suicide

Two lessons

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“He loved me in the purest sense and I loved him. That’s how he kept me alive.” says Marsha about Ted, a catholic priest.

This relationship taught her two important things that she applied to her work as a therapist for seriously suicidal people. She wrote about these things and taught them to her students, the future generation of therapists.

  1. ‘I was unable to say thank-you then. Now I can.’

If you’re giving unconditional love to help someone cope with the hell they are in, if you’re holding them emotionally and physically, don’t interpret their absence of ‘thanks’ as a sign that you are not giving them what they need. You probably are.

2. ‘Keep loving them.’

When someone sees no point in living, they are like someone walking in a mist. They don’t see the mist. They don’t see that they are getting wet. If you’re walking with them, you may not see it either. But if they have a pail of water, you can collect the water that was mist, in it. Each moment of love adds to the mist, which adds to the water in the pail. By itself, each moment of love may not be enough. But ultimately, the pail fills up and the person in hell can drink that water of love and be transformed.

Like Marsha, I know this to be true. I’ve been there and drunk from that pail.

(Inspired by Marsha M Linehans’s book: ‘Building a life worth living’.)

I was so wrong.

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I thought that if his doctors would have recognised how sick Saagar was, they would have known that the best thing to do was to refer him to the Psychiatric services. They would admit him to the hospital, look after him and keep him safe.  He would recover fully, return home and resume his life as normal – play the drums, read and speak French, play cricket, go out with his friends, go to the gym, make me laugh till I had tears in my eyes and soon, return to University.

Now I know, that I was so wrong at so many levels.

  1. Recognise?

The GP didn’t think his condition was life-threatening, even after he told him it was. How much more obvious did it have to be? They didn’t believe him. If at all they did, they didn’t take him seriously. Or maybe they simply didn’t know what to do.

GPs are not trained or supported in looking after suicidal patients.

  • Refer?

If they would have made a referral to the Mental hospital, he would have waited for a long time to be seen. Maybe he would have died while on the waiting list, like many others.

GPs are dis-incentivised to make referrals to specialist services in various ways.

  • Admit him to the hospital?

No chance! That would not have happened as there would have been no beds. If there were beds, there would have been others much sicker than him, ahead of him in the queue.

Hospitals have very poor capacity and very high thresholds for admission to inpatient beds.

  • Keep him safe?

490 patients died while detained under the Mental Health Act in the year up to March 21. At least 324, for non-COVID reasons.

Ref: https://www.bbc.co.uk/news/uk-politics-59336579

Being an inpatient does not mean –  safety.

  • Recover fully?

Many patients report traumatic experiences while admitted to mental hospitals. The treatment is often not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support.

There is little understanding of what the patient needs, to recover.

(Ref: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/experiences-of-inpatient-mental-health-services-systematic-review/C5459A372B8423BA328B4B6F05D10914)

I am presently reading a book – ‘Building a life worth living’ by Marsha, M Linehan. She is the psychologist who developed Dialectical Behavioural Therapy, to help suicidal individuals to build their lives. Much before she did that, she was a seriously suicidal and self-harming young adult.

I am learning so much.

Marsha M Linehan – Author of ‘Building a Life Worth Living’

Grey day

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I didn’t light his candle today. Not because I forgot. But I just couldn’t be bothered. He left without saying bye. I know it’s silly to bring this up now, after so many years. He needed to do whatever it was he needed to do. He needed to go. I understand. But the missing makes my heart crumble again and yet again. How is it possible to keep going after its smashed so many times? It feels like the old yellow rubber duck in his bath, being stamped heavily upon, by a topless angry Arnold Swarzenegger wearing big black military trousers and boots. What is this thing that pretends to drum in my chest, tattered and torn?

He broke the rule. Saying good-night was our ritual for many years. After settling him in his bed, I religiously kissed him on his chin, both his cheeks, first left and then the right, his closed eyes, first the left and then the right and then, once on his forehead. He put his little arms around my neck and we both held each other for a short while before I switched off the light and went to my room. We loved it and slept peacefully.

He didn’t respect our little rule. Maybe he couldn’t. But, I deserved at least, a proper good bye. But then, can anyone truly know who deserves what?

all my love,

endlessly

black and white portrait.

Thank you Prime Minister.

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Recently, our highly respected Prime Minister declared there was a need to treat ‘problem drug users’ with ‘compassion’ by investing in rehabilitation. In the same breath, he said that his government would  ‘wage a war’ on drugs by removing passports and driving licenses from drug-users to tackle drug-related crime. He rightly emphasized that drugs were really ‘bad for society’.

Little surprise that he said absolutely nothing about the invisible drug that is freely available in shops and restaurants and can easily be found in homes, clubs and pubs. Many of us use it everyday even though it causes severe social, financial and health damage. As good friends, family and colleagues we often encourage each other to use it, while thinking nothing of using it ourselves. Some of us go as far as taking offense, when someone declines our offer to use it. Yes, alcohol is a drug. It is a depressant, even though it can fool us into thinking and feeling otherwise. It causes more than 60 types of diseases and injuries.

[Courtesy: Science Direct : https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/ethanol-effect%5D

Alcohol use, particularly heavy use and dependence is directly associated with suicide in three ways:

(1) through its dis-inhibiting effects, it emboldens people to attempt suicide

(2) individuals with Alcohol Use Disorders are at an increased risk of suicide as compared to the population at large

(3) alcohol consumption co-relates with suicide rates, all over the world.

Thank you dear PM for giving us a chance to think about our relationship with ‘drugs’, especially at this time of year which can be difficult for some and over-festive for others.

I wish you good company, much fun and laughter now and always. May you be blessed with lots of cake.

(by Charlie Mackesy from “The Boy, the Mole, the Fox and the Horse”)

Ref: Suicidal Behaviour and Alcohol Abuse:  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872355/#b26-ijerph-07-01392

A report and a film.

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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

Suicide in Children and Young People