It’s a psych hospital with a unit specializing in people with charges, not a prison (where they should have been). If a patient were genuinely suicidal they would need to be immediately accessible to the staff member responsible for preventing it. Additionally, seclusion, even with the legally required assigned observer, requires justification and a doctor’s order, and in this case it’s impossible to justify because seclusion is specifically contraindicated in high suicide risk (see above).

These are all clinical guidelines and often even state regulations that make perfect sense and save a lot of lives in the situations they’re designed for. The issue is that assessing suicidal ideation has to be done almost entirely based on subjective reports of symptoms (internal thoughts), and there are almost no objective outward signs. The only objective outward signs that exist immediately beforehand (previous attempts count as a lifetime risk increase) are prepatory behaviors, and a) the patient typically actively hides those behaviors and b) they’re not assessable immediately in the moment; they have to be caught by regularly and directly observing the patient. Our other option is to start asking suicidal people if they really mean it and/or just kicking them out if they sound enough like they’re lying and to say the least current clinical guidelines do not support that strategy.

It doesn’t take long to learn how to take advantage of such a system if you’re the kind of man that likes assaulting young women. I’ve met a lot of men who struggle to understand the sheer quantity of these men that exist and that often they’re released right back out into the community for a variety of reasons that do and do not make sense but are all perfectly legal.

I also have had a lot of male patients do this now that I no longer work forensics, but there’s less of them and they’re usually not as bold. They’ll usually just take a lot of time dressing and undressing in front of the sitter, walking around the room naked, making inappropriate comments about the sitter’s appearance/ activities they would like to engage in, needling them for personal information, etc and that’s just bothersome because they’re literally trapped with the patient (it would obviously be a firable offense to leave a patient on suicide watch). These are the times I do my best to get a male sitter (assuming the patient isn’t just equal-opportunity, which is fortunately rare), and short of that I just make sure to rotate people through so nobody has to deal with it too much any one shift.

Female patients do so far, far less, but when they do they are usually a bit bolder about it, which can be troublesome. I also generally assign same sex sitters when possible, but I specifically avoid sitting male staff with female patients as much as possible just because unfortunately delusion-based sexual abuse claims are likely to be followed further in that gender combo than vice-versa.