You
and Yours ~ Looking at New Initiatives ~ Suicide Strategy
Presenter Liz
Barclay
with Carolyn
Atkinson, BBC
Radio 4 ~ 21st January 2005
(Click
here
 to listen to the original BBC programme using Real
Player)
Suicide rates in
England have fallen to an all time low. We look at new initiatives
designed to help people who want to take their own life. Professor
Louis Appleby is a Mental Health Advisor as
well as National
Director of Mental Health and
Dr Nandy Nwogwugwu works in a Psychiatric
Emergency Clinic
at Homerton Hospital in London.
Rowena's,
life was turned around after she arrived at Maytree on the brink of
suicide.
N.B. :
THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT
COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF
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ACCURACY.
BARCLAY:
The suicide rate in England has fallen to an all time
low and the number of young men killing themselves has dropped
to the lowest level for almost 20 years. This has been put down
to the government's national suicide prevention strategy for
England which was introduced in 2002 to reduce suicides by a
fifth by 2010. Despite the downward trend however, there are
still 4,500 suicides a year in England, more than the total
number of road deaths, so there's more to be done.
Two years ago on You and Yours we reported on the opening of the
UK's first suicide respite centre called Maytree. It's run as a
charity in the borough of Camden in London, which has the
highest suicide rate in the country. Suicidal people accepted as
suitable spend four days at Maytree's House and are helped
through their crisis. It's proven that if people come through
that suicidal period the majority never attempt suicide again.
Carolyn Atkinson spoke to Rowena, whose life was turned around
after she arrived at Maytree on the brink of suicide.
ROWENA:
Everything was so black, the blackness just didn't go.
It was like a black tidal wave coming over me and I couldn't
swim to the shore, that was how it was. It had been going on for
months and nothing appealed to me at all and I'd had depressions
before but it just accumulated and got worse and I didn't even
want to go to hospital or seek treatment, I didn't want to go
through all those procedures. Hospital, I mean in such a bad
state, who wants hospital, no thank you. And a few weeks before
that I'd seen something about the Maytree in one of the local
papers. It interested me that there was a house that you could
be looked after without having drugs put on you, that sort of
interested me at the time. But I got to a stage I thought well
would it be worth a try and just thought well even if I do
finish my life I can at least see if this lot were a crazy lot.
And part of me really didn't want it to work either, I felt that
bad. But I thought oh in the end I'll try, I'll just ring up,
there's no harm.
ATKINSON:
So really one call and they'd convinced you that this
was possibly something that could help you.
ROWENA:
Exactly, yes they did.
ATKINSON:
And when you got to the point of coming to Maytree were
you on the verge of trying to kill yourself?
ROWENA:
I thought I was, I'd planned - if they couldn't help me
- I'd planned to just do it, yeah. You think ah well if I take a
few pills it'll soon be over, I'll be out of the pain and that
would have happened to me, I would have taken an overdose,
something - drowning or something you know, I'd come to a point
that I would risk the pain of dying to get out of the pain that
I had whilst living.
ATKINSON:
So when you got here, you were only here four days, it's a
relatively short time so what did they do and how were they able
to sort of turn round your thoughts and feelings?
ROWENA:
The day I got here I went to my room, which was lovely, I
thought this is a nice room, very pleasant this room anyway. A
lady knocked at the door and walked in to put a duvet on my bed,
she was so sympathetic. And she started chatting and I felt I
wanted to talk to her. I certainly could talk about things I'd
never been able to talk to anybody else. Deep things, there were
people here that were so receptive, that I could open up and
talk about real things that were really bothering me that I've
held on to for years. I felt all these people seem to want to
know me and that was the - the point of where I got so low and
black, I felt nobody wanted to know me and that's why I wanted
to commit suicide. When all these people started to come in and
want to - I felt like a VIP.
ATKINSON:
So you didn't see yourself as anything or anybody?
ROWENA:
No, not at all, no. Having any value whatsoever - no way. No, it
like opened a window onto the wider world because I'd shut that
window out.
ATKINSON:
And do you feel really that it's the first thing that's really
worked for you?
ROWENA:
I planned to - wanted to commit suicide in depression
definitely, definitely. It's lovely to go somewhere and feel so
black and negative and come out feeling so positive. And you say
how can that happen in five nights, four days - well it happened
for me. It can give you more confidence that you've got a right
to enjoy life and be happy. They give you the tools to be a
captain of your own ship. Can't say life is roses all the time
but it's not thorns and if you come across a storm in a rough
sea they give you the strength and ability to drive that boat
through rapids, so as to speak. So that you don't go under, you
get through to the other side and you feel stronger. And they
gave me these tools. That's what I carry with me, that I can
cope, I can steer my boat through rapids. It's given me a lot to
look forward to actually.
BARCLAY:
Rowena was talking to Carolyn Atkinson.
Maytree was endorsed in a recent suicide scrutiny report by
Camden Council and the local authority's now planning to open a
similar respite centre itself. So how do doctors and other
health professionals think of this service? Dr Nandy Nwogwugwu,
who works at Homerton Hospital's psychiatric emergency clinic in
London, has been successfully referring people to Maytree. Dr
Nwogwugwu, you're dealing with very vulnerable people who are on
the brink of killing themselves, how do you decide who might
benefit from something like this respite centre rather than
going to hospital or being sent home?
