Kaiser Permanente faces renewed criticism over mental health services after Santa Rosa suicide
Before she jumped to her death from the top of the parking lot at Santa Rosa’s Kaiser Permanente Medical Center over Fourth of July weekend, Barbara Ragan, 83, wrote a note to her children and her husband saying she “couldn’t stand the pain.”
Her medication routine had become a nightmare, upended by numerous prescription changes after the Prozac she’d used to treat her depression for years stopped working, her family said.
On July 5, dressed in a housecoat, nightgown, socks and slippers, Barbara Ragan drove the 10 miles from her home in Oakmont to the Kaiser medical center on Bicentennial Way. She went to the third level of the parking garage and stood on the edge. Santa Rosa police said witnesses below tried to talk her down, but she said nothing and let herself fall.
Denny Ragan said he believes his wife, who retired from Kaiser in South San Francisco more than two decades ago, was trying to make a statement. The only identification she had with her was her Kaiser medical card and her driver’s license, her family said.
“She drove right over to Kaiser … 16 years working there … she was very upset about them. She went right up to the parking area near the emergency room,” he said. “To me, that’s a statement of what they’re doing out there, how they treat people.”
Kaiser said this week that it extended its condolences to the Ragan family, but after thoroughly reviewing the case found that Barbara Ragan had received a “tremendous amount of care” in the weeks before her death. Officials said Kaiser mental health providers were in frequent contact with Ragan regarding her condition and the medications she was taking.
“We extend our deepest sympathies to the family,” said Dr. Mason Turner, Kaiser Permanente Northern California’s director of outpatient services for regional mental health.
“The care Ms. Ragan was receiving was exceptional care,” Turner said, adding that Kaiser was willing to work with the family to address their concerns.
But Ragan’s suicide has once again raised questions about what critics say are serious gaps in the company’s mental health services.
Specifically, critics say Kaiser fails to provide timely individual appointments to see a mental health therapist or psychiatrist. In recent years, Kaiser has been penalized by the state Department of Managed Health Care for serious “deficiencies” in its mental health care offerings.
Kaiser this week rejected such claims. Turner said the health plan has made great strides in expanding its network by hiring more mental health providers and contracting with an outside network to supplement its staff. The health plan said it hopes to become a national model for mental health care.
For more than two decades, Barbara Ragan had been taking Prozac. But Denny Ragan said that his wife only recently began feeling like it was wasn’t working for her.
“You could always tell something was always there, but it was livable,” Ragan said, adding that about a month ago his wife’s condition was worsening.
On June 15, the couple were at the Trader Joe’s on Cleveland Avenue when Barbara Ragan said she didn’t think she could continue shopping. She got extremely quiet, her mood worsened and she asked her husband to take her to the “emergency hospital,” Denny Ragan said. He said he didn’t know exactly what his wife was going through; her condition changed so rapidly.
“They’re the only ones that can explain what they’re going through,” he said. “I said, ‘Gee, you’re feeling that bad?’ She said, ‘Yes, can you please take me to the emergency room?’?”
Denny Ragan said emergency department staff told them the only thing they could do was give his wife a sedative and try to get her an appointment to see a psychiatrist.
Turner, the Kaiser mental health care director, said emergency department staff determined Ragan was not a danger to herself, and therefore they could not admit her. But they sought immediate help for her, he said.
Medical center staff were able to get her an appointment at Kaiser’s adult psychiatric services building on Round Barn Boulevard in 15 minutes, Denny Ragan said.
After seeing a psychiatrist there, Barbara was given prescriptions for Ativan and Lexapro. Denny Ragan said that since May 28, his wife’s medications were modified several times and that she was having an extremely difficult time with such repeated changes. Prior to the emergency room visit, Barbara Ragan had been prescribed Zoloft and Xanax, the family said.
Turner said such switches are not unusual when doctors are trying to find the right medications to meet a patient’s needs.