ANTIOCH -- When Afroza Chowdhury told police one evening last spring that her ex-husband had threatened to kill her if she didn't move out, she was taken to the Contra Costa County hospital in Martinez for a mental health evaluation. "I would rather kill myself than be killed by you," she had told him.
Hours later, hospital staff released Chowdhury and put her in a cab, bound -- at their direction -- back to her ex-husband's home. She never made it, choosing instead to jump from the cab as it was traveling on Highway 4, killing herself.
This is a copy of a photograph of Afroza Chowdhury made on Monday, Feb. 29, 2016, in San Francisco, Calif. Chowdhury died when she jumped out of a taxi cab that was traveling at freeway speeds last year. (Family photo) (family handout)
Chowdhury's April 5 suicide has rekindled questions about the county hospital's policies for treating and releasing patients brought to the hospital by police for mental health evaluation. Experts have questioned whether there should be more protections in place for mental health patients who have also been the victim of a crime.
"(She was taken) back to the home where she was threatened? None of that was looked at?" said Kathleen Krenek, executive director of Next Door Solutions to Domestic Violence. "I think the community needs to review this for ways the system could be improved."
The case also raises questions about the county hospital's practice of sending home in cabs patients who could be a danger to themselves and others.
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Three weeks after Chowdhury's suicide, William Shultz of Discovery Bay was evaluated at the same hospital for a mental health emergency following a police call and sent home in a taxi; a few hours later, he stabbed a 9-year-old boy to death while the boy slept.
A county health services spokeswoman declined to comment on whether the hospital has reviewed its policy on discharging people into taxis in light of the two incidents.
Tony Ahmed is photographed with a picture of his mother, Afroza Chowdhury on Monday, Feb. 29, 2016, in San Francisco, Calif. Chowdhury died when she jumped out of a taxi cab that was travelling at freeway speeds last year. (Aric Crabb/Bay Area News Group) ( ARIC CRABB )
Chowdhury's distraught son, Tony Ahmed, has filed legal claims -- a precursor to a lawsuit -- against Antioch police and the county hospital. He questions why hospital staff would have put his mother in a cab at 3:30 a.m., rather than calling a family member.
"I have a sister who lives back in Bangladesh, and obviously they're asking me, 'What kind of hospital releases a 60-year-old woman in the middle of the night?' " he said, taking several long pauses to hold back tears. "If I knew she was at the hospital -- 100 percent -- me and my wife would have come and picked her up."
Chowdhury had no prior history of mental health issues or making suicidal threats.
Police arrested Chowdhury's ex-husband that same night on suspicion of making a criminal threat and violating his probation for a prior drunken driving conviction. He was released from custody hours later.
Tony Ahmed said his mother called him that evening after police arrived, and passed the phone to an officer. During that brief conversation, Ahmed said he heard yelling in the background and asked the officer to call him back later for an update on the situation. The next phone call he received, though, came from his father the following morning, informing him that his mother had died.
Antioch police have declined to comment on the case, but Curtis Cope, a police officer of 30 years who has served as an expert witness on misconduct cases, says oftentimes patient-confidentiality restrictions and department policy prevent officers from informing next-of-kin in situations involving mental health.
Chowdhury, a former nurse, had moved from New York to Antioch so that she could take care of her ex-husband, who was suffering from an illness. The two had divorced many years earlier, and there wasn't ongoing tension between them, Ahmed said. He still isn't sure what motivated her to jump.
Attempts to reach Chowdhury's ex-husband for this story were unsuccessful.
"The week before, I took my daughter over there, and (Chowdhury) was hugging my daughter and saying, 'I can't believe this is my blood,' " Tony Ahmed said. "She would help everybody. ... One time she saw a little bird out in the middle of the street, and she stopped traffic in order to save the bird."
Tony Ahmed and his lawyer, Miles Cooper, have requested police records from the April 4 incident that preceded her suicide, without success. Similarly, Antioch police denied a Public Records Act request from this newspaper, saying such records are exempt from the law's requirements.
"One of the questions that we don't have an answer to is the police's perspective on this; they've been unwilling to give us the information," Cooper said. "And in my experience, when someone's unwilling to give you information, there's usually something in there that they don't want you to see."
Hospitals have strict guidelines when it comes to next-of-kin disclosure in cases involving mental health -- especially suicide -- but California law and the hospital's policy both require that staff make reasonable attempts to notify next of kin before releasing a mental health patient. County hospital Chief Psychiatrist Kristine Girard declined to comment on the specifics of the case, citing patient confidentiality, but spoke about the hospital's general practices.
"In general, efforts are made to contact someone such as a friend, relative, case manager, therapist, etc. for collateral contact," when a mental health patient is admitted and provides such information, Girard said in an email.
Chowdhury's medical records, obtained by this newspaper, give no indication whether she provided family contact information, and show no documentation of any attempts made by staff to seek out next-of-kin information.
But those records, which incorrectly refer to Chowdhury's ex-husband as her husband, show that she adamantly denied that she would try to kill herself.
"(Chowdhury) states that she is very upset with her husband but denied that she would ever kill herself over him," a doctor wrote after interviewing her. "She admits she was very upset when she endorsed suicidal thoughts to her husband and feels that it was an impulsive thing to say. ... (Chowdhury) reports feeling much better now (husband was taken into custody by police) and is requesting discharge home."
About two hours after making those statements, Chowdhury jumped from the taxi that was traveling 60 mph. Her actions demonstrate how hard it is, even for trained professionals, to accurately evaluate a person's suicidal tendencies, according to Elyn Saks, an associate dean and professor of psychology and psychiatry and the behavioral sciences at the University of Southern California.
"It's extremely difficult to predict violence, including suicide. The rate of successful prediction is not high at all," Saks said. "If someone is lying to you and saying 'I'm fine,' and you have no idea that they're lying, you're going to release them."
Still, the decision to place a woman who had recently been the victim of a reported death threat into a cab, in the middle of the night, and send her back to the place where she had threatened to kill herself, was "terrible," Saks said.
"I don't have any idea why they would do that in the middle of the night; it just doesn't make sense to me," she said.
Those sentiments were echoed by Krenek, who called for a third party to examine the case.
"I think what happened was absolutely horrible, and I also think what should happen is a death review board should see where the system -- from the arrest all the way through -- could things be improved?" Krenek said. "I think all the way through there were probably gaps and restrictions that led institutions to do what they did."
California law dictates that a patient cannot be held against his or her will unless they're deemed to be a danger to themselves, others, or if they're so mentally disturbed that they cannot provide themselves with food, shelter and clothing.
"Someone could be psychotic and delusional, and as long as they're feeding themselves and have somewhere to sleep, they're not able to be held against their will," said San Francisco public defender Daniel Meyer, who specializes in mental health issues. "It seems wrong for them to send her to the exact same environment which led her to make suicidal statements and that was just an unhealthy, unsafe environment for her. But if they don't think she's suicidal, she gets to make that decision for herself."
Contact Nate Gartrell at 925-779-7174 or follow him at http://ift.tt/1LYKASt.
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