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Editor’s note: This story was written with the assistance and full support of the family. Feather Publishing reached out to the Plumas County Mental Health Department for input, but because of patient privacy, the interim director could not respond with specific information regarding this case, and declined to discuss the situation generically. However, two former mental health directors helped shed light on the situation.
Fourteen-year-old Quincy High School student Paige Ferguson committed suicide Sept. 18 at approximately 3:45 p.m. — 45 minutes before a scheduled appointment at the Plumas County Mental Health Department.
The family is sharing their story to help others who might find themselves in a similar circumstance.
Following is their recollection of events, as well as information provided by county officials, former mental health directors and experts in the field.
Tried to get help
Quincy residents Tracy and Dave Sims were close friends of Paige and her father, Joe Ferguson, and the family was staying at the Sims’ property on Bucks Lake Road.
“Last year Paige started having issues and asked to talk to someone,” recalled Tracy, who describes herself as Paige’s “pseudo-mom.”
She contacted Plumas Rural Services and Paige was linked with a peer counselor.
While Paige seemed to enjoy that relationship, Sims worried that she needed someone with more skills.
“I didn’t understand why she wasn’t referred to someone,” Sims said.
But the school year ended, and Paige went to spend the summer in Elko, Nev., where her mother and sister reside. When Paige returned to Quincy before the start of the new school year, Sims said she knew the teen needed help.
She said that she called Plumas Rural Services the Thursday before Labor Day weekend, but didn’t get a response.
She called again the Wednesday following the holiday weekend and said, “I need some help here.”
“Plumas Rural Services apologized for ‘dropping the ball,’” Sims said.
Paige’s peer counselor had moved on to another job, and Sims was told that Plumas Rural Services would be at the high school the following week, and Paige would be linked with a new peer counselor. This time Sims asked for a referral to someone with more experience, but that individual had a full caseload, so it was suggested that Sims call the counseling program at Feather River College.
Rather than doing that, Sims said she told Paige she was going to find a private counselor. A health care professional referred her to the mental health department.
Sims said when she called mental health “she hit a wall.”
By Sept. 13, the situation had worsened. Paige told friends that she planned to commit suicide that evening.
Quincy High School Principal Sue Segura and the sheriff’s department was notified, and Joe Ferguson, along with Dave Sims, took Paige to the mental health department.
“When we got there the lady behind the glass told us everyone was at lunch, but she would try to find someone,” Dave Sims said.
That someone turned out to be Michael Gunter, a marriage and family therapist, who was also serving as the department’s interim program chief.
According to Tracy Sims, after meeting with Gunter, Paige said she would be more comfortable talking to a woman so Gunter set up an appointment for the following Wednesday, Sept. 18, at 4:30 p.m.
“As a lay person, when a mental health professional schedules an appointment that far away it tells me that they must see something that tells them it isn’t critical,” Sims said.
She said the weekend passed well, but by Monday, Sept. 16, Paige complained of flu-like symptoms and stayed home from school. By Wednesday, Sept. 18, Sims said she became concerned that it was more than the flu and thus began her calls to the department.
“I am so angry at him (Gunter); I started calling at 9:11 (that morning). I left panicked messages,” she said.
She said she told Gunter, “I need to talk to you; I need some help. I’m scared; I’m scared for her.”
Sims said that when they finally talked at 3:20 p.m., Gunter said he couldn’t discuss the teen with Sims because of privacy issues, and Sims was not a relative.
“He was so awful to me. I know the HIPAA (Health Insurance Portability and Accountability Act) rules; he went beyond,” she said.
Sims said she knew Gunter couldn’t break confidentiality, but she needed guidance on how to handle the situation.
Even recounting the conversation caused Sims to shake. “I did everything I could; something needs to be done.”
Paige shot herself at home at approximately 3:45 p.m., after asking Sims to pick up her homework from the high school so that she wouldn’t fall behind in her classes.
Sims said that she, with Joe Ferguson’s support, is “sharing our story so someone else doesn’t have to face a glass wall when they make a plea for help.”
“I do not blame Gunter for Paige’s death,” Sims said. “But I blame him for not helping when I pleaded for assistance.”
The glass wall
With some serious concerns leveled at the mental health department, Gunter, who is also serving as the interim mental health director following Kimball Pier’s termination, was asked to respond.
When asked if he was aware of the concerns that the family had regarding their interaction with the mental health department prior to Paige’s suicide, Gunter said, “You know we can’t disclose information about a client.”
When asked if there was a protocol in place at the mental health department to deal with someone who is threatening suicide, he responded, “I’m not going to answer questions about protocols here.”
County Counsel Craig Settlemire said that Gunter was correct in asserting that he couldn’t discuss an individual case, and though he could discuss a situation generically, Settlemire said that “coming right on the heels of this event, it could be interpreted as what could have happened.”
Settlemire said he couldn’t say whether he has discussed the issue with Gunter because “we’re the legal counsel for the entire county and consultations are private.”
