Author: LisaSaysThis

Loves people and Brighton and Hove Albion FC. Find me on Twitter @LisaSaysThis

Zero suicide and the absence of blogs

Sarah Hughes, Alys Cole-King and me

On Friday 29th September, I approached Towards Zero Suicide, a Healthcare Conference UK event, with trepidation. As a conference chair, you need to be on top of your game – or least appear to be. And I hadn’t been at my best for the past month or so (hence the absence of blogs). No trigger this time, just lower than usual confidence and mood, disturbed sleep, horrid dreams and heightened anxiety. Despite all the good advice I write about here, my tendency is still to plough on through this stuff until it goes away of its own accord or bubbles up into something worse.

But this time I confided in a friend, who had already guessed I wasn’t OK. This led to me ‘fessing up to those closest to me and my GP, and then doing what was necessary to gradually get back on track. And I’m getting there. I cancelled a few things but this conference seemed too important, and anyway, I am the sort of person who needs the buzz that comes from intellectual stimulation and being in the spotlight.

There was another reason for feeling nervous. As someone who has experienced suicidal thoughts and feelings from time to time, and as a Samaritan (see my last blog), I have to admit to feeling conflicted about such an aim. I worry it could send a negative signal to those experiencing such feelings or who have lost someone to suicide.

But also I dedicate a considerable amount of my time these days trying to prevent suicide. This is why I had agreed to chair the conference, and why I thought carefully about how make the event respectful and supportive to all concerned, while also challenging the stigma and shame still associated with suicide.

En route, I did my own, unscientific, Twitter poll. Thank you if you participated. All I take from this is that I’m not the only one who started my day with mixed feelings about a laudable aim.

This was the conference programme.

And this is what I took away:

  • Some of us are more vulnerable than others to thoughts of suicide. But with enough stress and pressure, almost anyone will think about it.
  • Whether you have, as Sarah Hughes of the Centre for Mental Health described, made your peace with the term Zero Suicide, we can all embrace the hope behind the message. Because as Keith Waters of Derbyshire Health Care and the National Suicide Prevention Alliance reminded us, suicide is not inevitable.
  • The long history of suicide in our society helps us to understand the shame still associated with it. And we still need to tackle that shame, because ultimately it can kill.
  • There are no simple solutions to suicide prevention. It has to be locally relevant, dynamic and evolving. And it must involve everyone, from individuals to organisations, public and private. Those who traditionally resist engagement with suicide prevention strategies, such as coroners and the media, must be persuaded that they have a part to play.
  • While there are links to mental illness, most deaths by suicide are of people not in touch with mental health services. And yet suicide prevention is often seen as the sole responsibility of those working in mental health.
  • As Pippa Smith of British Transport Police said with such kindness and eloquence, a death by suicide is like no other. It touches not just those directly affected. And it can cause lasting damage.
  • Removing the means to carry out a suicide can save lives. But at the same time, if applied without sensitivity, it can also remove a person’s dignity, which may be the only thing they have left.
  • Mental health first aid is as effective as physical first aid. So why is in not mandatory in workplaces, universities, schools, hospitals, public spaces and across society? Including in mental health services, where staff sometimes lack the basic knowledge and skills to be effective in helping a suicidal person.
  • Too much emphasis is placed on risk assessment. As Alys Cole-King so brilliantly put it, you cannot accurately predict risk. It differs from person to person and changes moment by moment. Instead, clinicians need the latest evidence so they can assess the person rather than the risk, and provide treatment and care accordingly.
  • I loved Alys’ idea that when someone is suicidal, emergency services would ring ahead, as they do for major physical trauma cases. But instead of asking for the resuscitation room to be made ready, they would say “Please get the compassion room ready.”
  • NHS crisis services are being reduced to save money, causing damage to clients and staff. Why is this not a national outrage?
  • Third sector organisations such as  Suicide Crisis, run by Jo Hibbens who spoke eloquently about the people they support and the lives they save, can be wonderful. But they need the safety net and professional support of statutory services. They are not a cheap alternative.
  • Suicide prevention apps as we heard from Iain Murray, Choose Life Co-ordinator in Aberdeenshire, can really help to save lives. I loved how he has marshalled such wide community support for this work. Here is a link to the Scottish app and also the Grassroots Suicide Prevention Stay Alive app which I have mentioned before.
  • It was good to be reminded of the physical and psychological determinants and consequences of mental crisis, and how we can all help ourselves and one another. Thank you Luke Sullivan – great job.
  • Mental health staff are experiencing increased stress at work, according to investigative work done by Radio 5 Live. Here’s me talking to Rachel Burden about why we cannot expect them to give compassionate care if they are not treated with compassion themselves (at 2:39:50). It seems so obvious, and yet…

Thank you to everyone who attended and participated so wisely and generously. I think you are all amazing.

