Suicide prevention

Day 604

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‘Dying from a mental illness is just the same as dying from any other disease’ says Paulie O’Byrne, a young man from Canada.

Paulie suffered sexual abuse at the age of 19. It took a long time for him to get past his shame and tell someone about it. Many people didn’t believe him including his parents. He suffered with anxiety, depression and PTSD and took to drugs and alcohol in a big way to be able to cope with the pain. He felt suicidal on many occasions.

His recovery could only begin when somebody believed what he had to say. That’s his message – when someone tells you they have a mental illness or that they are suicidal or that they have been abused, all they ask for is to be believed.

‘As much as I love my support and friends and family, for me I would not call them. The reason I say this is because in my mind it would cause more hurt and confusion if I told someone close that I have a plan to end my life. I thank god every day for crisis lines- the humans that work for them are angels among us. I can boldly state right now I’ve called the crisis line over 50 times since 2010, and I’m still here. I’ve thought about ending my life on my birthday before, for the sole reason people will only have to feel sad 1 day a year, not my birthday and death day.’

He worked incredibly hard to get out of the dark place where he was. His counsellors didn’t give up on him and he didn’t give up on himself. He started a movement called ‘1 in 5’, the motto of which is ‘strength from pain’. He speaks and blogs about the high incidence of sexual abuse in men (1 in 5) in Canada and encourages other victims to come forward and speak about their experiences by doing so himself.

He lives in gratitude, one day at a time.
‘I am grateful for the fact that I can breathe.’

Day 602

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Victoria and Adam are Elaine’s little kids. Her husband Martin is an airline pilot. In March 2005 Elaine went into hospital for a routine operation on her nasal sinuses. Unfortunately things didn’t go as planned and she died after 13 days due to an anaesthetic mishap. Just a routine operation turned into a tragedy for this lovely family.

The inquest brought out the fact that the anaesthetist was unable to establish a patent airway on her after anaesthesia was induced. He was helped by a surgeon and another anaesthetist and still they were unable to keep the oxygen levels in Elaine’s blood at a safely high level.

At the inquest it was also evident that in that situation the anaesthetist ‘lost control’ and it was unclear as to who was in charge. Awareness of time and seriousness of the situation were lost too. There was a clear breakdown in communication between team members. The decision making ability, situational awareness and ability to prioritise were all inadequate.

It was interesting to note that the nurses in attendance knew what the next step should be and they brought the appropriate kit into the room but they were not paid any attention by the doctors. There was a clear lack of assertiveness on the part of the nurses. The inability to listen and be open to suggestions on the part of the doctors possibly contributed a great deal to Elaine’s death.

Human factors are responsible for 75% of aviation accidents. If we were to look at the mortality caused by human factors in the medicine, it would be equivalent to 2 plane crashes per day.

“In short, human factors, not technical inability led to my late wife’s death” says Martin. He went on to set up the Clinical Human factors Group in 2011, working with health care professionals and managers to make healthcare safer.

Thanks to Martin, the awareness of human factors has come into the forefront of medical practise and training. I have huge respect for the man. Victoria and Adam will know that although their mother died, many others will live due to the lessons learnt.

 

 

Day 601

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‘Never let an aircraft take you where your brain didn’t get to five minutes earlier’ – this is a commonly understood concept amongst pilots.

While none of us can predict the future, the ability to anticipate problems that might arise given a particular set of circumstances is a basic requirement for many high risk jobs such as fire fighting, policing, armed combat and medicine. Doctors do have a licence to kill and they inadvertently use it when they can’t or don’t anticipate problems. Working backwards, if we don’t think the worst might happen, we don’t actively look for it and definitely don’t plan for it. Before we know it, it’s too late and the adverse outcome is inevitable.

