Day 873

It’s Thursday.
It’s the 16th.
It’s March 2017.
Exactly 29 months.
2 years and 5 months.

I am in the same part of the same hospital, doing the same job with the same people as I was on that day. I am taking a break in the same clutterred coffee room where Saagar visited me a few months prior to his death.

Today, I sit here reading the House of Commons Select Committee Progress Report on Suicide Prevention. It informs the Government’s strategy on the same.

In a nutshell, it clearly states – Suicide is preventable. Current rates of loss of life in this way are unacceptable and most likely under-reported. Even though 95% of Local Councils have a Suicide Prevention Strategy, its implementation is very poor. We must have a way to reach those at risk but not in contact with health services. It commends the work of the voluntary sector. It identifies stigma as a big hindrance. It emphasises better targeted training for frontline staff, medical students and GPs. It expresses disappointments at the poor follow-up of patients after discharge from psychiatric services, at poor information sharing with families and poor funding/staffing of services.

It identifies self harm as the single biggest indicator of suicide risk. Poor psychosocial assessment and safety planning of these patients possibly contributes to a high rate of suicides. Proper support for bereaved families should be an integral part of suicide prevention. Irresponsible media reporting is damaging. Coroner’s need to call a suicide, a suicide.

All the things that we have been saying for all these months!
To think that at least 15,000 more suicides have already taken place in the UK since Saagar’s death!

Report:
https://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/news-parliament-20151/suicide-prevention-report-published-16-171/

Day 867

Posted by kidsaregifts20

Kooning
(The Attic, by William de Kooning)

In the 1920s, a Russian film director, Lev Kuleshov filmed a male matinee idol staring in turn at a bowl of soup, a young girl in a coffin and an elegant lady reclining on a couch. The actor got rave reviews from the audiences on his ability to effortlessly evoke hunger, grief and desire in the film. What they did not know was the fact that the director had used the same shot of the actor each time, just cut to each different object.

Humans have an innate need to impose order on the world. If we are presented with disparate images, we will try to assemble them into a meaningful order. It we are given a bunch of jumbled unrelated words, we will try to arrange them into a sentence that might mean something.

In the mid-twentieth century, Wiiliam de Kooning emerged as one of the pioneers of Abstract Expressionism. His art is known to put brains in a tizzy, desperately trying to order and make sense of the shapes within. Faces? Animals? Semi-clad human forms? Women? Doors?

ExcavationdeK
(The Excavation, by William de Kooning)

Maybe life is the same – unrelated images randomly juxtaposed, the human mind desperately struggling to make sense of them.

Ref:

William de Kooning: http://www.theartstory.org/artist-de-kooning-willem.htm
Kuleshov effect: https://www.youtube.com/watch?v=_gGl3LJ7vHc

Day 863

Posted by kidsaregifts20

Jalebis are the most luscious of Indian sweets . They are made from plain flour, ghee, saffron and sugar – the best possible ingredients. They bring back the sweet memory of home. Lately they featured in a Holywood film, Lion, as a trigger for a deep longing for home for a young displaced man. This longing grows into a desperation and then becomes a source of great suffering. Even though the body moves from one place to another, the heart can stay in one place for lifetimes, clinging on to sights, smells and sounds that mean ‘home’ and ‘love’. The power of the mind to revisit, relive, reconfigure and re-create life from all these stray scraps is tremendous.

This big blockbuster addresses issues of adoption, childhood trauma, migration and much more. The most interesting questions it has raised for me are – What is your narrative? What is the story you tell yourself? Do you ever question it? Are you willing to see how your life might change if you did question it? Are you willing to be proven completely wrong? Would that set you free? Would that empower you to change your direction?

The things we tell ourselves have more power than we know. They make the difference between life and death.

Lion

Saagar as Lion 🙂

Day 859

Posted by kidsaregifts20

Suicide Prevention Interim Report 2016-17 Summary:

This report published by the House of Commons Health Committee outlines five key areas for consideration by the Government before the refreshed strategy is finalised:

(1) Implementation — a clear implementation programme underpinned by external
scrutiny is required.
“To me, it is extraordinary and very distressing that four years after the strategy was published we do not know how many local authorities have implemented anything [ … ] we cannot allow more lives to be lost because we do not have effective governance and implementation. It is such a waste of time and a waste of money.” – Hamish Elvidge, Chair of the Mathew Elvidge Trust.

(2) Services to support people who are vulnerable to suicide—this includes wider
support for public mental health and wellbeing alongside the identification of
and targeted support for at risk groups; early intervention services, access to help in non-clinical settings, and improvements in both primary and secondary care;and services for those bereaved by suicide. We recommend that all suicide prevention plans should include mandatory provision of support services for families who have been bereaved by suicide.

(3) Consensus statement on sharing information with families—professionals
need better training to ensure that opportunities to involve families or friends
in a patient’s recovery are maximised, where appropriate.

Misunderstanding about confidentiality, lack of confidence, or even simply time constraints can lead professionals to adopt a ‘tick box’ approach to seeking consent. Professionals may err on the side of not involving families, rather than taking the time to explore fully with the patient whether there would be benefit in contacting a trusted family member or friend.34 Hamish Elvidge explained it very helpfully: One way is to say “Do we have your consent to share information with a family member, friend or colleague?” The chances are that the answer will be, “No.” Or you could say, “In our experience, it is always much better to involve a family member, friend or colleague whom you trust in your treatment and recovery, and we know the triangle of care is likely to result in a greater chance of successful recovery. This will result in you recovering much quicker. Would you like us to make contact with someone and would you like us to do this with you now?”

(4) Data—timely and consistent data is needed to enable swift responses to suspected suicides and to identify possible clusters, in order to prevent further suicides.

(5) Media—media guidelines relating to the reporting of suicide are being widely
ignored and greater attention must be paid to dealing with breaches by the
media, at national and local level. Consideration should also be given to what
changes should be made to restrict access to potentially harmful internet sites
and content.

Is this document a proof of more red-tape or a source of hope for the future?

Source: https://www.publications.parliament.uk/pa/cm201617/cmselect/cmhealth/300/300.pdf

Day 856

Posted by kidsaregifts20

Every investigation into an avoidable death is a learning opportunity for Trusts, clinicians, families, wards, patients, management, boards and the community. The lessons learnt can be passed on to other organisations and future generations. But unfortunately, often investigations are done in order to not find any deficiencies. They are defensive in nature rather than exploratory. They are reductive and analytical (Root cause Analysis) rather than holistic and empathic. Both approaches bring value to an investigation but often the greater good that can come out of them is overlooked.

200 avoidable deaths take place within the NHS every week. Each of them holds valuable lessons for the future but they are buried. Hence the same mistakes happen over and over again, costing more and more lives. In some organisations serious near-misses are recorded as ‘no-harm caused’.

We need collective intelligence, not individual genius. We need responsibility and accountability, personal and professional, shared and individual.

In 2015, a report was leaked to the BBC from Southern Trust that looks after 45,000 people. They had 1454 unexpected deaths over a 4 year period, 2011-2015. Of those, just 195 (13%) were treated by the trust as serious incidents requiring investigation. Deaths of adults with mental health issues were most likely to be investigated (30%). For those with learning disability the figure was 1%, and among over-65s with mental health problems it was just 0.3%.

“To err is human, to cover-up is unforgivable, to fail to learn is inexcusable.”
– Sir Liam Donaldson.

Ref: NHS Failure to probe deaths: Shocking: http://www.bbc.co.uk/news/health-35061716