PS I posted this blog on Sunday 1st October and in 24 hours have had many extremely kind messages. Yes, I really am ok. And thank you very much for asking xxx

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So what do you do these days?

Me and my friend Sally at the end of Ride 100 in 2016. Still laughing despite the pain.

People sometimes ask what I do these days. Here is a snapshot.

Today, I will be one of 12 Samaritan volunteers from the Brighton, Hove and District branch at TransPride.  This is a community event for people from the trans community to come together and be themselves in a safe, supportive space. Samaritans know it can be an alienating and difficult experience for some people just to be who they are. We are there to listen, but also to talk about what we do, in case anyone is interested in volunteering with us. I am really looking forward to it.

On Monday, 24th July 2017, Samaritans will be at railway stations across the country encouraging people to listen to one another and to know they are not alone. Volunteers from our branch will be on Brighton, Hove and Haywards Heath Stations from 7 – 9 in the morning and 5 – 7 in the evening, handing out leaflets, talking to commuters but most of all, listening. This national series of events is part of the ongoing partnership between Samaritans and the rail industry. Next time you travel by train, if you turn over your ticket you might see one of our messages. Please also look out for our posters on every station. As they say, we are in your corner.

On 6th August, we will be on the road again, this time at Brighton Pride, a massive event celebrating all things LGBT. We will have a well-staffed stall to publicise what we do. And because we also know that supposedly joyous occasions can be unbearable for those who are feeling lonely or desperate, we will be there as well for those who need us.

And I am back on my bike on Sunday 30th July 2017 raising money for Samaritans. You can read more about it here, including how to donate. No pressure, though – we all do what we can. 

I first learned about Samaritans aged 11 via an article in Readers Digest. I then read Monica Dickens’ novel The Listeners, based on her experiences of being a Samaritan volunteer in London soon after the charity started 64 years ago. Later, I read the collected short stories Is there Anyone There? edited by Monica Dickens and Rosemary Sutcliffe. And I called Samaritans once or twice, from a red telephone box like the one on the cover.

In my early twenties, I trained to be a Samaritan myself, and volunteered for a couple of years. I loved it. But I was economical with the truth about my own issues. While going through a particularly bad patch, I found I didn’t have enough to give. I should have told a senor Samaritan and taken time out. But instead I just left. I have felt bad about this ever since.

I think I always knew I would go back. But not that it would take quite so long. As I pedalled for 8 hours through Ride London 100 in 2015, raising money for Samaritans, I knew that the time had come. In January 2016, I booked myself into an information event at my local branch. And with support from amazing trainers and fellow trainees, I completed initial training, mentoring and probation and became a listening volunteer again.

What has changed in 38 years? More importantly, what remains?

New technology, of course. Emails and text calls, booking shifts and online recording. But still nothing beats listening to someone by phone or face-to-face. Nor being supported by a fellow Samaritan who somehow notices you’re having a tough call and offers you time to reflect. The equality between volunteers, new and experienced, lies at the heart of what we do. I’m so glad that hasn’t changed.

We had policies back in the day, but not like now. Over-reliance on them can have unintended consequences, stealing time, making people over-cautious and discouraging independent thinking. The policies we are asked to follow are designed to maintain high standards and keep everyone safe. And if they need to be changed, it is up to us to say why and how.

Training is more thorough nowadays – in 1978 selection and training happened over a weekend. But the focus on being there for distressed people hasn’t changed at all.

Once more, I find I get more than I give by being a Samaritan. I love the stillness and focus of the Ops Room. I am inspired by the courage of our callers and the humanity of my fellow Sams.  It is lovely to be back.

It is true that not everyone has the capacity to be a Samaritan. You have to be able to set aside judgement and the humility to learn how to listen really carefully. But I truly believe that many more people could do it than probably realise. All it really takes is genuine love for other humans.

