A report and a film.

A report published last month by National Child Mortality Database (NCMD) identifies common characteristics of children and young people who die by suicide between 1st April 2019 and 31st March 2020. It investigates factors associated with these deaths and makes recommendations for policy makers.

Every child or young person who dies by suicide is precious. These deaths are a devastating loss for families and can impact future generations and the wider community. There is a strong need to understand what happened and why, in every case. We must ensure that we learn the lessons we need to, to stop future suicides.

Key Findings:

-Services should be aware that child suicide is not limited to certain groups; rates of suicide were similar across all areas, and regions in England, including urban and rural environments, and across deprived and affluent neighbourhoods.

(No one is immune.)

-62% of children or young people reviewed had suffered a significant personal loss in their life prior to their death, this includes bereavement and “living losses” such as loss of friendships and routine due to moving home or school or other close relationship breakdown.

(Saagar was unable to return to his life at University due to a new diagnosis of a mental illness.)

-Over one third of the children and young people reviewed had never been in contact with mental health services. This suggests that mental health needs or risks were not identified prior to the child or young person’s death.

(Saagar had been in contact with Mental Health Services but they discharged him as soon as he showed signs of improvement. They did not follow him up. His GP was unable to identify his high risk of suicide despite his Depression scores being the worse they could be for at least 4 weeks.)

-16% of children or young people reviewed had a confirmed diagnosis of a neurodevelopmental condition at the time of their death. For example, autism spectrum disorder or attention deficit hyperactivity disorder. This appears higher than found in the general population.

(Saagar did not.)

-Almost a quarter of children and young people reviewed had experienced bullying either face to face or cyber bullying. The majority of reported bullying occurred in school, highlighting the need for clear anti-bullying policies in schools.

(At his Primary school in Belfast, his peers called him ‘Catholic’. He didn’t know what it meant but he knew it was not right. This went on for more than a year before I found out. When I spoke to his class teacher about it, she denied any problem.)

The film ‘1000 days’ tells us about Saagar and what we have learnt from his life and death. I am not sure what or how much the policy makers and service providers have learnt or changed but we have learnt and changed a lot and here we talk about that. The film is presently available on-line at the Waterford Film Festival (Short Programe 6), till the 15th of November at the link below. Please take 20 minutes to watch it if you can. You will learn something too. Each one of us can make a difference.

https://waterfordfilmfestivalonline.com/programs/collection-jlvwfxb8ctq

This night.

He was born when I was 28.

The monsters of pain took him in his 21st.

I was in my 49th.

Today, he would be in his 28th. I am in my 56th.

7 years ago, this night was his last in this house.

I am here tonight. Sleeping in his room.

7 years it takes for all my cells to be replaced.

7 chakras. 7 cycles.

7 colors. 7 musical notes.

7 days clumped into a week.

A bunch of random dates. Time as a thing.

Not straight. A mirage.

Revisiting.

Revolving. Rotating.

An illusion. A thought.

A future forgot.

Grow. Mature. Flower. See.

A constellation upon which I sit as fully me.

Push through the glass wall of Time. Release.

Rise and fall

free.

Ordinary people

Once upon a time there was an ordinary person. Making a living, being honest, spending time with the family, having a few friends and simple pleasures. Nothing special. Just ordinary.

Then they lost their child to the monster of unbearable pain. They carried on breathing and giving and receiving love. There was nothing ordinary about that. They couldn’t bear the thought of the same thing happening to anyone else. So, they went out to tell the stories of their angels to everyone. To exhibit the smithereens of their bleeding hearts. That was not easy or normal but they did it anyway. To say that there were other options that they wish their kids had been encouraged to explore. To give out the phone numbers of the good people out there who can help. To remind everyone that there was hope. There is hope.

These 3 dads were ordinary people. Now they are walking together for 300 miles over 2 weeks, making waves all over the country, connecting with people, smashing the stigma and sharing the stories of their lovely girls. Ordinary and beautiful. Just like you.

Please listen and take a look at what’s possible when love speaks and acts.

