Family: Patient’s too-soon release led to his suicide — (The Clarion-Ledger)

SSRI Ed note: Talented young musician kills self after Paxil dosage increases.

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The Clarion-Ledger

Jerry Mitchell •

July 25, 2010

NATCHEZ ­ A day before officials at the state mental hospital at Whitfield released his 32-year-old son, Jody Rutter alleges they gave him this choice: Pick your son up tomorrow, or we’ll release him to a homeless shelter.

Three days after being released on June 25 to his grandmother, Rutter’s son David committed suicide.

Rutter said he got the call to pick up his son from a nurse practitioner on his cell phone. “I was floored. I pulled over to the side of the damn road.”

It was the first time he had heard from State Hospital officials, he said, and wondered why they hadn’t called him earlier to learn more about his son’s mental history.

Federal privacy laws keep State Hospital officials from discussing David Rutter’s treatment, but officials said there is a much different story about his release. They said they had attempted to contact the father prior to June 24.

Adam Moore, public information manager for the State Hospital, said some patients choose a homeless shelter.

“They may prefer an unstructured setting or may not like the rules associated with a group home,” he said. “Some patients have absolutely no resources and either no family or a family that refuses to be involved in their care. If that is the situation, we will consider discharging to a homeless shelter, but that is after all other options are exhausted.

“During the past two years, about 2 percent or less of patients discharged from Mississippi State Hospital have gone to a homeless shelter.”

Dr. E. Fuller Torrey, executive director of The Stanley Medical Research Institute in Maryland, said he believes “releasing an individual with a serious mental illness to a homeless shelter is a clear indication of a bankrupt treatment system, although it is periodically occurring throughout the U.S. It is appropriately called dumping, not discharge. A true discharge includes a realistic plan for permanent housing and plan for medication supervision, if needed.”

The State Hospital has downsized so much that it is now a third smaller than it was five years ago.

State mental health officials have told lawmakers they want to replace much of the institutional care with community-based mental health care. But while downsizing has continued, community-based mental health care hasn’t replaced it in many areas.

“As the report by the PEER Committee noted, they’re behind in making this transition,” said Dr. Bo Holloman, who oversees psychiatric emergency service at the University of Mississippi Medical Center. “You’ve got to build a community care system before you begin to downsize the State Hospital.”

The appropriate approach would be to involve the family in planning care for the patient after discharge, he said.

Frank Spencer, executive director of Stewpot Community Services, said State Hospital officials release a mentally ill patient outside Stewpot about once a month.

Some of those who show up are taking psychotropic pills that have side effects, he said. “They don’t take them, and you don’t know when they’re going off again.”

At times, Stewpot officials have had to have these former patients recommitted to the State Hospital, he said.

Wilbert Logan, director of Jackson’s Billy Brumfield House, said the State Hospital sporadically drops off a patient. One came to his doors last week.

“He decided not to stay,” Logan said. “He went to a relative’s house, and the relative brought him back to the shelter for permanent residence. I said, ‘We’re not permanent residence for anyone. We’re a homeless shelter.’ ”

Jody Rutter said he pushed to get his son committed to the State Hospital hoping doctors would help treat him for mental illness and increasing talk of suicide. He said he’d noticed that his son’s talk of suicide had gotten worse since a physician prescribed the antidepressant Paxil.

In a competency hearing that followed, a local psychologist testified David Rutter needed long-term treatment at the State Hospital, his father said.

The psychologist diagnosed the son as having intermittent explosive disorder, and the judge ordered him sent to the State Hospital.

“When he blew up, he’d go off. He had a violent temper,” Jody Rutter said. “His grandmother, who had been keeping him, was scared of him. She was worried he would knock her down and she would break her hip.”

Believing his son would be staying for months, Jody Rutter said he was stunned to hear his son was being released after 28 days. David’s grandmother, hoping he was better, picked him up.

Jody Rutter said the nurse practitioner told him his son was an exemplary patient. “She almost made me feel like, ‘Why did you send him here?’ ”

He said if officials had spoken to him, they would have learned how manipulative his son was.

If people had happened to attend his son’s funeral and see the photographs shown that day, “all they would see is a laughing kid,” he said. “They would get no sense there’s a problem.”

There was a problem, and it had been present since he was young, the father said. “He just didn’t fit in this old world.”

He said his son was so talented he had already recorded three CDs of his own songs. “He played every instrument.”

The nurse practitioner who told him about his son’s release emphasized David was not bipolar and said doctors increased the amount of Paxil he was taking, Rutter said.

On June 28, David Rutter walked onto the front porch of his 87-year-old grandmother’s house and hanged himself with an electrical cord.

Hours after his son’s death, Jody Rutter called the nurse practitioner and told her to not have anyone make any follow-up phone calls. “I’m wanting you to know,” he said he told her, “David Rutter committed suicide