Suicide prevention

Day 758

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Prison statistics reported in June this year by the Howard league for Penal reform suggest the following:

  • 30% rise in ‘self inflicted’ deaths.
  • A dramatic increase in the number of women who took their own lives – 11 compared with only one during the preceding year.
  • The quarter between April and June 2016 recorded the highest figures for self-harm (9505, of which 665 led to attendances at hospital), 6086 assaults, including 1,540 assaults on staff.
  • Number of prisons awarded the worst possible rating has doubled in the last year.
  • Number of murders in prison over the last 2 years is more than the previous 8 years put together.
  • Budget cuts meant that prison officer numbers fell from 24,000 in 2010 to just over 14,000 by 2014

‘Prisons are not only becoming more dangerous, they are becoming more dangerous more quickly.’ Could it be because mental health issues continue to dominate the police custody world as officers strive to make detention a better and kinder experience for individuals suffering from a crisis. Without proper support from and liason with Mental health services, these individuals land up on the streets or in deeper trouble.

Statements of difficult predicaments from National Custody Seminar, September 2016 :

“You can be dealing with a detainee who is ready for release, and they say to the custody sergeant ‘as soon as I walk out of here, I’m going to jump under a train’ or hang themselves, or create some horrible outcome.”

“The custody officer is then of course faced with a very difficult problem to solve. If they are telling you and you’ve got no reason to disbelieve that they may kill themselves or self-harm, what do you do? Do you let them go? How long do you follow them for?”

“Some officers have tried to detain people for their own good because they can’t rely on the Mental Health Act. Common sense tells you it’s the right thing to do, but the law says you are breaking it. I think that’s a loophole that needs to be sorted out and addressed.”

The deteriorating statistics could surely be a reflection of 2 key services starved of resources trying to look after vulnerable people – Mental Health and Police services.

Sources:

http://howardleague.org/news/prisons-are-becoming-more-dangerous-more-quickly/

https://www.theguardian.com/society/2016/apr/12/ministers-prison-reform-overcrowded-understaffed-invest

http://polfed.org/newsroom/3683.aspx

Day 754

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Life is stranger than fiction. 16 years ago Saagar came to live in Belfast. Today I attended a Suicide Prevention conference entitled ‘What works? Speaking Truth to Power.’ in Belfast.

It was encouraging to see more than 250 people in the audience – counsellors and other frontline staff, police, GPs, policy makers, funders and voluntary groups. I met other bereaved parents and activists passionately working towards improving mental health services within the NHS and in the voluntary sector. It was inspiring. It gave me hope.

I shared Saagar’s story and the lessons that could be learnt from it. They listened. Afterwards, many came up for a hand-shake, a quick chat and a hug. One lady said, “I have been a psychologist for 12 years. Thank you for reminding me why I chose to be one.”

John Steinbeck, the American novelist once asked his long-time friend, the second Secretary General of the UN, Hammarskjold what he could do to support him and the UN. ‘Sit on the ground and talk to people. That’s the most important thing’ said Hammarskjold.

The longest journey starts with a single step which is to engage in conversation with people in our immediate environment, the place where we have set down the anchor of our lives and to take concerted action with them. The significance of dialogue lies in the process, in sharing thoughts and taking pleasure in each other’s company. This allows each individual to find meaning and feel like a valuable part of a community.

 

Day 734

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2 months ago I made a presentation entitled ‘Understanding Resilience’ to a group of roughly 30 people in their twenties. It was well received and the feedback was encouraging. Here is the quantitative analysis, marked out of 5.

Content:  4.39

Presentation: 4.38

Relevence to me:  4.13

Overall:  4.38

It was interesting to see that the lowest score was to do with relevance. It means that while most of them liked the content and had an overall good impression of it, many of them thought it didn’t apply to them.

Perhaps it reflects the fact that at present they feel strong. Great! Long may it stay that way! If I had attended a presentation like that a few years ago, I would have thought the same. But I do hope that if any of their friends, colleagues or family is in a vulnerable place they will be able to spot that and reach out to them. I also hope that if they see a distressed stranger, they will be sensitive to that and offer support.

The low score could also indicate an inability of some of us to acknowledge our own fragility.

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Day 726

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Sarah Fitchett is a neonatal nurse and a lecturer. She is also a mother bereaved through suicide. Like me, she is affiliated with PAPYRUS Prevention of Young Suicide Charity by way of fundraising and awareness raising. This is an e-mail from her:

“I delivered an awareness session to GPs in Birmingham last week and they were desperate for more training.  They were literally asking me,
“What should I say?”
“What if the answer is yes?”
“What am I looking for?
“There are no services available to signpost young people to – CAMHS is so stretched”
“How will I know?”
“How do I cope with losing a patient to suicide?”
I really hope they will come on ASIST.  Such a lot of work is needed. One of our young volunteers, a mental health nurse from Bristol self-funded a place on ASIST because she had no idea how to help someone at risk of suicide, neither did any of her colleagues. Her training hadn’t covered it and there was no training available to her.  A WM police officer self-funded a place on ASIST and used her annual leave to attend because so very much of her role is attending people in crisis.”

