The other side of suicide – An inquest

I missed the call a few weeks ago while I was running an event at work, and found an answerphone message that went something along the lines of ‘it’s the coroner’s office, call us back’. When I called back, no one knew who I was or why I had been called. I had an anxious wait while they asked around the office, and by the time I got through to someone, I was just relieved to know that the cause of the phone call was to ask me to give evidence for an inquest for someone I already knew was dead. My friend had committed suicide almost a year before and I had given a statement at the time, and now I was being asked to be interviewed in the coroner’s court and give further evidence.

Prior to the inquest, it would have been nice to deal with someone with some sense of tact, or with adequate training, who could provide useful information. This didn’t happen. Instead, I dealt with someone who told me the wrong date for the inquest (‘oh that’s funny, I gave you the wrong date!’ Hilarious.) who was unable to email me details of the date, time and location of the inquest. To top it all off, he called to tell me that my friend’s father had informed him he would be travelling to the inquest alone, and did I not think he should be travelling with someone? As it was, I didn’t. I was pretty upset and stressed about the whole thing, and in regular contact with my friend’s dad. If he needed someone to go with him, that was his own decision. I wasn’t even travelling from the same part of the country but this apparently passed the coroner’s office by. I’m sure the man at the coroner’s office thought he was being caring and helpful, but in reality, the emotional blackmail was inappropriate and stressful. We had no idea where to get food or if anything would be provided, or how long it would take. Apparently asking for an events co-ordinator capable of using a calendar, providing useful information, and speaking to the bereaved with tact was out of the question.

Thankfully, on the day they took slightly better care of us. The coroner herself was very kind and approachable and tried to put everyone at their ease. The inquest is never used to apportion blame – the only purpose is to establish who the person was, how they died, when they died and where they died. We heard evidence from the pathologist who conducted the autopsy, the cognitive behavioural therapist, the hospital psychiatrist, the police officer who conducted the investigation, the housemate who found the body, and me, as a character witness.

Leading up to his death, my friend frequently told me that the health’care’ he was receiving was insufficient. That he was routinely dismissed, downgraded from urgent care, talked down to and passed from one doctor to another. That he found the therapy sessions to be distressing and draining and that he would go from one person to another, asked uncomfortable and personal questions about his mental distress and suicidal urges, only to be told he just needed to try harder to engage with the therapies and not to kill himself. He would go back home, try harder, give up, try to kill himself, give himself over to therapy again, get told to try harder, get sent home. Wash, rinse, repeat. There are only so many times that a vulnerable and sick person can go through this process before they begin to believe it isn’t worth trying any more, and stop asking for ‘help’.

I was expecting (hoping) to find some poor psychiatrist that knew he was in need of urgent care, maybe even inpatient care, who just didn’t have the resources to treat him. Other mental health professionals I know have this problem all the time – that someone is sick and clearly needs more care, but that there just aren’t the resources to give it. To some extent we saw this with his therapist, who identified that he was far too complex a case for the level of care she was trained and able to offer, and when he came to her saying that he had planned a method and date to kill himself, and just needed to get hold of the pills, she rang all the alarm bells at the hospital she could to try and get him more appropriate help.

What I did not expect was that this was an utterly pointless dead end. The hospital had three levels of care:

Routine: regular three-month checkups

Urgent: a worsening in condition that merited being seen in the next ten working days

Critical: the patient needs to be seen in the next four hours. The patient will do harm to themselves, or someone else without intervention.

Despite outlining suicide plans to a therapist and trying other methods in between (it presumably took a while to get hold of the pills he needed to die) my friend was never considered critical. We were given no answers as to what he would have had to do to be taken that seriously, to have someone believe that he meant himself serious and immediate harm. The psychiatrist simply stated that he had seemed articulate, intelligent and ‘with it’ and was therefore not a high risk patient. My friend was a well-spoken, intelligent, English graduate. Even on the day he died, none of his closest friends guessed at his intentions. Because those who are mentally ill and unstable are not all raving, gibbering maniacs incapable of stringing a sentence together. I know this – the psychiatrist on the other hand seemed flabbergasted.

