A patient at a state mental hospital in Rochester killed herself by hanging, becoming the second patient of a state-operated facility to die by suicide since March.

Natasha J. Stewart, 26, of St. Paul, the mother of a 6-year-old boy, was found dead on June 22 after she hanged herself with a bedsheet from a door in her hospital room, according to hospital and county officials.

The death comes just four months after a patient at a mental-health and addiction treatment center in St. Peter, Minn., also hanged himself with a bedsheet, and has renewed calls for more staffing and stricter oversight of mentally ill patients at state facilities.

Suicide attempts at state-operated treatment facilities in Minnesota total about 30 to 50 a year, but deaths by suicide are rare. The two deaths this year mark the first suicides at state-run mental facilities in the past four years, according to state records.

Sources familiar with Stewart’s death say the patient suffered from severe depression and had expressed suicidal thoughts to staff members, but was left unobserved for up to 15 minutes after excusing herself from group therapy at the hospital.

In response, Department of Human Services Commissioner Lucinda Jesson said Friday that she has ordered a review of Stewart’s death and a “systematic evaluation” to determine why suicides have increased. In addition, the state is rolling out a new, computer-based training initiative for state staff designed to raise awareness of the symptoms of people who may be at risk of suicide, according to a memo obtained by the Star Tribune. Staff at Minnesota’s seven, 16-bed community behavioral health hospitals, including the one in Rochester, will be required to undergo the training by Aug. 14, the memo said.

In 2014, the state recorded 44 suicide attempts at state-operated facilities, up from 34 in 2013. So far this year, there have been 25 suicide attempts (three since March) and two deaths.

“Our hearts go out to the patient’s family,” Jesson said in a prepared statement. “All suicides are tragic, but this death is especially troubling because it is the second apparent suicide in our facilities and the third attempt since March.”

Officials at the state’s largest nurses union said inadequate staffing at the Rochester hospital likely played a role in Stewart’s death. “Patients do not receive the one-to-one care they deserve, even when they indicate they are having suicidal thoughts,” said Rick Fuentes, a spokesman for the 20,000-member Minnesota Nurse Association, which represents several registered nurses at the Rochester hospital where the suicide occurred.

Stewart appears to have planned her death in advance. A day before killing herself, Stewart had asked a friend to take her 6-year-old son, Tristan, from his home in St. Paul to Stewart’s mother’s home in Fairbury, Ill., where many of her relatives live, according to Laura Knapp, Stewart’s former mother-in-law. Family members later realized she may have been protecting her son, whom she “loved dearly,” Knapp said.

On the June afternoon of her suicide, Stewart calmly excused herself from group therapy without indicating any intention of harming herself. Hospital staff assumed Stewart was going to the bathroom so they did not follow her to her hospital room. Stewart arranged the hanging bedsheets in a way so they were not visible to the staff making the rounds in the hospital corridor, sources familiar with the incident said.

“She’s been depressed before, but she seemed really determined this time,” Knapp said.

Still, Knapp said family members are still wondering why Stewart, who had expressed suicidal thoughts while at the Rochester hospital, could have been left alone even for a short time. “We are in total shock,” Knapp said. “People keep asking, ‘How could that happen in a state mental hospital? Shouldn’t they have been watching her more?’ I suppose only the good Lord knows.”

According to an obituary, Stewart graduated with honors from Rochester Community College in 2012 with a Veterinarian Technician degree. She was committed by a judge as mentally ill in October of 2014, according to court records.

In March, Logan Brodal, 28, a patient at the Community Addiction Recovery Enterprise (CARE) program in St. Peter, Minn. was found hanging from a bedsheet in the facility’s exercise room. The outpatient mental-health and addiction treatment center was so understaffed that other patients had to hold up his body while a staff member loosened the bedsheet. A week before his death, Brodal was taken off a suicide watch where he was to be monitored every 15 to 20 minutes, according to union officials representing the facility’s employees.

Suicides are extremely difficult to predict and prevent. Often patients will appear calm and even happy in the hours or days before deciding to take their own lives because they perceive they have found a solution to their anguish, said Dr. George Realmuto, medical director at a state-run psychiatric hospital for children and adolescents in Willmar, Minn. “People who are determined to kill themselves will often go to great and meticulous lengths to accomplish their goal.”


Twitter: @chrisserres

Staff reporter Paul McEnroe contributed to this report.