Kimball Pier, the county’s former mental health director, said that she wasn’t aware of the situation — that a 14-year-old threatening suicide had been in her department until late on the afternoon of Sept. 18, when she was packing up her office.
The Plumas Board of Supervisors had terminated Pier’s contract following a 1:30 p.m. closed session Sept. 18, but that same morning she had attended the regular clinician meeting, when therapists discuss “who should be on the radar.”
Pier, like Gunter, is prevented from discussing specific cases, but she said she couldn’t recall any mention of a teenager threatening suicide during that meeting.
“I wasn’t informed and there was no information given to me. Typically I would be in the loop,” she said.
She was “in the loop” during the immediately preceding Sept. 14 – 15 weekend, when the on-call clinician called her to discuss the hospitalization of some patients.
As for the 14-year-old, Pier said that if the department gets a parent who says, “‘I think my child is suicidal,’ it’s the job of mental health not to waste any time.”
She added that is why there is a “clinician of the day” to ensure that there is someone always accessible to clients.
John Sebold served for 12 years as Plumas County’s mental health director before he retired in June 2012. He agreed to discuss his department’s standard of care for individuals who threatened suicide, which included a prompt response, a good assessment and safety plan, proper documentation and consultation with a supervisor or other clinician.
“The rule of thumb is that if you had any self-harm issue with a client, it was always staffed by a supervisor,” he said. “It had to be that way so no one is out there on their own.”
Sebold said that there were weekly meetings when the clinicians would discuss cases, but there was someone available at all times, even in the middle of the night, to talk about a situation.
“One of the things I tell clinicians is that if you go through this job without someone killing themselves, you’re lucky,” he said. “People are severely despondent and sometimes they don’t tell you what they are really thinking.”
He said that there are very few clinicians “who don’t look back” at how they handled clients.
Proper assessment is a vital component, according to Sebold, but it’s difficult.
“You can make a really good assessment and the teen can be very cooperative, but a day later they can get a call, and then all of a sudden you go from low risk to high or moderate risk,” he said.
Sebold said that it is critical for a clinician to “document a clear safety plan of how the child will be safe” until they can be seen again.
One of the questions he said he would ask is, “What is the teen’s family’s ability to offer safety and support?”
He added, “A big variable is guns. Having guns in the house is a serious risk factor.”
If a suicide does occur, good documentation is critical. Sebold said he took that issue very seriously and held annual trainings with an attorney from the California State Association of Counties.
“She would do trainings on liability, risk and documentation,” he said.
Experts agree with Sebold’s emphasis on documentation.
In an article printed in the Journal of Psychiatric Practice, attorneys Skip Simpson and Michael Stacy discussed circumstances that could cause legal action and wrote, “Suicide, however, is the most common cause of action against mental health care professionals.
“Documentation is a cornerstone of the defense of a potential suicide case.”
The duo also addresses the importance of consultation with other mental health professionals.
They conclude by saying, “Most importantly, proper documentation serves the higher purpose of promoting quality care.”
And in the wake of Paige’s death, that’s what the Sims and Joe Ferguson say they want to ensure for the future and why they want to share their story.
Facts about teen suicide and suicide prevention
The following information is provided by the National Institute of Mental Health.
Q. How common is suicide in teens?
A. Suicide was the third leading cause of death for ages 15 to 24 in 2009, accounting for 14.4 percent of deaths.
Q. What are some of the risk factors for suicide?
A. Risk factors vary, but some important risk factors are:
—Depression and other mental disorders.
—Substance abuse disorder (often in combination with other mental health disorders).
—Prior suicide attempt.
—Family history of suicide.
—Family violence including physical or sexual abuse.
—Firearms in the home.
—Exposure to suicidal behavior of others, such as family or peers.
However, it is important to note that many people who have these risk factors are not suicidal.
Q. What are the signs to look for?
A. Following are some of the signs to look for:
—Talking about wanting to die or kill oneself.
—Looking for a way to kill oneself, such as searching online or buying a gun.
—Talking about feeling hopeless or having no reason to live.
—Talking about feeling trapped or in unbearable pain.
—Talking about being a burden to others.
—Increasing the use of alcohol or drugs.
—Acting anxious or agitated; behaving recklessly.
—Sleeping too little or too much.
—Withdrawing or feeling isolated.
—Showing rage or talking about seeking revenge.
—Displaying extreme mood swings.
Q. What can I do for myself or someone else?
A. If you are concerned, immediate action is very important. Suicide can be prevented and most people who feel suicidal demonstrate warning signs. Recognizing some of these warning signs is the first step in helping yourself or someone you care about.
If you are in crisis and need help, call this toll-free number available 24 hours a day: 800-273-TALK (8255) and you will reach the National Suicide Prevention Lifeline. All calls are confidential.
You can also visit suicidepreventionlifeline.org.
Locally, help can be accessed by calling the following entities:
The Resource Center: 530-283-5515.
Plumas County Mental Health Department: 530-283-6307.
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