This is an article she’s written about the absence of suicide prevention training on the nurse’s curriculum and the stigma associated with suicide within the medical community: http://theconversation.com/even-nurses-arent-immune-to-the-stigma-of-suicide-66008

11th October 2014 was a saturday. I had tickets for the Omid Djalili show for us. Saagar loved stand-up comedy and I thought it might help him. He sat on my right. I watched his responses. He appeared to be under a cloud. He did laugh but his laughter was subdued. At break time I bought him a drink and for some strange reason it felt like a significant happening, like an unforgettable scene in an iconic film. It was the last time I bought him a drink. It was the last time we went for a show together.

Let us do everything we can to save young lives.

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Thank you Omid for bringing him some happiness. Even if it was short-lived.

But then, everything is temporary, short lived! 

Day 725

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Another story.
Another young man.
Another family.
Another mother.
Same themes. Same gaps. Same cover-ups.

“Y went to University, experiencing life away from home for the first time. Although only a 40-minute train journey away, he lived in halls of residence, sharing a flat with four other students. I saw him at least once every fortnight and although I knew he was upset at the break up of his first serious relationship, there were no signs that he was struggling to cope with his studies or not enjoying university life. He appeared to be the same quirky teenager who made friends easily and faced challenges full on.

One Sunday he failed to come home for lunch with the family. Frantic, I drove to his halls where an ambulance and police car were parked and I was given the news that our beloved son was gone. It was another 24 hours before we discovered he had completed suicide. Nothing could have prepared me or our family.

Five months later we attended an inquest into his death where an open verdict was recorded, and the Coroner claimed that everything possible had been done by health care professionals to support Y following a university doctor diagnosing him with depression and prescribing anti-depressants. He had been referred for counselling and his university tutor was informed.

At the inquest, the GP had legal representation. A representative of the university’s counselling service gave evidence on behalf of the counsellor; a statement was read out from a doctor who had admitted Y to hospital following two incidents of self-harm, and another statement was read from the university tutor in whom Y had confided.

As a family, we sat completely dumbfounded that all of these people knew that our child was suffering from mental health issues. Not one of them had contacted any of us, or identified us as a ‘safety contact’, yet felt the need to be legally and professionally protected in court.

Just one month after starting university and following the break-up with his girlfriend, Y made his first suicide attempt. We were not informed. The reason we were given was that he was an adult and all of the professionals involved had a duty to respect his confidentiality. The counsellor’s representative commented that it was ‘possible’ that it ‘may have been suggested’ that Y talk to me about his situation, but she could not confirm that this was the case.

Had Lawrence been involved in any sort of accident then I would have been contacted immediately, but because his admission was a mental health issue the veil of confidentiality came down and prioritised clinical staff welfare rather than that of my son.

Did we as a family – or me, specifically, as his mother – fail him? We failed to see his suffering, but when he was around us he was the usual Y we all knew and loved.

Did the university fail him? Yes, they should have informed his emergency contact/next of kin that he had expressed suicidal thoughts.

Did the clinicians fail him? Yes, by averting culpability and absolving themselves within a care system culture that protects its own and isolates the patient from their family – the people closest to them and those who would have provided the love, care and protection that could have saved a young life.

As a family we felt that the ‘professionals’ closed ranks to protect themselves. In the weeks leading up to that awful day, and the months before the inquest, their self-protective instincts mattered more than the duty of care they had towards protecting our son Y, a caring, funny, intelligent young man with a whole lifetime of adventures in front of him.”

NO CONFIDENTIALITY WHEN IT COMES TO SUICIDE.

In Jan 2014, an official document was published – “Consensus statement on information sharing” (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271792/Consensus_statement_on_information_sharing.pdf)

“The statement applies to adults in England. Information can be shared where it is in the public interest to do so. In practice, this means that practitioners should disclose information to an appropriate person or authority if this is necessary to protect the child or young person from risk of death or serious harm. A decision can be made to share such information with the family and friends, and normally would be.”

Who’s left to deal with the loss for the rest of their lives? The people who never knew it was happening. The people who would have gone to any lengths to avert the tragedy. The people who had a right to be informed.

10th of october 2014 was a friday, the beginning of my last weekend with my darling son, the last italian meal we shared. All that is left now is a broken heart holding many beautiful memories on one hand and reliving the nightmare over and over again on the other.