Pediatric Psychiatrist Discharges Child; Results in Suicide

Case Overview

This case involves a fifteen-year-old male patient who presented to the emergency room after being arrested by the police for displaying strange behavior in public. The patient was admitted to the inpatient psychiatric ward for observation and was started on a mood stabilizer for a diagnosis of Mania. The patient stayed in the hospital for two weeks and was discharged after his mood and affect appeared to be stable. The patient left the hospital with a lithium prescription and was told to follow-up with his primary care physician to set up psychiatric evaluations. The patient was found dead two days later in a hotel room next to an empty bottle of his psychotropic medication.

Questions to the Psychiatry expert and their responses

Should this patient have been admitted longer and directly handed off to a psychiatrist for further mental status evaluation?

Caregivers should be vigilant about suicidal potential and should document their assessments in the medical record at each visit. Poor impulse control in patients with a personality disorder, particularly those with a cluster B disorder, places some degree of legal responsibility on the physician.

About the expert

This board certified and fellowship trained pediatric psychiatrist has remained in active practice for a decade, during which he has acquired a high ranking directorship of a pediatric psychiatry department, as well as academic faculty positions in clinical psychiatry at among the nation's top medical centers. He is also extensively published in his field. and has given nationwide invited lectures on the topic of child psychiatry.