I hate my shoes.

(‘A pair of leather clogs’ by Vincent Van Gogh 1853-1890)

“I am wearing a pair of shoes.

They are ugly shoes.

Uncomfortable Shoes.

I hate my shoes.

Each day I wear them, and each day I wish I had another pair.

Some days my shoes hurt so bad that I do not think I can take another step.

Yet, I continue to wear them.

I get funny looks wearing these shoes.

They are looks of sympathy.

I can tell in others eyes that they are glad they are my shoes and not theirs.

They never talk about my shoes.

To learn how awful my shoes are might make them uncomfortable.

To truly understand these shoes you must walk in them.

But, once you put them on, you can never take them off.

I now realize that I am not the only one who wears these shoes.

There are many pairs in the world.

Some women are like me and ache daily as they try and walk in them.

Some have learned how to walk in them so they don’t hurt quite as much.

Some have had to wear the shoes so long that days will go by before they think of how much they hurt.

No woman deserves to wear these shoes.

Yet, because of the shoes I am a stronger women.

These shoes have given me the strength to face anything.

They have made me who I am.

I will forever walk in the shoes of a woman who has lost a child.”

  • Author unknown.

One death by suicide is one too many. On World Suicide Prevention Day, today, let us start by

  1. believing that suicides are preventable.
  2. knowing that we all play a part, however small, by being aware, educated and resourceful.
  3. being kind and courageous enough to ask the ‘S’ question, listen and respond.

Now, they are pink.

The day after he died, our door-bell went berserk. This time the same young woman from the local florist, who had been here thrice already, stood at the door again. She had arrived with yet another bouquet of pure white lilies and roses. She stood just outside our front-door with tears rolling down her cheeks. Had this stranger accessed her own sadness or was she feeling mine? I thanked her and tried to console her, wordlessly holding her hands in mine, not believing any of that was happening.

Our eyes met through the fresh white flowers and films of salt water. She didn’t know me or the young man who had died and I didn’t even know her name. But we were flowing in the same river of humanity. Of loss.

For weeks, every room in our house reeked of the sickly-sweet stink of white lilies. I used to like that fragrance before all this but now it screamed ‘DEATH’. It crept into every empty space, crevice and corner. It sneaked under tables and inside locked cup-boards. It suffused my clothes and hair and got into my body like poison.

All these years later, that smell can still hit like an axe on top of my head when I walk past an innocent flower shop.

On my birthday last week, a bunch of Freddie’s flowers arrived unexpectedly. I thought I had cancelled that delivery but it seems I hadn’t. Roses, lilies and gladioli – but this time, they are a pretty pretty pink. Six days on, they are open and smiling and guess what … no heart-breaking fragrance.

Our long-distance relationship is working. Thank you, sweetheart.

One moment on a Friday morning.

Time is a scaffolding. Not the real thing. A construct. A transactional entity. An illusion. A convenience. A cage.

The Time is always Now.

Right now I hear Si pottering in the kitchen downstairs.

Michael, his friend is waiting in his car outside the front door. The engine is whirring, parked slightly to the left of the middle of the road with just enough space for passing cars to slide past.

My second cup of tea is waiting. Steaming.

The sunshine had penetrated many curtains to reach the park across the road.

The wind is gently encouraging the trees to wake up and dance.

The indoor plants watered this morning are feeling fresh. A large green Poinsettia (from last Christmas) on my left and a pink orchid on my right.

The ‘to-do’ list is staring at me from the far side of my table, feeling left-out. My Mind is pulling hard at me, trying to get me out of writing, into ‘doing stuff’. I am watching it. It looks like a toddler yanking at her Mum’s dupatta pleading for attention.

Black and green bins are lined up in tidy rows on the pavement along both sides of our street, waiting to be emptied. Five years ago, when the bin-collection day changed from Tuesday to Friday, I immediately thought I must tell Saagar. Then I remembered. Now, I think of him when I see the bins. I recall us putting the bins out together. In the Now. I feel that memory become a twinge in my chest. Sometimes, it becomes a cloud in both my eyes.

