Intended for healthcare professionals

Editorials

Suicide prevention in England

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5102 (Published 13 August 2019) Cite this as: BMJ 2019;366:l5102

Re: Suicide prevention in England - what is missing here?

During the course of the last 8 years I have met and worked with many people who were deeply suicidal. Some of these people have now, tragically, ended their own lives..
This has led me to explore extensively what is going on especially in the lead-up to suicides.

I have been very concerned to discover that, for many of these people, the compulsions to end their lives are actually driven by cumulative and/or adverse effects of antidepressants and other medications. The most worrying aspect of all is that the medical profession has been extremely reluctant to engage constructively to recognise - and do something about - the very real risks that we are flagging up (1).

"For those who have had acute adverse reactions, some have been left with severe nervous system damage after just brief exposure to the drug. For others, many years may have elapsed before long-term problems made it necessary to try to ‘come off’ the drug(s) – and attempted withdrawal has been catastrophic. Several cases of life-threatening serotonin syndrome have been missed by doctors and the symptoms further poly-drugged. The accounts describe shattered lives, relentless desperation and deep enduring suicidality, suicide attempts and actual suicides."

The reference 10 in this Editorial article is particularly interesting - revealing beyond any doubt the position that GPs are being placed in, apparently having no idea of the real effects of the 'antidepressant' drugs that they are prescribing, per guidelines, supposedly to 'save lives' (2).

"Although primary care is crucial for suicide prevention, clinicians tend to report completed suicides as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from perspectives of bereaved family members and GPs".

We have discovered a very troubling widespread issue that none of the suicide prevention charities and initiatives will even engage in discussion around the issue of effects of prescribed medications needing addressed. Recent twitter exchanges with leading figures in UK National Suicide Prevention initiatives have confirmed that there seems to be a complete ‘block’ on any discussion of these issues. This makes a mockery of ‘suicide prevention’.

Steps could be taken right away to ensure that yet more people are not put at risk. I am co-author of this ‘Voice of the Patient’ systemic review paper which offers some practical suggestions (3).

(1) Brown M, French F, Duthie A, Thorpe B: Is the BMJ – and the medical profession it represents – really listening to patients? BMJ Rapid Response April 2018 https://www.bmj.com/content/360/bmj.k1408/rr-0
(2) Leavey G, Mallon S, Rondon-Sulbaran J, Galway K, Rosato M, Hughes L. The failure of suicide prevention in primary care: family and GP perspectives - a qualitative study. BMC Psychiatry2017;17:369. doi:10.1186/s12888-017-1508-7. pmid:29157221
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1508-7
(3) Guy A, Brown M, Lewis S. The Patient Voice: An analysis of personal accounts of prescribed drug dependence and withdrawal submitted to Public Petitions in Scotland and Wales. APPG-PDD October 2018
http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patien...

Competing interests: No competing interests

19 August 2019
Marion Brown
Psychotherapist and Mediator (retired)
none
Helensburgh