Amid the debate about the lack of care received by patients suffering from mental ill health, the impact this lack of care has on the “carers” must be considered (Report, 6 March).
My husband recently killed himself after six years of suffering from severe depression. Four years previously he had made a very serious suicide attempt. Despite this, he was returned home from hospital the very next day as “he was not suicidal”. After 14 nightmare days he began to claw himself and was eventually admitted to a psychiatric ward. After three months on the ward, during which he had made a further suicide attempt and tried to escape on two occasions, he was discharged, still highly suicidal.
Suddenly I was deemed to be his carer. I was not asked if I was happy to take on this role or if I was even capable of caring for him. I was given a leaflet on how to apply for benefits and “rewarded” with 10 yoga classes. I pointed out to a community mental health nurse that they were expecting me to care for a man who had twice attempted to abandon me and part of me hated. Living with a man seriously intent on suicide is mental torture.
Now, due to the stress of trying to keep him alive for years, the shock of his suicide and the weight of my grief I am left with acute trauma. I have effectively stopped functioning, my adult son is now forced to be my carer.
Two weeks ago I presented the health trust with a 24-page complaint. This comprised of the emails I had sent them over a two-year period expressing my concerns about his treatment. After two years I was too worn down to continue the fight. One of my last emails read simply “I am now completely unable to cope with [my husband]”. This must stop.
• While 271 deaths after NHS failures is an appalling statistic, we need to apply careful thought to what an appropriate response might be. One has to consider the impact of the “zero suicide” policy and its “every suicide is preventable” mantra.
Those with mental health problems are already at risk of having their liberty taken from them when they are deemed in dire need of assessment and treatment. In 1999 research by Aaron Beck et al showed how very few people deemed to be at high risk of suicide go on to do so. They estimated that even in a group with 100 times higher risk of suicide than the average person in the street, you would need to detain and observe 500 people for one year to save one life. This is not to say that this isn’t worth doing, but that there needs to be clarity around the implications of saving a life.
Those with mental health problems (one in four of us) often find that their voice does not get heard once they have entered services. I wonder how this will be helped if the interventions of staff are aimed not towards achieving the best outcomes for their patient, but ensuring that clinicians cannot be blamed if tragedy occurs.
Your investigation on preventable deaths linked to mental health services, including those for children and young people, is powerful evidence of the systemic failures that frontline staff such as child psychotherapists have been trying to raise awareness of for several years. As well as being dreadful individual and family tragedies, the avoidable deaths of the young people you report demonstrate a continuing lack of specialist care that the government and local commissioners are failing to address. Evidence from Young Minds and the Royal College of Psychiatrists is that funding is not reaching the front line, and that many areas struggle to provide comprehensive services meeting the full range of needs, especially for children and young people with severe and complex conditions. According to a recent survey of therapists and counsellors in the NHS, 84% say that, over the last five years, young people have needed to have increasingly high levels of illness in order to access services. Your investigation shows that, even then, many are not receiving adequate care or effective treatment. Unless new money is ringfenced for specialist NHS services and training we will continue to fail the most vulnerable in our society in ways that are truly shocking.
Dr Nick Waggett
Chief executive, Association of Child Psychotherapists (ACP)
• In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org