the hospital.

Despite the fact that the reports were missing critical information, MHAM was able to identify the following:

  • There were 211 death reports. One-fourth happened in the community post-discharge; three-fourths happened inside hospitals.
  • Over 25 hospitals reported deaths, with Botsford/Beaumont Farmington Hills having the most at 59. This facility (part of a formal merger in 2014) had a geropsychiatric program and admitted many elderly individuals who subsequently died, often in other parts of the hospital
  • Cardiac disease was cited most often (47 times) by hospitals on the “cause of death. There were 14 suicides cited and five drug overdoses, some of which could have been suicide.
  • As for presenting circumstances at time of admission, aggression/combativeness was cited the most (63 times). Next was suicidal or self-harm ideation, with 54 mentions.
  • Use of restraint/seclusion was reported 60 times. Respondents were asked if restraint/seclusion directly or indirectly contributed to death. Except for six blanks, every report said No – even in three cases where death occurred during restraint/seclusion.
  • Narratives about community deaths included 9-10 suicides (whereas the hospitals had reported 14 on the “cause of death” line). These also indicated 7 substance abuse­ related deaths (compared to 5 reported on the “cause” line by hospitals).
  • Lifesaving measures in the hospital were most often reported as None because of Do Not Resuscitate/hospice orders (81). Most mentioned as an attempt to save lives was CPR (44).
  • The state’s reporting form failed to request vital information about the recipient’s condition including the medications that the individual was receiving while inpatient.

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