Stop the secrecy

Imagine that a loved one wants to commit suicide, so you take them to the hospital and have them put on a watch where they are checked every 15 minutes to ensure that doesn’t happen. Then it does. How can that occur? Apparently all too easily, according to a Star investigation by reporters Olivia Carville and Theresa Boyle. So easily that last May, after the Star started asking questions, the government created a task force to come up with recommendations to prevent suicides in hospitals.

That group, headed by psychiatrist Ian Dawe, won’t report until 2016. But its first recommendation should be to stop the secrecy surrounding suicides in hospitals. Only by comparing information and prevention methods publicly can hospitals hope to stop the tragedies.

But ending that secrecy won’t be easy. It’s thoroughly ingrained in a self-serving system.

For example, the Star investigation that sampled almost half of Ontario’s hospitals found that at least 96 patients have died by their own hand while under care since 2007. A further 760 were seriously harmed while attempting suicide in hospitals.

But how many of those suicides or attempted suicides took place while patients were actually under suicide watch remains a secret. So how can hospitals learn from each other where the danger points are?

It gets worse. Hospitals are required to hold reviews after a suicide to find out what went wrong and what could have been done to prevent it. But hospitals are not required to release the information publicly or even to share it with other institutions.

As a result there are inconsistencies with how hospitals approach suicide prevention. For example, some hospitals use clothing and shoes with drawstrings, ties and shoelaces that can enable a suicide, while others use only clothing and shoes that close with Velcro or elastic bands.

For its part, the government has taken one small but important step toward a more transparent system. This month, it introduced changes to the Quality of Care Information Protection Act so that hospitals will be required to share the details of a suicide and how it occurred with family members. Until now, deplorably, hospitals have been able to argue that they did not even have to tell families how their loved ones died.

There’s more good news: Dawe’s task force is looking at a “systems-wide” approach to solve the problem that involves survivors, family, policy-makers and researchers. That suggests he is open to information-sharing and transparency in the system.

That is the right first step.