Rockland man's suicide calls attention to mental health services

ROCKLAND – Less than a day after Brian Dickinson was discharged from a private psychiatric hospital in Boston , he caught a train south and hitchhiked back to his hometown of Rockland, placed a phone call to his mother and then vanished.

Almost a month later Dickinson, who had battled alcoholism and mental illness for decades, his family said, was found dead in the woods off Hingham Street near Route 3. That was in November. The cause of death was suicide.

“He walked 150 yards into the woods and hung himself,” his mother, Carol Dickinson said. “Why was he discharged in this mental state?”

His death underscores what the Dickinsons and others say is the state’s and private insurers’ lack of commitment to mental health.

A report issued last April by the National Alliance on Mental Illness, Massachusetts sharply criticized the 40 percent reduction of publicly funded beds for psychiatric patients in the state since 2005 and the $60 million worth of budget cuts between 2009 and 2011.

“The system is woefully underfunded and has been for years,” said Laurie Martinelli, the mental illness alliance director.

Mental health spending in the state last year was $703 million. That figure is up from $671 million the year before, but adjusted for inflation, the alliance claims it is a $170 million less than in fiscal 2009.

Suicides are on the rise in Massachusetts, increasing more than 35 percent between 2003 and 2011, according to the latest figures collected by the Department of Public Health. There were 588 suicides in 2011, compared in 424 in 2003.

More than half of the suicide victims suffered from a documented mental illness such as depression, and 37 percent were undergoing some mental health treatment, last year’s report from the state health department stated.

The report found that 27 percent of suicide victims had an alcohol or substance abuse problem.

The director of the state’s suicide prevention program, Alan Holmlund, said that suicide numbers have continued to climb at similar rates in recent years.

“We have more mental health services available than most states do. I think it’s more an issue of getting people who are experiencing depression and other symptoms of mental illness to reach out for help,” said Holmlund. “Especially the middle aged male population doesn’t reach out so we have to reach out to them.”

Funding for suicide prevention in the state has been just under $4 million for each of the last three years.

But Martinelli and others have demanded that both public and private insurers raise the reimbursement rates for behavioral health care.

“All these places are closing their psychiatric (units) because they don’t make any money,” said Martinelli.

A recent analysis of insurance coverage presented to the State Health Policy Commission found that the state Medicaid program actually spends more per person on behavioral health care than private insurers – a monthly average of $93 a month compared to $16 from commercial plans.

On the South Shore, Rep. James Cantwell, D-Marshfield, agreed that the state must do more to fund services.

“People need to get access (to mental health and substance abuse treatment) before there’s an emergency. It’s a critical need,” said Cantwell, who has held community meetings in the aftermath of recent suicides of young residents in Marshfield and Scituate.

By the time doctors sent Brian Dickinson to Arbour Hospital in Jamaica Plain on Oct. 17, it was already an emergency, said Carol Dickinson.

“He was escalating, banging his head against the wall as hard as he could,” she said. “I called the police again and they took him to South Shore Hospital, but there’s no psych unit at South Shore Hospital.”

Two days later, Carol Dickinson said her son was committed to Arbour Hospital but was discharged after three days. State law does not allow a psychiatric hospital to hold a patient involuntarily for more than three days unless the hospital believes the patient poses a danger to himself or others and petition a district court for involuntary commitment for up to six months.

But Carol Dickinson, who is a registered nurse, questioned why her son was released.

Arbour Hospital said its discharge decisions are made by a lead psychiatrist along with a nurse and a social worker, but it could not comment on Dickinson’s case because of privacy laws.

Brian Dickinson’s suicide is under investigation by the Department of Mental Health, which is mandated to investigate any patient death that happens within 30 days of being released from a licensed psychiatric facility in the state.

In 2014, the state mental agency looked into 42 such deaths. In the last decade, the Department of Mental Health investigated 160 cases of patients dying within 30 days of being discharged from state-run facilities and 472 patients who died within 30 days of leaving a licensed facility.

Carol Dickinson met with a state investigator for about an hour last month, but he didn’t tell her when he would finish his investigation.

“We just want to know where the breakdown was, why he was shown the door after three days,” said Kathy Dickinson, Brian’s sister.

Carol Dickinson said her son was a “free spirit” who struggled especially after the murder of his older brother, Scott Dickinson, who was stabbed to death two years ago in New Hampshire.

“It affected him deeply, the murder,” said Carol Dickinson, who has lost two of her grown sons in less than three years.

The grief is clearly written on the faces of Brian Dickinson’s mother and sister. “He had his demons but mainly he had a heart of gold,” Carol Dickinson said.

Follow Chris Burrell on Twitter @Burrell_Ledger.

WARNING SIGNS

• Talking about wanting to die
• Talking about feeling hopeless or having no purpose, feeling trapped or in unbearable pain
• Increased use of alcohol or drugs
• Sleeping too little or too much
• Showing rage or talking about seeking revenge

Source: Suicide Prevention Resource Center

WHERE TO GET HELP

National Suicide Prevention Lifeline: 800-273-8255

Samaritans: 877-870-4673

Mass. Department of Public Health: Links to suicide prevention resources

4,398 people were treated in Massachusetts hospitals for self-inflicted injuries in fiscal year 2012.

51 percent of the 588 suicide victims in 2011 had a diagnosed mental illness such as depression.

27 percent abused alcohol and/or drugs.

3-to-1 is the ratio by which men exceed women in committing suicide.

Source: Massachusetts Department of Public Health

By the numbers