Project Eighty-four and more

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84 life-size statues of men were seen standing at the edge of tall buildings in central London in late March representing the same number of men lost to suicide every week in the UK – a hard hitting visual project aiming to bring this tragic loss out into the open from behind closed doors.

Common threads emerged from articles published in April:

“Students more likely to kill themselves” in the Times: Researchers from a Hong Kong University analysed the ONS figures and found that the number of university students in Britain increased by 5 per cent between 2012 and 2016. The total number of suicides among students increased by 32 per cent, from 139 to 183 deaths. A think tank said that a law banning universities from contacting the friends and family of students who are struggling should be revisited.

The number of first year university students reporting mental health problems in UK Universities has risen five fold in 10 years. A combination of increasing awareness of mental health issues, a lowering of the taboo previously attached to mental health services, mounting debts, homesickness, loneliness and a greater sense of anxiety about the future may be some of the reasons for it. Some vice-chancellors still think that mental well being is not the business of universities and it’s just about developing the mind. But developing minds means nothing unless students settle down well in their new environment and be ready to learn.

According to recent ONS statistics on loneliness, people between 16-24 are at the epicentre of the loneliness epidemic in the UK. More so than the elderly. Women were found to be lonelier than men. Other variables were renting a home rather than owning one, being single or widowed, having poor health and feeling disconnected from the local community.

In an article entitled “Doctors knew my son was suicidal. I should have been told before he died” in the Guardian, I raise this question yet again: Is confidentiality more important than helping someone at risk to stay alive? Is it correct for a father to be informed by doctors after the death of his son,”Now that he is dead I can tell you that this was not his first attempt”?

Is it?

 

Community is the answer.

“…the lonelier a person gets, the less adept they become at navigating social currents. Loneliness grows around them, like mould or fur, a prophylactic that inhibits contact, no matter how badly contact is desired. Loneliness is accretive, extending and perpetuating itself. Once it becomes impacted, it is by no means easy to dislodge.” – By Olivia Laing, The Lonely City.

In the summer of 1999 I moved from New Delhi to a little place called Antrim in Northern Ireland. I lived in a tiny room in the accommodation for junior doctors on hospital grounds. I didn’t know a soul there. Slowly I made a few friends at work. Unlike now, there were no mobile phones, whatsapp, skype, facetime or facebook then. Telephone calls costed a bomb.  People were friendly but everyone was a stranger. Initially I didn’t get their sense of humour at all. I felt foolish. I longed to speak my own language with someone. Anyone. But there was no one who would understand.

One evening I went to buy some chocolates to a nearby petrol station. There were 2 cashiers but only one of them had a long queue of people waiting their turn. I didn’t understand why. I went up to the cashier without a queue and made my payment. I didn’t get the meaning of the looks on people’s faces. It didn’t help that I was the only coloured person for miles. From some face expressions it was obvious that they had never ever seen a coloured person outside of the television. I felt alone. Very alone.

Urban loneliness is a common phenomenon.  Isolation causes inflammation. Inflammation can cause further isolation and depression. The cytokines released as a result suppress the immune system giving rise to more illness.

Frome is a historical town in Somerset. It is known as one of the best places to live in the UK. Dr Helen Kingston, a GP, kept encountering patients who seemed defeated by the medicalisation of their lives. They were treated like a cluster of symptoms rather than a human being with health problems. Staff at her practice were stressed and dejected by what she calls “silo working”.

With the help of the local council and Health connections Mendip, she launched a community initiative in 2013. It main intervention was to create a stronger community. They identified and filled gaps in communications and support in the community. They employed ‘health connectors’ and trained up volunteers to be ‘community connectors’.  They helped people with handling debt or housing problems, sometimes joining choirs or lunch clubs or exercise groups or writing workshops or men’s sheds (where men make and mend things together). The aim was to break a familiar cycle of misery.

In the three years that followed, emergency hospital admissions rose by 29% across the whole of Somerset. In Frome they fell by 17%.

No other intervention, drug or procedure on record has reduced emergency admissions across a population.

 

 

 

 

 

 

 

Rule 12: Pet a cat when you encounter one in the street

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In difficult times, it’s important to hold on to something sustaining, like a sparkling crystal in the darkness, like the sweetness of stroking a cat or a dog. Take every opportunity to make life easier, lighter.

Let a tragedy be only tragic and not absolute hell. There is a big gap between the two. Like the difference between someone lying on their death bed and someone lying on their death bed surrounded by their family yelling and screaming at each other. If we didn’t make worse the terrible things that there are, if we could just put up with the terrible things that exist, maybe we could make the world a better place.

The motivational speaker and Clinical Psychologist, Jordan B. Peterson speaks about his latest book – “12 rules for life. An antidote to chaos.”  He says he wrote it for himself as much as for anyone else.

