By Richard Chidwick, posted on 14th November 2013
Aside from doing some freelance writing I also volunteer for the Oxfordshire Mind Information Service. One of the key things we learned about in the training I have just completed for the service is how to deal with a ‘crisis call’. And given the info line, (part of the Mind mental health charity), is for people to find out about mental health issues, (often their own) the caller could easily be mentally ill. On the other side of the phone I have to be ready for any type of call, from the basic call asking for a number for a mental health service to someone ready to harm themselves or even take their own life.
While harming yourself to the point of ending your own life is not an easy thing for any person to do, it does happen, and if we look at the statistics, in the UK, the highest suicide rate per 100,000 for males, females and for all persons was in Scotland. Male suicide rates are on average 3-5 times higher than female rates and men aged 30-44 are the group with the highest rate. On the info line we might get one suicidal call per year, but one call is still too much to bear thinking about. But it still could happen!
On the phone in a situation where someone is in crisis and ready to harm themselves, it is a very hard thing to deal with. But for all those people who work in a crisis centre, like the one shown in the second episode of Channel 4′s Bedlam last week on Thursday, from psychiatric nurses and to psychiatrists to Like Dr Martin Baggaley, you realise how hard it is to actually keep someone in a secure unit against their will, when a patient is suffering from mental illness.
And it struck me with Dominic’s case, shown in this programme that a mild mannered man in his 40’s who had a history of self harm, and potentially suicidal behaviour, that someone in this state needs to be kept in confinement for their own wellbeing. But, at what stage do you put someone in confinement, possibly even section them to prevent them from harming themselves? And this is why I asked Dr Baggaley to help me with some expert advice that could be used for anyone reading this piece who has thought of harming themselves, like Dominic did when he took his son to university. In the programme, we discover only hours later after taking his son to university, we discover Dominic had taken an overdose of pills and consumed alcohol in an attempt to take his own life.
Before I delve further into the subject of self harm I would like to introduce you to Dr Martin Baggaley. As well as being a consultant psychiatrist in the Psychosexual and Relationship service, Dr Martin Baggaley is also the Executive Medical Director at the South London and Maudsley NHS Foundation Trust (SLaM).
Martin was first drawn to work in the mental health sector as a medical student, where his charismatic consultant inspired him to such a degree he felt the need to move into his profession. He also found the patients he worked with ‘fascinating,’ and wanted to understand them more and “help where he could,” he says.
Dr Baggaley also explains: “It is often said that 10% of patients with schizophrenia and 15% of patients with manic depression go on to commit suicide in their life time. However at any individual point in time the chance of them killing themselves is low so it is hard to predict.” With Dominic’s story, one realises how much of an effect his down spiralling mental health had on his family before he recovered. Even at the point of recovery, when Dominic was allowed to go free from the unit, as he was diagnosed with a personality disorder, rather than a mental health problem. His daughter talks of his father “not acting weirdly,’ and his wife being emotionally and physically ‘exhausted,’ as she says, following the families’ ordeal with Dominic’s mental state.
To our relief Dominic’s story ends in a positive note in the programme. He is still alive, avoiding self harm and seeking help through other services, perhaps Complex Needs, an organisation set up to deal with people with personality disorders or as Dr Baggaley points out: “A community mental health team would support him and refer him for specialised psychotherapy.”
Just to make things clearer for our readers a personality according to the American Psychiatric Association is: “A class of social disorders characterised by enduring maladaptive patterns of behaviour, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual’s culture. These patterns develop early, are inflexible and are associated with significant distress or disability.” While it should be noted this definition can be varied, here is at least some clarification. According to the International Encyclopaedia of Social and Behavioural Sciences says: “Personality, defined psychologically, is the set of enduring behavioural and mental traits that distinguish human beings.” This is why personality disorders are defined by experiences and behaviours that differ from societal norms and expectations. It is worth bearing in mind that one could have a personality disorder and suffer from mental illness, and the two states of mind can coincide.
In Dominic’s case, as mentioned he was judged to suffer from a personality disorder, and Dr Baggaley points out: “It can increase the risk [of suicide] because of the impulsivity associated with the disorder.”
To offer a little more information on how suicidal cases can be dealt with Dr Baggaley elucidates the situation for us: “First treat the underlying cause (e.g. depression or schizophrenia).”
For anyone having thoughts of self harm or suicidal thoughts, their condition can be treated by reducing the: “available means (e.g. remove firearms, not prescribing large amount of lethal drugs, removing ligature points for hanging etc). Encourage the patient to discuss their thinking with you and to jointly acknowledge the risk without over reacting,” says Dr Baggaley.
While we understand that suicide and self harm, like Dominic’s story are quite rare, rare is rare enough. It is not a subject to be swept under the carpet, and maybe Dominic’s story can send out a message to others in desperate situations. Suicide and self harm needs more coverage, and following this successful depiction by the SLaM team, there should be more coverage in the media of suicide so others won’t be tempted.
Thanks for reading the piece. If you know someone or are someone who has considered self harm, the Samaritans help line and website are always available. Telephone: 08457 909090 or Email: email@example.com