Four days into it’s maiden voyage, the largest passenger liner of its time, the Titanic sank. It received six warnings of sea ice on 14 April 1912 but continued travelling near her maximum speed when her lookouts sighted an iceberg in its path. Unable to turn quickly enough, the ship suffered a killer blow and slowly sank over the early hours of 15th April. 1635 of the 2224 people on board died.  The vast majority of the crew were not trained sailors but were either engineers, firemen, or stokers, responsible for looking after the engines or stewards and galley staff, responsible for the passengers. They were taken on at Southampton on short notice and had not had time to familiarise themselves with the ship. Knowing what we know now, is it surprising that the ship sank?

Saagar gave us warnings but we didn’t pick them up. Shouldn’t alarm bells be ringing nice and loud when a young man with a recent diagnosis of a mental illness is discharged in a hurry from Psychiatric services and he scores 27/27 on his PHQ-9? Whose responsibility is it to join up the dots?

When a plane goes down, the pilot goes down with it. When a patient dies, often nothing happens to anyone else. There is no black box. Tracks get covered, mothers over-react, things get forgotten and life goes on….

 

Day 591

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The Manchester Report on Suicides in Children and young people in the UK published earlier this month states that 201 people aged between 10 and 19 killed themselves in 2014 in the UK, up from 179 in 2013 by 12%. The ONS (Office of National Statistics) figures suggest that student suicides have risen to their highest level since 2007.

The BBC reported a synopsis of the report, highlighting that this is the first time experts have studied the contributory factors on this scale. Their findings showed:

  • 36% had a physical health condition such as acne or asthma
  • 29% were facing exams or exam results; four died on an exam day or the day after
  • 28% had been bereaved
  • 22% had been bullied, mostly face to face.

The study also found that 23% had used the internet in relation to suicide – including searching for methods or posting suicidal thoughts.

“I think the numbers are the tip of the iceberg,” says Ged Flynn, chief executive of Papyrus, an anti-suicide charity. “I think the pressure on young people in increasing. Peer pressure – from family, teachers and friends – has always been there, but it does seem to be increasing. And the need to be liked, the need to be popular, the need to be happy, is fairly universal. And it’s unrealistic.” Hopeline UK, has seen a large rise in contacts from young people and parents in recent years, quadrupling since 2013. It says that most of the calls, texts and emails it receives relate to exam stresses.

This little news clip from 5 News summarises the findings. Of the 20 minutes they interviewed me for, about 20 seconds was telecast. Of the 3 warning signs I mentioned, only 1 was included. Well. I suppose something is better than nothing. At least they are talking about it.

 

 

Day 589

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Ruth was 47. She lived with Bipolar Disorder for 20 years. For all those years her mother looked after Ruth and volunteered for a Mental Health charity. The week after Ruth’s death, her mother rang the Charity with the bad news of her suicide. She didn’t receive as much as an e-mail of sympathy from them.

Saagar was under the care of our GP (General Physician/Family doctor). I didn’t hear anything from him after Saagar’s death. At the Coroner’s inquest the GP said that he had been advised against calling me by the Medical Defense Union (MDU). They claim to be ‘on your side’ and give ‘expert guidance and support’. It goes to show that on hearing of Saagar’s death the first phone call the GP made was to the MDU. The advise he got given was medico-legal in nature and that is what he was looking for. Interesting! Isn’t it?

I had the honour of meeting Ruth’s mum today. We could see so many similarities in Saagar and Ruth. Both adorable, affectionate, creative  and kind. I was her mirror and she mine. The bond we felt was very special. She let me try on Ruth’s sun-glasses. She thought they looked great on me and I do too. She let me have them. In that moment, I felt exactly how she must have felt – deep pain tinged with a tiny drop of relief; deep loss with a sense of peace. RIP Ruth.

Here’s a poem I found on the Order of Service for Ruth’s funeral:

Afterglow

I’d like the memory of me to be a happy one.
I’d like to leave an afterglow of smiles
When life is done.
I’d like to leave an echo whispering softly down the ways
Of happy times, bright and sunny days.
I’d like the tears of those who grieve,
To dry before the sun.
Of happy memories that I leave when my life is done.

-By Helen Lowne Marshall