“You set an ideal and find that there is a long way to go. It is a constant readjustment. There is also something positive about that. It’s not that there isn’t such a thing as a good person. Our idea of what constitutes good isn’t right because a good person is one who is trying to get better. The real goodness is in the attempt to get better. It’s in the process, to use an old cliché.

The central figure of western culture is Christ. He is the dying and resurrecting hero. What does that mean psychologically? Well, it means that you learn things painfully. And when you learn something painfully, a part of you has to die. That’s the pain. When a dream is shattered for example. A huge part of you has to be stripped away and burnt. And so, life is a constant process of death and rebirth and to participate in that fully is to allow yourself to be redeemed by it. So, the good in you is that process of death and rebirth, voluntarily undertaken. You are not as good as you could be. So, you let that part of you die. If someone comes along and says, there’s some dead wood here. It needs to be burned off. You might think, well that’s still got a little bit of life. When that burns it’s gonna hurt. Yes. Well, no kidding. Maybe the thing that emerges in its place is something better and I think this is the secret of human beings. It’s what we’re like. Unlike any other creature, we can let our old selves die and let our new selves be born. That’s what we should do.”

When asked if he falls short anywhere in his book, he says,
“Until the entire world is redeemed, we all fall short.”

Source: Synopsis of the book: https://www.nateliason.com/lessons/12-rules-for-life-jordan-peterson/

A vacuum in the NHS.

When Saagar was ill, he filled out an online form and referred himself to IAPTs – Improving Access to Psychological Therapies. This programme  began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year. I have used this service in the past and found it useful. I suggested to him to fill out the form a second time and he did. They usually call back within a day or two. He didn’t hear back from them.

I recently found out that IAPTs does not look after suicidal people. I would like to know what they do when they read a self-referral form of this nature.

There is a vacuum in the NHS. There is little face to face support for those who feel life is no longer worth living. Why do most people with physical illnesses ask for help? Possibly because they trust they will receive appropriate help from the system. Why is it that many people with mental anguish don’t approach the medical services for help? Probably due to lack of trust.

The Listening Place works towards filling that vacuum. A few days ago I visited their premises, a short walk from Pimlico station, in the heart of London. This airy, green, warm and welcoming place felt ideal for anyone in need of care, support and understanding. Here, individuals can speak openly about their feelings without being judged. They receive on-going support from trained volunteers over a number of weeks as deemed appropriate. The volunteers help relieve emotional pain and stress and offer opportunities to consider alternatives to suicide. Anyone over 18 can be referred to them by themselves, other charities, NHS as well as health and social care organisations. They try to give continuity by facilitating you to speak with someone who knows you from before. They charge nothing and keep your information confidential. It is remarkable that they are open 9 am to 9 pm, 7 days a week.

Phone: +44 2039067676; Email: referrals@listeningplace.org.uk

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Sarah Anderson, who was once director at the largest call centre for the Samaritans, set up The Listening Place in 2016 and the service has since helped hundreds of individuals with its unique approach to care. During our chat, Sarah’s passion and dedication to the cause comes through, loud and clear.

The world needs more people who give a damn about other people.

(PS: Through the grapevine I hear the future funding of IAPTs is in jeopardy. The vacuum grows.)

 

 

 

Acer and Ajahn

After Saagar’s death, it felt as if a big black boulder had landed in the middle of our living room. There wasn’t much space around it. It occupied the entire room. I had no escape from this uninvited guest. I had to squeeze my way around it to get past. Its roughness abraded my skin. It was stubborn, heavy, ugly, lifeless, crude and unmoving. It had made a home in our house. It was here to stay. I had no choice but to live with it and look at it. It stared right back at me non-stop. Its weight was suffocating. It sat on my chest, jutting its chin out, determined to get me. I pushed with all my might but it didn’t budge an iota.

It’s still there. But I can negotiate my way around it without the jaggedness making me bleed. We can sit and watch each other without wanting to kill each other. It has relaxed and settled into my space and I can breathe. A green shoot has peeped from underneath it. Another slender sapling has appeared out of the crevice near the window.  The old sharp corners don’t catch anymore. They have rounded off. Life is happening around it.

If I had remained firmly rooted in the pure physicality of the world, I couldn’t have co-existed with this deeply unpleasant and unwanted occurrence. Spiritual teachings and practices have been a respite from my mind, the generator of pain. I am nowhere near ‘wise’ but I remain open to universal knowledge. I allow it to bring me peace, however momentary.

Amaravati Buddist monestary is one of my refuges. A few months ago I spent 5 days there in Silent retreat. A beautiful plant with asymmetric leaves overflowed from an indoor pot. With permission I brought 3 leaves home, allowed them to root in water and then planted them in soil. They look happy.

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In December 2017 we planted an Acer in Saagar’s memory at Amaravati. It’s called ‘Winter flame’ or Acer Palmatum. A friend of a friend is a ceramist. She is making a set of drums and drumming sticks with Saagar’s initials, to be placed at the tree. I have never met her. She has never met me or Saagar. But we are connected. We all are connected.