NWOGWUGWU:
Well a lot of the patients who come to us who are suicidal the
fact that they come is actually an indication that they're
reaching for some kind of help. And so in the course of
discussing with them we begin to explore the options available
to be able to intervene in whichever crisis they're going
through. Now previously the option of going to hospital, some
patients don't see it to be quite suitable because of sometimes
they attach stigma to being in a place where otherwise society
would view as for mad people.
BARCLAY:
Indeed, as Rowena said - who wants hospital.
NWOGWUGWU:
Yeah. And then we have like another option of maybe sending them
home and engaging them with our crisis resolution team who visit
them at home. But then sometimes the stresses could be in the
home environment. So with the opportunity of a place like the
Maytree it offers an alternative intervention strategy, which is
not so to speak a hospital based thing. So when we offer them
these options some actually reach for it and naturally they
decide in the end.
BARCLAY:
But it was an untried concept as far as you were
concerned, how did you have the confidence to make that first
referral?
NWOGWUGWU:
Yes it was untried but we - the Maytree sent us their brochure,
we went through it - the concept obviously is quite appealing,
having a place of respite that is not hospital based, that
doesn't have the attached stigma. So it was more or less a trial
thing and obviously the feedbacks were quite encouraging.
BARCLAY:
What is that feedback? Rowena said it's the first time that
anything like this has ever worked for her, is all the feedback
that positive from your patients?
NWOGWUGWU:
Well like some patients we don't hear from them again. Some come
back for some other thing and we realise yes that this person
came once and was very suicidal and they say yes it was quite
useful - a useful experience for them.
BARCLAY:
To what extent do you think something like this is contributing
to the overall fall in the suicide rates that we've been hearing
about today?
NWOGWUGWU:
I can't really make any comments about statistics but I do
believe in general that it would make - it would add to the fall
in the suicide rates, yes I do.
BARCLAY:
So do you think we should be rolling things like this
out around the country?
NWOGWUGWU:
Yes I think so.
BARCLAY:
Dr Nandy Nwogwugwu thank you for joining us. Professor
Louis Appleby is the national director of mental health.
Professor Appleby, to what extent do you think innovations like
this are helping towards the downward trend?
APPLEBY
I think in general they're making a major contribution.
There's some quite important elements of what people need in the
way that the Maytree was described. For example, it provided
prompt availability in a crisis and a lot of people who are
suicidal talk about the need to seek help, the need to get help
straightaway, not to wait for it over a period of days. It was
obviously - it's a service which seems to enjoy good working
between the non-statutory sector and conventional mental health
services, so when that happens you get a service that's based on
what people need, rather than the way that services operate. And
then of course it sounded like it was emphasising self worth and
one of the things that goes wrong for people who become suicidal
is that they start to feel hopeless, so that nothing will ever
change, nothing will get better but also that they themselves
are unworthy and they're worthless people. And if you can
directly affect that pattern of thinking then you have a better
chance of preventing suicides in people in crisis.
BARCLAY
Now we know from today's report that overall the suicide rate in
England is down again, it has fallen to an all time low, and
that fewer young men are killing themselves. In what other
categories are we seeing successes?
APPLEBY
That's right, the general population suicide rate has fallen.
The rate of suicide in young men has fallen. We've highlighted
that because that's been particularly resistant in the past to
the kind of prevention measures that have been employed. In fact
the rate in men overall has come down and the rate in older
women, over a period of years, has come down. The other group is
people who are under mental health care - the number of suicides
by current psychiatric patients has fallen and in particular the
number of deaths on inpatient wards has dropped from about 200
five or six years ago to around 150 per year.
BARCLAY
So to what extent would you say this is a success? I
mean the target is to reduce the suicide rate by 20% by 2010,
and according to Professor Keith Hawton at the Oxford University
Centre for Suicide Research that would mean approximately 1,000
fewer suicides per year, so there's a lot of reduction still to
be done, are we saying we are facing success?
APPLEBY
Well it's - I think the signs are positive. I think we have to
be a little bit cautious because suicide rates do fluctuate and
sometimes it's hard to predict how they're going to change. But
the last few years has seen a consistent year on year fall in
the number of suicides, from a recent peak in around 1998-99 up
until now the reduction has been 500 deaths per year. Now that's
quite a big change in the number. But of course we need to
repeat that between now and 2010 before we can say that we've
reached the original target.
BARCLAY
Are we leading the way, do you think? Yes Europe still has a
higher suicide rate than a lot of the rest of the world -
Eastern Europe particularly. But in Britain we do seem to be -
we do seem to be getting to the nub of this matter - are we
leading the way?
APPLEBY
Well I think we're doing as well as any other country and better
than most. If you look at other countries in Europe there are
several countries in which the suicide rate has fallen in the
last few years. But what's different about this country is that
our starting point was really not all that high in comparison to
other parts of Europe. So we take Denmark, for example, there's
been a big fall in the suicide rate in Denmark but they started
at a very high level, so the scope for reduction was much
greater. In Britain we started off at - what in European terms
was a relatively low suicide rate and yet we've still been able
to bring it down further, so that's more difficult and therefore
I think we should be more - happier about that.
BARCLAY
Professor Louis Appleby, director of mental health,
thank you.
Original
Story
from BBC Radio 4
Transmitted: 21.01.05 - Suicide Strategy © BBC MMV
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