All I heard all day was ‘we followed protocol’, or ‘it’s ‘XXXX’s responsibility really’ or ‘it didn’t seem like he was going to do it right away’, even when he told his therapist he expected to be dead within the month. My friend told his therapist he wouldn’t give her all the details of his plans as then someone would try to stop him. So when after a hospital appointment where the psychiatrist sent him home after another ‘try harder at your therapy’ consultation with nothing more constructive than a self help book, my friend discharged himself from care, and they simply wrote up the discharge letter the next day. No one saw the appalling lack of support as an issue. No one saw him telling the therapist that he ‘wouldn’t need anyone’s help anymore’ as a sign for concern. And then a few days later, he was dead.

But apparently, this is fine, because protocol was followed. Apparently this is fine, because he wasn’t a ‘critical’ case. Apparently, unless you are a raving lunatic, frothing at the mouth, you never will be. And nothing more will come of this injustice and that practitioner will just go back to following routine. I have never been more angry. I left the room, and called the man a bastard, a shite, a fuckwit, an uncaring cunt, a shit-for-brains and briefly felt better until I realised that I didn’t have the words to express my contempt for this man or the system he represented.

I don’t think that even with proper care my friend could necessarily be saved. He wanted to die. But I do think he deserved better – a better chance at getting well, more compassion, more dignity. And this inquest, distressing as it was, will do nothing to change the system that failed him so badly. And so I ask for three things from you today.

1.) Take mental health seriously. Attention-seeking isn’t a cause for contempt, it is a crude acknowledgement that help is needed. It is not a cause for shame or blame any more than cancer, diabetes, flu, or any other illness is.

2.) Mental healthcare isn’t always up to standard. If your friend tells you they aren’t getting help, take them seriously. Believe that some therapists are unhelpful and condescending or that care isn’t always available. Help them build a network of support so that they don’t have to rely on whatever the doctor offers.

3.) Talk about it. Change it. Don’t keep this issue hidden. Donate to Mind. Fundraise. Raise awareness. Don’t suffer in silence.

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It’s Movember!

Or the month formerly known as November. If you’ve never heard of Movember before, get educated. Movember is about ‘changing the face of men’s health’ and raising awareness for difficult issues like prostate and testicular cancer.

It’s about raising awareness and education – getting health checks. Talking about embarassing issues. It’s also about using the month of November to grow as hilarious a tache as possible and raise money doing it. The rules state that all Mo Bros must be clean shaven at the beginning of the month, and then work their hardest to get the best moustache at the end of it.

Chris’ branch of Natwest in Cambridge are taking part, and have their own team page even if currently only Chris is registered on it. Nonetheless, go into NatWest on Fitzroy Street in the last week of Movember and you can fully expect to be met with some month old taches and the chance to donate to this great charity. ‘Male’ cancers just do not get enough publicity or charity relief – so mo bros and mo sistas – it’s time to get tache-tastic.

Life after suicide – a thank you post

Ok boys and girls, this is a seriously neglected blog, and I have lots of fun, adventure and food related posts coming up (I promise!) but first there are some thank yous to make. What I would like to do with this post is to say a massive thank you to everyone who supported me in my comedy charity bike ride which I did for Mind after my friend ended his own life. I started with the distant hope of raising £100 for Mind – I called my mum to ask if this was reasonable. We both though it was a little high and then decided we probably knew ten people between us who could be relied upon to donate £10.

I raised £800.

The messages of love and support on the webpage have been of great comfort to me, and many others. I am amazed by the generosity of everyone who has donated – sometimes total strangers, some even from overseas. Even recently, two people that Brunton number 1 and I know have had real issues with depression that we have been unable to talk to them about because it remains unacknowledged and taboo. This is not acceptable – and Mind is just one of many charities that is seeing that changed. I’m proud to have been able to support this amazing charity, and grateful to all the people that have made it possible. I can’t tell you all just how much it has meant to me that so many people thought this was a cause worth donating to.

