Upstream. A Mohawk Valley Blogzine.

Tuesday, March 28, 2006

Saratoga Hospital Fails Suicidal Police Officer. Expert Witness Perverts Justice.

Note: This article of mine appeared in The Sunday Gazette this past weekend. One thing that often perverts justice is the "expert" witness. Often a little research shows that they are not as expert as they would like you to believe.

If William Marhafer II had been admitted to Saratoga Hospital with chest pains and then had died of a heart attack 24 hours after being released, you can bet a jury would have found the hospital and doctors responsible for his death. But Mr. Marhafer went into Saratoga Hospital on Oct. 1, 2001 for severe depression. He was released on Oct. 5. On Oct. 6 he went to the Schenectady Police Department where he worked as a police officer and killed himself with his own gun.While it seems obvious to me that a man who kills himself 24 hours after being released from a psychiatric ward was not ready to be released, not everyone sees it that way. On February 21, 2006, a six member jury cleared Saratoga Hospital and three of its mental health workers of any responsibility in Marhafer's death. Although I don’t know the Marhafer family, nor am I familiar with Saratoga Hospital, I cannot accept the jury’s verdict.

It seems to me that there were at least two issues that were not adequately addressed by the hospital, its staff and by anyone in the subsequent trial. These issues are the special needs of police officers when they require mental health treatment and the access that police officers have to firearms.

Dr. Douglas G. Jacobs, a professor at Harvard Medical School, was paid $20,000 by Saratoga Hospital to be an expert witness at the trial. Dr. Douglas edited The Harvard Medical School Guide to Suicide Assessment and Intervention. A careful perusal of this book reveals two problems with it. First, by its own admission the purpose of the book is not only to be a guide to suicide prevention but it is to help the mental health professional avoid malpractice suits. It would require another article to explain how these two goals can work against one another. The more important problem with this book, however, as it pertains to the trial, is that it reveals that Dr. Douglas may be an expert on suicide, but he is not an expert on police suicide. Indeed, the only reference to a police officer committing suicide in the book is only four paragraphs long.

The National Police Suicide Foundation and, on the other hand, have a number of articles and a great deal of information about suicide among cops--information from mental health professionals, police officers themselves and their families. Most studies indicate that police commit suicide at twice the rate of the civilian population, even though police go through psychological screening before being hired. These sites gives the criteria for the typical suicide of a police officer. Marhafer met many of these criteria--white, male, around 35 years old, working patrol, and a recent loss or disappointment (Mahafer was under investigation at the time of his death).

Furthermore, these web sites make it clear why police suicide intervention is different from civilian suicide intervention. Police are trained to always be in control, often consider themselves indestructible, mistrust mental health professionals and are reluctant to confide in them, work a job with long stretches of boredom punctuated by short, high stress crisis situations, and often suffer from post traumatic stress syndrome among. These factors, among others, make police suicide intervention a specialty.

While Dr. Jacobs testified that Saratoga Hospital and its staff followed all the standard protocols for suicide prevention and intervention, it is clear that standard protocols are not adequate in dealing with police officers who are depressed or suicidal. Suicide intervention for police officers is a specialty that Saratoga Hospital does not seem equipped to handle.

If the hospital were equipped to deal with the special needs of depressed and suicidal police officers, how was it that Officer Marhafer ended up at the police station the day following his release, where he had access to a gun. While supposedly Marhafer was doing better, he was still clearly depressed and had an appointment for more outpatient treatment. Didn’t someone at the hospital talk to Marhafer’s superiors at the Schenectady Police Station about keeping him away from guns until he at least had his first follow-up appointment?

One thing Dr. Jacobs makes clear in his book is that access to lethal weapons strongly increases the risk of suicide. There are nearly fifty references to the role firearms play in suicides. These references point out that firearms are the most common means of committing suicide (57% of all suicides involve firearms), and that firearms are the most lethal method of suicide. 92% of people who attempt suicide with a firearm succeed as opposed to 78% who use carbon monoxide, 67% by drowning, and 23% by poisoning.

I believe Saratoga Hospital failed Officer Marhafer, but it’s too late to do anything about that now. However, it’s not to late too late to do something about preventing what happened to Officer Marhafer from happening to another police officer. In the April 1, 2003 issue of The Journal of Employee Assistance, Dr. Jacobs wrote an article titled Suicide and male workers. In it Jacobs states that “In May 2001, the Office of the Surgeon General of the United States launched an encourage the development of suicide prevention programs.” If there is a suicide prevention program that needs development at Saratoga Hospital, it is one for police officers. Maybe Dr. Jacobs will donate some of the $20,000 he got from being an expert witness at the trial in order to start one.


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