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An excerpt from a Dhamma talk by Ajahn Anando:

“We suffer because we constantly chase pleasure. We run away from pain.
Loose the greed for sensuous things.
See that the letting go of the world is peaceful.
Time is nothing. There is only ‘now’ and ‘change’.
Past and future are ‘thoughts’ in the Now.
Is there any way you can get into the past? Or the future?
Is there any way you can get out of ‘Now’?”

Resource:

https://www.amaravati.org/audio/

Turn the page…

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The wisdom of Paulo Coelho:

“One always has to know when a stage comes to an end. If we insist on staying longer than the necessary time, we lose the happiness and the meaning of the other stages we have to go through.
Closing cycles, shutting doors, ending chapters – whatever name we give it, what matters is to leave in the past the moments of life that have finished.

Did you lose your job? Has a loving relationship come to an end? Did you leave your parents’ house? Gone to live abroad? Has a long-lasting friendship ended all of a sudden?
You can spend a long time wondering why this has happened.

You can tell yourself you won’t take another step until you find out why certain things that were so important and so solid in your life have turned into dust, just like that.
But such an attitude will be awfully stressing for everyone involved: your parents, your husband or wife, your friends, your children, your sister.
Everyone is finishing chapters, turning over new leaves, getting on with life, and they will all feel bad seeing you at a standstill.

Things pass, and the best we can do is to let them really go away.
That is why it is so important (however painful it may be!) to destroy souvenirs, move, give lots of things away to orphanages, sell or donate the books you have at home.

Everything in this visible world is a manifestation of the invisible world, of what is going on in our hearts – and getting rid of certain memories also means making some room for other memories to take their place.
Let things go. Release them. Detach yourself from them.

Nobody plays this life with marked cards, so sometimes we win and sometimes we lose.
Do not expect anything in return, do not expect your efforts to be appreciated, your genius to be discovered, your love to be understood.

Stop turning on your emotional television to watch the same program over and over again, the one that shows how much you suffered from a certain loss: that is only poisoning you, nothing else.

Nothing is more dangerous than not accepting love relationships that are broken off, work that is promised but there is no starting date, decisions that are always put off waiting for the “ideal moment.”

Before a new chapter is begun, the old one has to be finished: tell yourself that what has passed will never come back.
Remember that there was a time when you could live without that thing or that person – nothing is irreplaceable, a habit is not a need.
This may sound so obvious, it may even be difficult, but it is very important.

Closing cycles. Not because of pride, incapacity or arrogance, but simply because that no longer fits your life.

Shut the door, change the record, clean the house, shake off the dust.
Stop being who you were, and change into who you are.”

Let’s play Politics!

National Confidential Inquiry into suicide and homicide in people with mental illnesses 2016:

In-patient suicides:

Suicide by mental health in-patients continues to fall, most clearly in England where the decrease has been around 60% during 2004-14. This fall began with the removal of ligature points to prevent deaths by hanging but has been seen in suicides on and off the ward and by all methods. Despite this success, there were 76 suicides by in-patients in the UK in 2014, including 62 in England.

Suicides after discharge:

The first three months after hospital discharge continue to be a period of high suicide risk. In England the number of deaths rose to 200 in 2014 after a fall in the previous year. Risk is highest in the first two weeks post-discharge: in a previous study we have shown that these deaths are associated with preceding admissions lasting less than 7 days and lack of care planning. There has been a fall in post-discharge deaths occurring before first service contact, suggesting recognition of the need for early follow-up. In all there were around 460 patient suicides in acute care settings – in-patient and post-discharge care and crisis teams – in the UK in 2014.

First of all I want to say that every suicide is a huge tragedy and must be prevented at all costs. Behind each of these numbers are precious lives and beautiful people. I don’t allow myself to forget that even when I am angry. This blog is a mere observation on how I have seen politics being played in front of my eyes in the last week. In light of the above findings, in consultation with his expert advisors and in all his wisdom, Mr Jeremy Hunt has decided to focus his attention on in-patient deaths – a group that is manned by the most highly trained professionals in a very controlled environment, a group that is on the list of ‘never-events’, a group that has already shown a decrease by 60%, a group where even a small reduction in numbers will amount to a big percentage and will make him look good.

With all good intentions, he has converted a healthy aspiration of Zero-suicide in the community to an unhealthy target for in-patients creating huge anxieties. Last week at the NSPA conference I heard Mr Hunt speak in the most self-congratulatory of tones about how wonderful it is that UK is the first country to legislate for ‘Parity of Esteem’. I am sorry Sir, that means nothing on the ground. The workforce coming in contact with the majority of suicidal people in the UK is largely untrained. They don’t even know how to talk with them, let alone ‘look-after’ them. The massive funding cuts focus on mental health which in turn results in poor training of junior doctors. When questioned directly about ‘parity of training’, he masterfully slips and slides away.

In my eyes you don’t look good Mr Hunt.