Moving on

Suicide itself is still incredibly taboo, and many people are surprised at the frankness with which I tell them that my friend took his own life. I personally feel nothing for the stigma or the taboo – I knew my friend, and I know that his life is worth no less to me for the fact that he ended it. However, it has still been a difficult thing to reconcile, although in many ways it gets better over time. The abruptness of the death undoubtedly makes assimilating the loss into my life, reconciling the idea that my friend has gone, very difficult. He has become both more and less to me all at once – I worry continually that I’ll forget silly things, like what his voice sounded like. As much as it surprises me how quickly certain memories have become vague, it is as though other memories I forgot that I had have come out of hiding. Things which never used to make me think of Burgess now often serve as a (sometimes sad) reminder – things like old tape decks and record players, Neon Bible, and in-jokes that no one gets any more. I read our old emails and remember that before the depression took hold there was a rich and varied life there, and that we were awesome together.

‘Are you Twiglet?’

The thing that actually makes me the saddest is the loss of my nickname – only Burgess ever called me it. It was funny (and awkward) when my suicide note was addressed to ‘Twiglet’ with an accompanying note saying ‘someone please call Twiglet’ and my number. Unfortunately no one knew who the hell Twiglet was and I was saved in his phone and address book as ‘Twiglet’. When the police eventually called there was an awkward ‘are you Twiglet?’ conversation that was so funny I wanted to be able to tell Burgess – it was only when I realised I couldn’t that the enormity of what had happened hit me. Now no one gets to call me Twiglet, and it surprises me every time how sad that makes me. I’ve also learned that it is not appropriate to laugh hysterically at being called Twiglet by a police officer. I think I weirded that poor lady out more than a little bit.

I’m sure any of you who were close to Burgess (and even some who weren’t) will relate to the feeling that it never feels like the right time to ‘move on’. I find myself thinking I wish that his death would just stop making me sad, and then feeling terribly disrespectful because it should be a sad-making thing. I’m reliably assured this is all part of the process. The sense of loss doesn’t really go away – you just get used to the weight of it on your shoulders, get used to the feeling that he is actually gone. Burgess used to refer to suicide as ‘leaving’ or ‘catching the bus’ and it never really felt like a permanent thing, almost as though you could just be dead for a while until you got better, like some kind of extreme rehab. Having spent months talking about suicide this way, I had almost become desensitised to what suicide would actually mean, and the permanence of what he had done to himself came as an awful shock. It makes it hard to accept that until we meet again in the great Western Bank library in the sky, this is it. I’m gradually getting used to the idea of life without my pal – it’s a slow process, but I’m getting there. I wish all the best for anyone reading this who is going through the same.

Continuing support

No one deserves to live a life so troubled that they feel as though they need to take their own life, and no one deserves to lose a friend that way – just as no one deserves to die of cancer, or AIDs. That’s why I’ll probably continue to make regular donations to Mind.

My page is open to one-off donations until the end of the month, so anyone who thinks that cycling over 25k in the rain dressed as princess Leia with accompanying R2D2 merits sponsorship there’s still time to rock up and sponsor me.

http://www.justgiving.com/Amanda-Brunton

There’s also a main ‘In Memory’ page where people can continue to do ‘In Memory’ sponsorship events and read all the lovely comments people have posted, or donate directly to Mind.

http://www.justgiving.com/remember/20094/Alex-Burgess

So thanks to all the generous people who made this all possible (you’re all awesome!) and thanks to all the people who’ve been instrumental in helping me through this difficult time (you all get a pat on the back).

Burgess would be super embarrassed by all this fuss, but doesn’t get to do anything about it, so here’s a chirpy mugshot of us both 🙂 We made an awesome pair!

On depression, suicide, and Star Wars fancy dress

For those of you who know me, then I am sure this post is only going to describe an event I am sure you are all aware of. However, the blog is increasingly getting views from outside of  my immediate friends and family, and so I shall start at the beginning.

8 weeks ago one of my closest friends took the decision to end his own life.

