Western State Hospital handed a mentally ill man the means to kill himself, then tried to cover up a series of embarrassing mistakes that led to his death.

Those are the results of a six-month, exclusive KIRO Team 7 Investigation.

Investigative Reporter Chris Halsne acquired some rare videotape, along with other previously undisclosed documentation, which unravels a suicide that never should have happened.

A warning first: certain video content might upset sensitive viewers.

When a patient dies behind the gates of Washington’s largest state-run mental hospital, the Department of Social and Health Services tells us that it's none of our business. In addition, that agency refuses to provide thousands of the records KIRO-TV requested regarding multiple suicides there. You are about to learn why that agency so badly wants to keep its secrets.

Basketball, wrestling or football -- Anthony Gordon dominated every sport he touched.

As he got older, he added rap music to his interests, getting his brothers and the rest of his large, loving family involved.

His contagious smile was easy to see, but his mom, Phyllis, knew there was something seriously wrong inside her son's head.

"By the time he was 20, it was fully evident that he was sick. We didn't know what to do. He was acting strange. He thought we had cameras all over the house watching him."

Paranoid schizophrenic, depressed, then suicidal; Anthony tried to kill himself by taking 360 pills all at once just before Christmas 2007. He survived, and, in hopes of getting him some badly needed psychological help, Phyllis urged doctors to commit her son to Western State Mental Hospital.

He entered there on Jan. 3rd.

Anthony was dead by the 4th.

Phyllis Gordon fought back tears as she described that moment to Halsne.

"The chaplain and two sheriffs knock on my door. 'Your son's dead. He hung himself.' My husband started screaming and I fell down like a sack of potatoes."

Anthony Gordon was on suicide watch and was, by policy, supposed to be visually checked every 10 to 15 minutes. That didn't happen, so he had time to prop the bed in his private room up against the wall. He tied his own noose from a sheet and wrapped it around a handrail.

KIRO Team 7 Investigators discovered that should have been impossible. The bed frame was custom designed to be bolted to the floor, but the hardware had never been installed on Gordon’s bed.

Although DSHS refused to provide us any relevant documents regarding the suicide, we obtained hundreds from a variety of sources anyway, and they are damaging.

To set the timeline, workers found Gordon hanging at 2:14 p.m. on Jan. 4th. We located exclusive video of that moment from a hall camera outside his room, number 26.

Western State Hospital told Lakewood police, who are in charge of investigating the suicide, that staff did a census check on Gordon at 1:30 p.m., stating "he (Gordon) was standing looking out the window" in his room.

However, an internal hospital monitoring sheet indicates nobody did that suicide check at 1:30 or 1 or 12:30 or noon.

"The biggest mistake they made was lie to my family," says Gordon's twin brother, Dewayne. He told us employees at Western have been less than forth-coming about the last few hours of Anthony's life.

"They had something to hide. Something went wrong out there and they don't want us to find out about it."

The most suspicious record we uncovered is a progress record stamped with a time code of 13:25. That's an hour before Anthony Gordon's hanged himself. Again, prior to the suicide, an employee noted "room 26 bed was in normal position."

Craig Awmiller of Disability Right Washington has reviewed thousands of pages of Western State Hospital patient care files and has never seen such an out-of-place comment in a monitoring report.

"I would strongly suspect that entry was made after the death to make it look like the bed was O.K. It suggests that there was knowledge as to how the person died and an attempt to go back and make every effort to say, I suspect falsely, to make it appear that they did everything right."

World renowned forensic psychologist Dr. Ken Muscatel, agrees. At our request, he reviewed reports we uncovered regarding Gordon's death.

"There were some errors made that turned out to have terrible consequences."

Muscatel told Halsne, Western, simply put, "screwed up" when it failed monitor a patient whose chief complaint was "Hallucinations & suicidal thinking."

"No doubt he was seen as a risk. He had two factors, which is unpredictable behavior and obviously highly mentally ill at the time. So, they said, 'Hey, let’s put this guy on a close watch.' Frankly, if they had put him on a close watch, the likelihood of this occurring would have greatly diminished."

Monitoring camera videotape we have in our possession proves Gordon missed at least three room checks. It didn’t appear to be from lack of staffing. There are 12 employees in the day room just outside Gordon's room 26. The tape shows several employees laughing and horsing around for nearly an hour while Gordon hanged in his room a few feet away.

Team 7 Investigative Reporter Chris Halsne tested to see if the bed could silently be heaved upright against the wall. Using the same type as Gordon’s, Halsne found out that moving the 200 pound bed, with pull-out drawers, made significant amounts of noise. The movements were easily heard outside in the halls, even with a closed door.

Phyllis Gordon believes her son would be alive today if Western had simply strapped down that bed and cared enough to keep an eye on him.

"Even though my son was sick, we loved him! They took absolutely not one of those precautions. Not one. They put him in there and they let him go."

DSHS refuses to comment, but this post accident memo shows the state did learn a couple of lessons from Gordon's suicide.

First, managers agreed it was a bad idea to assign him a psychologist who was on vacation. (Yes, that really happened.)

Secondly, staff agreed it was a good idea to bolt all the beds down, which they started doing just four days after Gordon hanged himself because his was not secured.

A January email we obtained says "We will be attaching the beds to the center portion toward the wall with a bolt to the floor with a chain and a chain bolted to the bed. We will then attach a padlock, so that the bed can be secured from tipping up on end."

Team 7 Investigators also reviewed 40 other deaths that occurred inside Western State and found some patterns, so disturbing, that it has sparked a federal probe.

We'll bring you more on that breaking investigation later this week on KIRO 7 Eyewitness News.