Now, I hold him in my heart on Fridays and every other day. He lives in me. Speaks through me. Sees the world and keeps me calm.

The neighbour’s son’s school bus stops at the same spot every day. He boards it wearing his yellow anorak every day. He sits at the same seat every day – by the window on the left, second row from behind.

The world goes on and I go on with it, carrying you in me. Loving you. Keeping you alive.

Fresh off the boat

Twenty-two years ago, when I first landed in the UK, I arrived as a qualified anaesthetist. I didn’t think of myself as a ‘female doctor’. I did not classify myself as one from the ‘ethnic minorities’. Both of those things were incidental to the fact that there was a job to be done and I could do it well, even if it was in a completely different setting, four and a half thousand miles away from home, at Antrim Area Hospital, Antrim, Northern Ireland. I was nervous but being from an army family, I was accustomed to moving every couple of years from one state of India to another (states as different as Punjab and Bengal), making it my own, learning from a different way of life and moving on to the next. I was sure of my ability to adapt.

My belongings comprised of a family photograph in a silver frame, a suitcase, mostly filled with books and two hundred pounds in cash. From the window of the plane I could see forty shades of green, in a mesmerising patchwork across the fields and hills of Ireland. The sky was the deepest, most startling blue. My heart was up in my throat with the excitement of living and working in a country where everyone was educated (why wouldn’t they be if education was free?)  and well-mannered (why wouldn’t they be if everyone was well looked after by the Government?)

One of the secretaries from the Antrim Area Hospital, Mary, very kindly came to receive me at the airport. The drive from Aldergrove Airport to the hospital was like gliding through a picture postcard. After Delhi, I could fully appreciate the wide golden-green expanses gleaming in the sunshine with not one human being in sight. When I complemented Mary on how gorgeous her country was, she was perplexed, “Really?”

Saagar was 5 years old then. He had stayed back with his dad. My plan was to find my feet and have him join me as soon as possible. I wanted to get my post-graduate exams within one or two years and go back to work in India. In the next few months, as I settled into my job, I acquired a cheap second hand Renault 19, found a family home and an appropriate child-minder. In the tea room of the hospital, the nurses would tell me about their families and ask me about mine. When I told them that I had a 5 years old child back home, they would say, “How could you leave him there?” I didn’t know what to say to that.

I still don’t.

Same story

“Three weeks before that day he was at a bridge and he called his friend who called the police. They came out but just told him to call the GP. One week before that day he called another friend saying he had a panic attack. The friend picked him up. Four days before that day they told the GP what was happening. She gave him a prescription for anti-depressants and said it would take 3 weeks for a referral. 4 days later my brother was dead. At no point did anyone tell the family.”

That day was sixteen days ago.

I wonder if anyone sat down with him to listen to what was going on with him. Two friends, one GP and the Police – none of them could put him in touch with his life and keep him safe. Yes. Ultimately it is up to him but I wonder if he was told that it might be helpful to get in touch with his sister, his brother, his mother, his father – the people who had known him all his life. That he could choose someone who he had a deep connection with, someone he trusted, and let them know how fragile he was at present. Someone who truly cared.

I wonder if you’ve seen this recent advert from St John’s ambulance where a dad is desperately trying to save his son. It encourages lay people to learn First Aid, in case of a physical health crisis. It’s a good one.

Save the boy”

Let’s put this in the context of doctors not knowing how to give First Aid to someone in a Mental health crisis.

The police not knowing that this is life-threatening, that there are resources in addition to the GP, like A&E, Maytree, Papyrus, Samaritans, CALM, their community, their family.

The GP not knowing that this is life-threatening, that there are things in addition to antidepressants that help, like having a proper conversation, exploring the suicidal ideation, informing them that it would be in their best interest if they included a family member or a friend of their choice in their care, giving them details of helpful Charities, giving them compassion and hope, drawing up a Safety Plan, getting in touch with the local Mental Health Crisis Team and  being aware that antidepressants can make things worse for young people in the short term.