I have not been totally truthful here – this is not the beginning of the story. However, poor mental health is such a taboo subject that it is often only from this point that friends or family become aware that one of their loved ones is suffering from a potentially life-threatening illness. The days of ‘The Big C’ are long since over; cancer is no longer a taboo subject which simply cannot be mentioned in polite conversation, and has to be hidden away by the sufferer. Yes, it’s frightening. Yes, it can feel defeatist, or like weakness to admit to those around you that you suffer with an illness that you cannot hope to fight without extensive treatment, and that you are afraid of the outcome. However, sufferers of this (often long-term) illness are quite rightly treated now with the respect and sympathy they deserve, rather than fear and shame.

My hope is that one day, depression and mental illness can be given the same respect. It is an illness which is not, on the whole, the fault of the sufferer. Nonetheless, the stigma associated with it dictates that the sufferer is often treated as though they can just ‘cheer up’, as though there is some blame to be apportioned to them for their suffering, or that treatment is an unnecessary luxury. Attention seeking somehow. Consider for a moment how it must feel to be afraid to die of cancer – an illness that you as an individual are powerless to stop. Now consider what that fear of death represents when you are afraid you may simply do it to yourself, and feel equally powerless. You expect nobody to take your fears seriously, and moreover, in order to receive treatment you have to beg, explaining over and over what you fear you may do to yourself. For many, this is a terrifying reality from which suicide provides the ultimate relief.

So what really happened?

The more truthful account of my friend’s life and death is this: he was a wonderful, talented, intelligent young man. Despite mental and physical illness of a severity that would have rendered a less robust person incapacitated, he achieved an outstanding 2:1 in English literature from a top university. He was a dedicated friend, a maverick, a lover of gin and a thoroughly entertaining person to be around. He had terrible taste in music, clothes and wine. He was high maintenance. He needed continuous emotional support to continue to live life as normal. He didn’t like to ‘be a burden’ to those around him, and although he was often hard work, he was an equally generous friend in return.

The last eight months saw an accelerated worsening of the depression, anxiety, and physical illness from which he had suffered for many years. His ability to go about day-to-day life was eroded a little bit at a time. Occupational health forms require that you declare mental health problems – they also ensure that you are almost unemployable. Mental health’care’ on the NHS is a total lottery depending on funding. In my friend’s case, he was sent home from hospital with a self help book when his therapist said that his suicical feelings had become out of control. Two weeks later he was found dead.

The mother of a close friend of mine is a mental health nurse, who describes a mental healthcare system almost entirely propped up by charities. These charities are having their funding systematically cut back, yet no state-sponsored health service has taken their place. Hopefully no one reading this blog will ever have to experience what my friend suffered – the humiliation of begging for help, while suffering with one of the cruellest illnesses of them all. However, the sad fact is that one in four of us will suffer from poor mental health. Even if you don’t experience it yourself, odds on someone you know will.

Why am I telling you all this you may ask.

Because something needs to be done. The hardest part about all this is that my friend isn’t coming back. We couldn’t save him. All we can hope to believe is that he is now experiencing in death the peace that he desperately wanted in life. This doesn’t solve the fact that for many out there, they are still living out the reality of mental illness without adequate support, feeling unable to express to those around them the suffering they are experiencing.

In just over a week I will be cycling 20k on my 35 year old, beaten up Raleigh shopper. I’m doing it dressed as princess Leia (I decided to auction off the right to pick my fancy dress…) and I have made a home made R2D2 to put on the back of the bike for running repairs. Mental illness isn’t always depressing. My friend would be laughing himself silly if he knew I was doing this now! I’m doing it for the charity Mind, as it helped support my friend and I through the worst of times. The most important thing they do is make mental illness talked about, and make help accessible. If you want to donate, hop on over here:

http://www.justgiving.com/Amanda-Brunton

Your support will be very much appreciated, but more importantly it’s the attitude that’s got to change. People have got to start seeing this as a real and treatable illness. People have got to stop believing that it is the fault of the sufferer. And above all, we have to start prioritising mental healthcare rather than letting vulnerable individuals fall by the wayside.

Rant over – normal cheery, food-related service will return with the next post 🙂