The mother of a Byron woman who killed her four children and then herself has filed a lawsuit against a Cody psychiatric clinic, claiming that her daughter’s use of ketamine led to the murder-suicide that shocked Wyomingites this winter.
The lawsuit, filed on Monday, claims that Sage Psychiatry Services allowed Tranyelle Harshman to take ketamine, a powerful anesthetic increasingly used to treat depression and post-traumatic stress disorder, at her home, which violates best practices for prescribing the drug.
The lawsuit coincides with some conservative lawmakers’ growing concern about how psychiatric drugs are used in Wyoming, including more traditional anti-depressant and anti-anxiety medications. (Harshman was also taking an anti-anxiety medication when she died, according to the coroner’s toxicology report.)
Harshman was being treated for post-traumatic stress disorder and postpartum depression, according to the lawsuit.
According to the lawsuit, Harshman took ketamine at home in February and then shot her four children and herself “while in an altered or dissociative mental state.” The lawsuit accuses the clinic of negligently assessing the young mother’s suitability for ketamine treatment and failing to monitor her drug use.
Lawmakers on the Joint Labor, Health, and Social Services Committee held a hearing earlier this summer to investigate whether psychiatric drugs play a role in Wyoming’s high suicide rate or in acts of extreme violence such as Harshman’s murder of her children.
Health department officials and practitioners have cautioned against drawing too broad a link between the use of certain drugs and tragic outcomes.
“This is sad on so many levels, but I don’t want to scare people away from ketamine; ketamine is a wonderful drug,” Tracy Richard, a southeast Wyoming-based nurse anesthetist who administers the drug in a clinical setting and opposes nearly all at-home use for psychiatric treatment, told WyoFile. “We don’t know what happened with this person and there’s just so much that goes into this.”
According to the attorney representing Harshman’s mother, the lawsuit was motivated by how ketamine was administered rather than the drug itself.
“The purpose isn’t to demonize ketamine,” Sean Olson, the Colorado-based attorney leading the case, told WyoFile over the phone on Wednesday. “The goal here is to ensure that this type of incident never occurs again. Ketamine is a potentially dangerous drug that is increasingly being used for medical purposes. It is crucial to follow safety guidelines when using it.
Sage Psychiatry Services did not return a voicemail from WyoFile seeking comment on Wednesday.
Shannon Hughes, an instructor at Colorado State University and therapist who advocates for psychedelics and drug policy reform, told WyoFile that ketamine was developed as an anesthetic, and its use as a therapeutic drug is a relatively unregulated area of practice.
According to Hughes, there are several ways for people to obtain ketamine for at-home use, including through telehealth programs. However, she stated that taking it in a clinic and under supervision is widely regarded as best practice.
“These drugs alter your behavior,” Hughes explained. “That is what they do.” And that is why you should be closely monitored when starting any new medication.” Hughes stated that all psychiatric drugs carry risks, many of which include suicidal or violent thoughts.
On the other hand, she claims that ketamine provides long-term benefits for some people who would otherwise be permanently dependent on antidepressants. Therapists who administer ketamine to their clients during sessions can lead to long-term progress in addressing the underlying causes of depression, she said.
“For some people ketamine is a real game changer,” Hughes pointed out.
According to a study published in the peer-reviewed journal Nature, ketamine has “a significant therapeutic effect” in terms of reducing suicidal thoughts.
Hughes suggested that medical boards and other regulatory bodies issue more uniform guidelines for the use of ketamine. “Until then, it’s kind of the wild west,” she told me. Richard also described ketamine therapy as a “wild west,” and expressed concern about the increasing availability of ketamine for home use, a technique she strongly opposed for psychiatric treatment. But she questioned whether Wyoming lawmakers had enough information to address the issue of psychiatric drugs.
In the weeks following the murder suicide, Harshman’s husband expressed concern that his wife’s toxicology report would give the public the wrong impression. “This isn’t a chance to demonize different therapies,” Cliff Harshman told a Cowboy State Daily reporter, “this works for a lot of different people.”
Rep. Paul Hoeft, a Republican whose Park County district includes Powell and borders Byron, is bringing a draft bill to the committee’s October meeting that would require the state to better document when suicide victims or perpetrators of serious violent crimes have psychiatric drugs in their systems.
Though that information is frequently gathered through coroner’s toxicology reports or law enforcement drug testing of criminal suspects, Hoeft hopes to establish a centralized database to track correlations.
“There’s some concerning associations going on between psychotropic medications and violent outcomes which we’ve seen recently, and which has prompted this lawsuit,” Hoeft provided to WyoFile.
To his knowledge, lawmakers are not attempting to regulate the use of psychiatric drugs, but rather seeking more information about possible links to violent deaths.
Hoeft’s bill arose from the committee’s June meeting in Casper, during which lawmakers questioned county coroners and Wyoming Department of Health officials about whether psychiatric drugs were causing suicides or homicides.
Two county coroners told the committee that while they conduct toxicology reports on all deaths, they are unable or do not have the authority to determine whether psychiatric drugs influenced someone to act.
“Neither of the medications that she was on ended her life,” Fremont County Coroner Erin Ivie stated at the meeting. “So, for our purposes, the question is: What was the cause of death? The cause of death was a gunshot wound. What was the manner of death? Suicide. She did it to herself. What is the protocol for the other people? [Harshman has four children.] Homicide.”
Wyoming Health Department Director Stefan Johannson cautioned lawmakers against drawing conclusions solely from Wyoming’s suicides and homicides.
Even though the state has a high suicide rate per capita, the total number of deaths results in a small sample size to investigate the correlations described by Hoeft and other lawmakers, Johannson said.
“I would just caution that drawing lines of causation is very difficult when our numbers in Wyoming … are so low, and you try to draw connections or correlations between chemicals that might have been present,” he told me.