Over-medicalisation of suicidal thoughts and behaviours in a setting where most medics are uneducated and unsupported in managing these crises.

Save the boys and girls by insisting on education for all professionals in medicine, nursing, law-enforcement, prison service, youth services, social work, for schools universities, hair-dressers, cab-drivers, students, parents, teachers, managers and everyone else is the only way to get it right – A multi-agency approach to Suicide Prevention.

In the USA, ‘legislation’ was recognised as essential to Suicide Prevention(SP) in 2012. At present, 10 states have legally mandated training for all health care professionals.

ASIST Training (Applied Suicide Intervention Skills Training):

Men like dahlias.

Without fail, he abandoned her the moment they entered the residence of the hosts of any drinks party they ever attended.

They had lived in the village for two years. Here everyone knew everyone. In the summer of 1976 Jane and Christian attended one such party. As soon as they got there, Christian was off, having a drink and a laugh with his friends. She could hear them raising a toast at the other corner of the large garden. Jane found herself standing near the hedge, admiring the flower beds and talking to her local GP, Dr Hamilton and the vicar. It was 7 pm and the garden was bursting with colours. “I do love these glorious dahlias” said Jane gazing down at the voluptuous crimson beauties. She looked up to find a shocked expression on the faces of both the men in her company. Had she said something awful? She worried.

The vicar looked at his feet, his left eyebrow still lifted in an arch. The doctor glanced sideways awkwardly, pretending he had heard nothing. ‘Only men like dahlias’ murmured the vicar. Jane turned red. There was so much she did not know. She quickly changed the topic to the nearby white roses, hoping they were safer. Uncontroversial.

The next day Jane had an appointment with Dr Hamilton. She said, “The Tamoxifen is terrible. I can’t fit into my shoes or get a full night’s sleep. Food makes me sick and I am impossible to be around. Don’t know how anyone puts up with me. My husband must be a saint.”

‘Yes. It can be quite de-feminizing” empathised Dr Hamilton.

“It was only a small tumour and they got all of it out. That was two and a half years ago.” Jane reminded him.

‘Okay. If the side effects are so bad for you, maybe we should stop it’ he thought aloud.

“That would be wonderful. And … it might make me stop liking dahlias.”

A Vision

By JR Leach

I had this vision back last spring,
When the land was ruled by corrupted kings,
And greed was fueled by hoarding things,
But things that one could touch.

The vision spoke of melted gold,
The value of the world resold,
“The price for life” is what we’re told,
By men who own too much.

As fear spread through a world; forlorn,
With threats of plague that ne’er were born,
Fresh chains were forged and willing-worn,
By those who feared the lie.

And though once joy had been assured,
Through weighing risk, and griefs endured,
Death could no longer be ignored,
For all souls fear to die.

This fear was stoked by those town criers,
Who peal the bells but start the fires,
And sing the songs their lord requires,
To whom they humbly thank.

Fresh tides of evil rise with haste,
As hands of Midas are replaced,
By hands whose touch turns all waste,
And paper sharp and blank.

“But rules are rules” the fearful sigh,
Content to see their forebears die,
No hand to hold, no last goodbye,
Just pixels, bright but cold.

“But rules are rules”, the state replies,
While deaf to all those muffled cries,
That sound from those with honest eyes,
And doubt the fear they’re sold.

And even children are not spared,
For misery is widely shared,
And dished by those who swore they cared,
But cared for guidelines more.

So mired and masked, the schools return,
Devoid of joy but forced to churn
Out abstract facts, for all must learn
That learning’s just a chore.

The vision ends when all is grey,
While shapeless, mouthless words relay,
The promise of a brighter day,
But no such day arrives.

A year drifts by, and so does youth,
The vision now a dismal truth,
But ‘truth’ is passé and uncouth,
While fiction blooms and thrives.

But even in this twilight hour,
imprisoned in our lonesome bower,
The words we speak retain their power,
And words can never die.

So speak your thoughts, and rise above
The barbs and briars of those who shove
The truth away, just think and love,
And you’ll escape the lie.