Published by WXYZ.COM
Summary generated on August 25, 2020
CLARKLAKE, Mich. - Michelle Burt followed the ambulance closely.
Last October, the mother of three was headed west on I-96, behind an emergency vehicle carrying her her 15-year-old son Johnathan, who had just left an appointment with his therapist.
On this October day in 2019, they were making an urgent, two-hour trip to hospital in Grand Rapids.
At an age when obtaining a learner's permit is normally a teen's biggest challenge, Johnathan's struggles were far greater.
Later that month, Johnathan would be charged with a misdemeanor stemming from an incident at school.
Over the course of his admission, Stid said Johnathan seemed to get worse.
Hospital records obtained by 7 Action News detail his turbulent 13-day stay.
On his third full day of treatment, a Pine Rest physician wrote that Johnathan said he would become suicidal if he was released.
On October 28 during a group therapy session, the facilitator noted that John expressed regret for not taking his life when he had the chance.
"States he regrets not pulling the trigger," the facilitator wrote.
On October 31, a nurse wrote that John "Reported he cut himself earlier this afternoon" with a broken fork he used at lunch.
That same day, he left group therapy early after stating: "I just want to die, I should have pulled the trigger."
On some days, John's hospital records showed progress during his treatment, but they were always followed by thoughts of self-harm or suicide.
On November 2, he rated his depression a "10/10," described suicidal thoughts as "Constant" and said: "I still feel depressed and wanna die every day."
On November 4, his last full day of treatment, a nurse wrote that John "Stated he has no positive support people, no hope for future, no reason to live."
That same day, John "Described suicidal thinking, with plan to use a gun or 'whatever way I can, the moment I get out of here.'".
The next day, for the first time in 6 days, records show John did not report feeling suicidal.
Michelle was skeptical, and said she asked what would happen if she refused to pick her son up from the hospital.
That day, Michelle picked her son up in the afternoon and took him to his grandmother's house.
That same night, just hours after he was released from Pine Rest, Johnathan put a gun to his head and pulled the trigger.
His sudden death was not a secret to the state officials at the Department of Licensing and Regulatory Affairs, or LARA, which regulates Pine Rest and every other licensed psychiatric hospital in Michigan.
The hospital notified LARA of his suicide just days after it took place, as they are required.
Despite the red flags surrounding his death, the state asked no questions about his care or release.
7 Action News shared Johnathan's hospital records with Watkins, who said an investigation into his treatment and discharge are necessary to ensure the hospital acted appropriately.
In a statement, Pine Rest spokesman Jim Rose declined to comment on the specifics of Johnathan's care, citing patient privacy, but said the hospital "Is saddened by any loss of life and our thoughts and prayers go out to the family of the individual involved in your media request."
As 7 Action News has reported, LARA has failed to investigate virtually every patient death reported to them since at least 2016.
LARA spokesman David Harns said the death was not investigated because it did not involve the use of restraints or seclusion, which the department has previously said are the only circumstances where they will investigate patient deaths.
In March, our reporting prompted lawmakers to introduce bills that would change that-requiring every death be looked into by state authorities.
"The intention is to make sure we investigate so that we can do a better job. We owe it those patients. We owe it to the people that love them and surround them," Vanderwall said.
Nine months since John's loved ones buried him, they say they're no closer to understanding why they ever had to.