Come October

3/10/2019. 6 am: I am excited. At the airport, waiting to board my flight to Washington Dulles. Change to another flight to Manchester and then a taxi ride to Concord, New Hampshire. This is the first leg of my travels as a Churchill Fellow. I have checked in and am having a cup of tea. I have just come across this post from a young woman on Facebook:

“According to my local crisis team, I was ‘too articulate’ to be feeling suicidal.
As a writer, and someone who works in languages, I am a naturally very articulate person. Because I could speak so clearly about my thoughts and feelings, I was discharged from the crisis team as I didn’t fit the bill of someone suicidal, or indeed, of being mentally unwell enough to need their support despite evidence to the contrary.

The Papyrus text line allowed me to articulate how I felt (you don’t have any choice really when you’re using the text service, you have to ‘say’ it how it is!!), and that was delved into so much deeper with thoughtful questions, suggestions and recommendations that allowed me to get through a real low point and see that there was hope. At no stage did they reply with ‘sorry, you’re too articulate to be feeling the way you claim’.

Non-judgemental, kind, compassionate, a REAL life saver, especially in the current climate of NHS mental health cuts.”

Judgement. The ultimate wall. Even a positive judgement can be harmful. A missed opportunity. A lost life. Who fills the gaping holes created by ‘unfit for purpose’ services, NHS cuts and ignored carers?

Charities. Families. Friends.

The needs of young people are different. They need an active, positive and creative interaction to make sense of how they feel. They need to be heard and understood. They need to know in their hearts that they are deeply loved and cared for just the way they are. They need to know that things get better. Educating families is crucial.

4/10/2019

Today’s gem: Mayo Clinic video for parents. All parents of adolescents should see this.

Day 795

As I read this piece of research, I could see Saagar and me reflected in it. It rang true. It gave me a deeper understanding about myself, my humanity and the precious fragility of our closest relationships. This qualitative research by Prof Christabel Owens et al tries to understand the needs of concerned family members and friends that can better equip them to intervene when their loved one is suicidal or in distress. It focuses on micro-social systems, like families or a group of friends as opposed to macro systems like nations and societies. (http://www.bmj.com/content/343/bmj.d5801)
Microsociology is the study of thoughts, feelings, moods, behaviours and forms of language that serve to maintain or threaten bonds between individuals.

Life is lived in small units – husband and wife, mother and son, boy-friend and girl-friend and so on. This is the level at which suicidal crises unfold and are managed, very often without any help from clinical services.

Family members and friends are the real frontline of suicide prevention but little is known about what goes on in these settings. A series of narrative interviews with the next of kin of 14 young people lost by suicide were analysed : What did they see and hear? What did they think was happening? What actions did they take and why? What additional knowledge, skills and support would have been useful?

Findings:

  1. Warning signs were rarely clear at the time. For example, one dad of a 19 year old boy said,“He had a teddy bear hanging from a light cord in his bed room.” In retrospect, the signs were clear but at the time, they were offset by countersigns or were difficult to decipher, open to a range of interpretations.
  2. Significant others engaged in normalizing and legitimizing their behavior. For example, a mother of a 29 years old man said, ”A few times he rang me in the early hours of the morning absolutely piddled out of his head and he’d be gabbling on but I couldn’t understand a word he was saying because he was drunk. I’d say, “Look, I’ll come and see you tomorrow and we’ll talk about it then.” I’d go there and nothing would get said and he’d seem alright.” In almost all cases, more weight was given to countersigns. The boundaries of normality were stretched to accommodate a loved one so as to avoid ‘pathologising’ or labeling them as that may be perceived as rejection.
  3. Fear (of loss) prevented them from saying or doing anything that might have prevented tragedy. For example, the partner of a 26 years old woman said, “I was trying to find the right words to persuade her to go to the GP. It’s bloody difficult and I was afraid she’d react badly. The situation was delicate and I had an awful lot to loose. And I ended up loosing it anyway.”

The article concluded that these are highly complex decisions. Due to a deep emotional involvement, we often cannot think and act in a rational manner. These findings are now being used to devise emotionally informed suicide prevention efforts, as opposed to cognitive ones which are most commonly used. These methods will help people like you and me to acknowledge and overcome our fears and act appropriately.

So far this leaflet had emerged as a result of this study:

https://www.exeter.ac.uk/media/universityofexeter/ref2014/documents/UoA2_leaflet.pdf