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Seeing how the NHS handles attempted child suicide scares me Seeing how the NHS handles attempted child suicide scares me
(5 months later)
Sometimes when I look into a child’s eyes I see anxiety as they decide to tell me they want to kill themselves. They might be worried at my possible reaction; will I show disapproval, be upset? Instead, I feel a deep sadness; how can somebody so young have reached the point in their lives when they think this is the only option left?Sometimes when I look into a child’s eyes I see anxiety as they decide to tell me they want to kill themselves. They might be worried at my possible reaction; will I show disapproval, be upset? Instead, I feel a deep sadness; how can somebody so young have reached the point in their lives when they think this is the only option left?
I am an outreach child and adolescent mental health nurse in the north of England. I act as the first response following a suicide attempt in a young person. I carry out a risk assessment, arrange follow up support, then decide if a young person is safe to go home, or needs a place of safety.I am an outreach child and adolescent mental health nurse in the north of England. I act as the first response following a suicide attempt in a young person. I carry out a risk assessment, arrange follow up support, then decide if a young person is safe to go home, or needs a place of safety.
Ninety-eight children under 15 killed themselves in the UK from 2005 to 2014, according to figures from the Office of National Statistics. These figures don’t include the number of children who have attempted suicide or who have suicidal thoughts. According to a 2013 report from the mental health charity MindFull, based on a YouGov survey of more than 2,000 young adults, one in five children has symptoms of depression and nearly a third (32%) have thought about suicide before the age of 16.Ninety-eight children under 15 killed themselves in the UK from 2005 to 2014, according to figures from the Office of National Statistics. These figures don’t include the number of children who have attempted suicide or who have suicidal thoughts. According to a 2013 report from the mental health charity MindFull, based on a YouGov survey of more than 2,000 young adults, one in five children has symptoms of depression and nearly a third (32%) have thought about suicide before the age of 16.
As part of my job, I manage the strong emotions among parents, while they are waiting in A&E, not knowing if their child is going to live or die. I remember a child who took an overdose after breaking up with their first love. The child woke up at home, realised they were still alive so took another overdose. I could not tell the parents if their child was going to live. They were in shock.As part of my job, I manage the strong emotions among parents, while they are waiting in A&E, not knowing if their child is going to live or die. I remember a child who took an overdose after breaking up with their first love. The child woke up at home, realised they were still alive so took another overdose. I could not tell the parents if their child was going to live. They were in shock.
Some parents blame themselves; “Was I a bad parent?”, others might blame the school, bullying and so on. Some parents tell me that they are going to punish their child for the upset they have caused; some flatly refuse to take their child home. I have had to politely point out that this is a criminal offence; you can’t wilfully abandon a child. At times like these, I’m forced to swallow my sense of disbelief and outrage.Some parents blame themselves; “Was I a bad parent?”, others might blame the school, bullying and so on. Some parents tell me that they are going to punish their child for the upset they have caused; some flatly refuse to take their child home. I have had to politely point out that this is a criminal offence; you can’t wilfully abandon a child. At times like these, I’m forced to swallow my sense of disbelief and outrage.
It gets hard when I have to find a place of safety for the child. They may have symptoms of a severe mental illness, or the risk of further attempts is very high. Some young people have told me they were angry that their attempt did not work, and will try again. This time, they inform me, using a more violent method. I have seen some children who try many times to complete suicide, or at least act it out, which is obviously still very risky. At this point I might try and get them a bed on a mental health unit.It gets hard when I have to find a place of safety for the child. They may have symptoms of a severe mental illness, or the risk of further attempts is very high. Some young people have told me they were angry that their attempt did not work, and will try again. This time, they inform me, using a more violent method. I have seen some children who try many times to complete suicide, or at least act it out, which is obviously still very risky. At this point I might try and get them a bed on a mental health unit.
The biggest problem for me is the attitude of other medical staff. Once, when I was trying to implement a safety plan in a busy emergency department – calling social services, child psychiatrists – a senior A&E doctor overheard what I was saying. He berated me for listening to a child who had said that wanted to kill themselves, telling me that it is up to the person what they do, so why was I trying to help. He was not even involved in the case. I wondered if he had forgotten that this was a 12-year-old child. The fact that they were saying such things, even for effect, as he suggested, still merited action. If this is the only way a child can get attention, then there must be something wrong.The biggest problem for me is the attitude of other medical staff. Once, when I was trying to implement a safety plan in a busy emergency department – calling social services, child psychiatrists – a senior A&E doctor overheard what I was saying. He berated me for listening to a child who had said that wanted to kill themselves, telling me that it is up to the person what they do, so why was I trying to help. He was not even involved in the case. I wondered if he had forgotten that this was a 12-year-old child. The fact that they were saying such things, even for effect, as he suggested, still merited action. If this is the only way a child can get attention, then there must be something wrong.
When I call A&E to see if there is anyone for me to see, I sometimes get the response; “No thank you, we have no naughty children today”. I remember a nurse telling me very loudly for the whole ward to hear: “Hurry up and get that teenager out of here, they are taking up a bed”. This particular teenager had been repeatedly raped by her mother’s boyfriend and the resulting court case was the next day. They could not face being re-traumatised so had decided that death was the better option.When I call A&E to see if there is anyone for me to see, I sometimes get the response; “No thank you, we have no naughty children today”. I remember a nurse telling me very loudly for the whole ward to hear: “Hurry up and get that teenager out of here, they are taking up a bed”. This particular teenager had been repeatedly raped by her mother’s boyfriend and the resulting court case was the next day. They could not face being re-traumatised so had decided that death was the better option.
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It is the system, however, that causes me the greatest stress. The lack of adolescent mental health beds across the country has been well publicised. I remember one time, a few years ago, I was working with a young person who had presented at A&E with a long history of suicidal thinking, a terrible family history and clinical depression. I called the child psychiatrist who agreed that they were at very high risk. I spent more than a week trying to find a bed, anywhere, in England for them. They spent a few days in a cubicle in A&E, then on surgical wards and other places; each night they had a different bed. I remember NHS England suggesting that there were no beds anywhere in England at one time. The NHS had just run out of places. Does the public know just how close to the edge the health service is?It is the system, however, that causes me the greatest stress. The lack of adolescent mental health beds across the country has been well publicised. I remember one time, a few years ago, I was working with a young person who had presented at A&E with a long history of suicidal thinking, a terrible family history and clinical depression. I called the child psychiatrist who agreed that they were at very high risk. I spent more than a week trying to find a bed, anywhere, in England for them. They spent a few days in a cubicle in A&E, then on surgical wards and other places; each night they had a different bed. I remember NHS England suggesting that there were no beds anywhere in England at one time. The NHS had just run out of places. Does the public know just how close to the edge the health service is?
• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
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