If you are interested in volunteering with us, either as a listener or a support volunteer, please take a look at this. We would be so pleased to hear from you.

 

 

Watching my privilege

Trustees of the Mary Seacole Trust (from left) Jean Gray, Lisa Rodrigues (vice chair), Karen Bonner, Dawn Hill (President), Trevor Sterling (chair), Roxanne St. Clair (treasurer), Jermaine Sterling, Ros Trennick, Steve Marsh (secretary), Raf Alam.

In 1973, aged 18, I joined the NHS. My first job was at a learning disability hospital. It was a backwater for patients. And also for staff, 50% of whom were Black, Asian or other ethnic minority (BAME) backgrounds. Since its inception, the NHS has recruited internationally in order to meet staff shortages in less popular parts of the service. That hospital relied on nurses from Ghana, Nigeria, the Philippines, Mauritius,  Sri Lanka and the West Indies to look after some of the most vulnerable people I have ever met.

Three months later, I left my new BAME friends to start nurse training at the prestigious Hospital for Sick Children, Great Ormond Street (GOS). Here, things were different. Of the 150 student nurses who started in 1973, 150 were female, almost all were middle-class, and every single one was white.

There were of course BAME staff at GOS. They worked in the kitchens and cleaned the wards. They served us in the canteen. There were a handful of black and Asian nursing assistants, and the occasional agency nurse. And there were BAME pupil nurses, doing a shorter, less academic course than ours, who would eventually become State Enrolled Nurses, a second-class role which precluded them from promotion to becoming a staff nurse or sister. I cannot recall a single black ward sister. 

This is not a criticism of my alma mater, by the way. Things were the same across all the London teaching hospitals. 

41 years later, we discovered that not much had changed. In March 2014, the year I retired from the NHS, Roger Kline published his excoriating Snowy White Peaks report. We learned that whilst 70% of the NHS workforce was female, and 20% BAME (30% BAME amongst nurses, and 40% BAME amongst doctors), the top of the NHS was almost totally white and predominantly male. 

This stinks. It is institutional sexism amd racism. I have written about it before, and how Mary Seacole can help us challenge such shocking stigma and discrimination. 

On Thursday 29 June 2017, 1 year minus a day since Mary’s beautiful statue was unveiled outside St Thomas’ Hospital, we launched the Mary Seacole Trust at the Black Cultural Archives in Brixton. Our aim is to use Mary’s legacy – compassion, creativity, dynamism, entrepreneurship and most of all, never giving up – to inspire people of all ages to achieve their best in whatever walk of life they choose. You can read about our first two programmes and a bit more about us on our new website. Plus a lovely 5 minute film made by one of our trustees, Jermaine Sterling. Do take a look – it’s great!

But when I was asked by our chair, Trevor Sterling (who left school at 16, yet is now a renowned lawyer and partner in a prestigious law firm plus one of the funniest, nicest and most effective people I have ever met) if I would be the new charity’s vice chair, I had to think hard. I felt the need to challenge myself about whether such an honour was deserved. I have had my share of difficult experiences, but I have not experienced racism. White people like me have to take care to avoid cultural misappropriation. We have to watch our privilege.

So I talked to my BAME friends, including some of the other trustees. And they said this. They reminded me that we are all part of the human race, brothers and sisters under the skin. And they welcomed my support because making sure everyone achieves their best is not just their fight. It is our fight. 

So I said yes. I promise them and all of you to use my talents, such as they are, plus my experience and connections to help inspire people of all ages to achieve their best, based on merit, passion and hard work. Not what school they went to, who their parents are or the colour of their skin. 

Just like Mary Seacole. Mary had to fight many fights. She never gave up. And nor shall we.

To sign up as a member of the Mary Seacole Trust, or just to learn more about us, click here. 

Thank you. 

 

​Girls like Theresa 

Our Prime Minister reminds me of one or two girls I went to school with. Not the ones who were friends with me, I hasten to add. Girls like Theresa had a small coterie who made no secret of their opinion that girls like me were idiots. In my case this was probably true. But not so of everyone on whom they looked down their elegant noses.

Girls like Theresa almost always came top. They were clever. They also worked harder than anyone else. They took copious notes in lessons and revised studiously for tests because they despised failure. They seemed uninterested in the things that distracted girls like me – rule-breaking modifications to our school uniforms to make them less frumpy, for example. Plus pop music, make-up and Boys.

