I run a Suicide Crisis Centre and feel huge sadness that I sometimes encounter clinicians who express their view that a particular patient’s suicide is inevitable. This happened again only last week while we were discussing the findings of our research project into deaths by suicide in our region. A clinician who knew “Elsa”, one of the young women who died, said he had felt it was only a matter of time before she ended her life.
I have lived experience of suicidal crises and set up our services because I felt there was a need for a different kind of help for some people in crisis. We see clients who, like me, have had difficulty engaging with mental health services or have not responded well to the treatments offered or methods which were used. Sometimes clients express surprise to us: “You don’t seem to have given up on me”. We never will. They had experienced clinicians who had.
If a person appears not to be improving or responding well under mental health services, then I would assume that a change of approach or even a change of service may be indicated. I do not believe we should ever reach the stage where we say: “We have tried everything – there is nothing more to offer”. I have heard clinicians say of some of our clients: “The person is attempting suicide so frequently/self-harming so severely that it is becoming inevitable that they will die”.
Clinicians had little hope of my ability to survive back in 2012. A GP told me that she and her colleagues believed that I probably would kill myself. I had made two suicide attempts which required hospitalisation and could see no reason to live. They could identify few protective factors which would prevent me from ending my life. I had also not found mental health services helpful. My psychiatric records indicate that my long-term risk of suicide was recorded as “high”. The notes of a meeting of mental health clinicians showed that they felt they had nothing more to offer me.
They had not found a way to help me, and therefore I was categorised as a patient “who could not be helped”.
I changed GP surgeries and asked to be referred to an NHS Trust in a different part of the country. Psychiatrists assessed me and concluded that I had bipolar disorder. Although this came as a shock initially, it …