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Suicide

When a Loved One Is at Risk of Suicide

Their doctor can tell you.

Many people are struggling with poor mental health in these difficult times. When hope is taken away—hope of seeing loved ones, making a living, paying one’s bills, feeling like a normal human being—that is when people have suicidal thoughts.

Shockingly, antidepressants often consequently prescribed can increase suicidal thinking and attempts. A recent study shows that one in every 200 people started on them goes on to attempt suicide.1

Photo by Andrew Neel from Pexels
Source: Photo by Andrew Neel from Pexels

Even stopping antidepressants brings problems. Last month, the Royal College of Psychiatrists bowed to external pressure and published guidance that fully outlined the true possible extent of withdrawal symptoms.2

Among these are suicidal thoughts and a feeling of inner restlessness and inability to stay still—a state known as akathisia, often so relentless and overwhelming that it may itself precipitate suicide attempts.

It is particularly surprising that some mental health professionals still don’t know that they can inform families of a patient’s fragile mental state, if there is suicide risk—even when the patient is over 18.

GPs and others may think that they are bound by their duty of confidentiality even in such cases, but they are not. In 2014, the Department of Health published a consensus statement, signed by eight professional organisations including the Royal College of Psychiatrists, Royal College of General Practitioners and Royal College of Nursing.3

It made clear that a person considering suicide may be deemed lacking in mental capacity (if they are not making an informed decision) which, in turn, allows practitioners the right to inform a friend or family member who can help prevent them from coming to serious harm.

The 22-year-old son of a friend of mine hanged himself eight years ago. Raj (not his real name) was depressed because his life wasn’t working—dreams of a future in broadcasting had been suppressed to follow his overbearing father’s desire for him to become a scientist. He had failed his exams, dropped out of studying, and, in the tunnel vision of depression, could see no future.

As he had no GP at the time, having just left university, he was referred through a walk-in clinic for assessment by the local mental health team. He told the community psychiatric nurse there that he thought about suicide every day, had researched hanging, and that he had made an extremely serious suicide attempt two years previously, when he took an overdose, slashed his wrists, and stabbed himself in the chest.

He was prescribed antidepressants—without being told that this could initially increase his suicide risk.

Raj’s mother, desperately worried about him, was told nothing. Having got him registered with her GP by then, she arranged an appointment. Raj told the GP that he was thinking of suicide every day, leading the GP to contact the crisis team.

Later that morning, the GP phoned the house to tell Raj that the crisis team would be in touch shortly. Raj’s mother answered the phone and the GP politely asked to be put through to Raj, revealing nothing. The community psychiatric nurse from the team duly called. Again, the mother answered and, again, the nurse merely asked to speak to Raj.

Raj’s mother had been loath to leave the house but she had an important work meeting and, assured by her son that he would be all right, she left to attend it. She found him hanging from the stairwell on her return.

I know all this detail only because it came out at the inquest, where the coroner was so shocked that he wrote to the Department of Health to say that the rules on confidentiality needed amending.

Nine months after the inquest, Raj’s mother hanged herself from the same stairwell.

If Raj had seen a human givens practitioner, it is possible that this catalogue of tragedy would not have unfolded. He was living the wrong life and then he died the wrong death. I have since read moving accounts from other anguished, bereaved parents, incredulous that they weren’t informed of the danger their young adult children were in—all published years after the new guidance.

If you have concerns about the mental state and suicidal thinking in your own nearest and dearest, please make sure you alert mental health professionals involved in their care to the existence of the consensus statement. It might just help to save a precious life.

To find help near you, see the Psychology Today Therapy Directory.

References

1. Hengartner, M P and Plöderl, M (2019). Newer-generation antidepressants and suicide risk in randomised controlled trials: a re-analysis of the FDA database. Psychotherapy and Psychosomatics, 88, 247–8.

2. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

3. Department of Health. Information sharing and suicide prevention: consensus statement (2014). Department of Health.

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