Occasionally a girl like me would get a better mark for an essay or exam than a girl like Theresa. And she would seem rocked by this. She had worked just as hard as usual; how could she have been beaten by someone like me? This outcome did not compute.

Girls like Theresa had parents who were sought after by the headmistress. Unlike girls like me whose parents either sucked up in an embarrassing way or were simply ignored. They won prizes for everything from needlework to deportment. Their school blazers were decorated with team captain, prefect and head girl badges. And correctly, they assumed that they would always be picked to represent the school at games. They had the right equipment, extra tennis coaching and at least one uncle who was a Cambridge blue. Girls like me had terrible kit. We had to fight for a place in the team.

But despite their sense of entitlement, girls like Theresa were also socially awkward. Now I understand the Myers Briggs Type Inventory (MBTI) I realise that they were probably introverted (I). Social interaction could be enjoyable for girls like Theresa. But it also required a huge effort. When an extrovert girl like me tried to chat lightheartedly with a girl like Theresa, she would be haughty and dismissive. I thought she hated me. But maybe she just didn’t know what to say?

Girls like Theresa were likely to have had a preference for Sensing (S) in how they dealt with the world around them. This made them great at retaining facts and revising for exams, but less good at dealing with abstract concepts and seeing the bigger picture. They could learn how to do these things, but they would always be more comfortable with detail. And at times of crisis, detail could overwhelm them.

Girls like Theresa almost certainly made decisions using rational thought and logic (T) rather than feelings. They were uncomfortable with people who expressed emotions too readily. Unless they were encouraged to develop their non-preferred feeling side, they were more likely to offer criticism than praise to others, and struggle to show empathy.

And girls like Theresa were more likely to have a preference for judging (J) and to seek to reach closure rather than to explore new possibilities. At their best, they could be decisive. They liked to plan everything and leave nothing to chance. But without encouragement and support to explore their non-preferred perceiving side, they could be closed to new ideas.

People with an ISTJ Myers Briggs profile can be great team players. They can also become very good leaders, but only if they pay attention to those aspects of their personality that require development. They will always find the demand for frequent interaction with others draining. They need wise and trustworthy advisers to encourage them when to be less cautious and when to follow their instincts. They must guard against making up their minds too quickly when they have yet to grasp the broader picture. And they will almost certainly need help to understand that if you allow your head always to rule your heart, you may come across as cold and uncaring.

I recall a girl like Theresa who became head girl. It started well. But the wheels began to come off quite soon. She lacked confidence to seek wise advice. And she uncharacteristically made one or two rash decisions because she relied on people who didn’t deserve her trust. This made her even more cautious and unapproachable. She ended up as a lesser version of herself than she had been before she first pinned on the sought-after enamel badge. I really hope that she is OK now.

Carl Rogers said: what I am is good enough, if I would only be it openly.

This applies as much to politicians as it does to ordinary people. Even head girls.

Sent from my Samsung Galaxy smartphone.

The Grenfell Tower fire – the political dimension to this tragedy

Andy Winter's Blog

This has been a week full of tragedy – the fire at Grenfell Tower. There has been an appalling loss of life and acts of amazing heroism.

We have been told that this is not the time to be political. But why not? Housing is political. The death of even one person is political

This was not a natural disaster. It was avoidable.

Everyone, rightly, is praising the emergency services. Fire fighters going into a burning building. Their bravery is beyond words.

But it was not so brave to close the three fire stations nearest Grenfell Tower.

There are 5,000 fewer fire fighters than there were 5 years ago. There has been a 25% reduction in fire prevention visits.

There has also been a 15% increase in the last year in the number of fire-related deaths in the UK, from 264 to 303.

If you put money before lives, people die.

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There is no such thing as a “suicide bomber”

​On Friday, mental health hero Professor Louis Appleby gave voice to the disquiet many of us have been feeling about the use of the term “suicide” in relation to the Manchester bombing. Overnight, we have learned of more atrocities around London Bridge and Vauxhall. Our hearts go out to all who are affected.

Now let us face facts. Taking one’s own life as a way of killing others is NOT suicide. It is multiple indiscriminate murder, even if those who do it have been callously brainwashed by others who view the lives of fellow humans as infinitely expendable.

After I had endorsed Louis’s comments via Twitter, I was challenged by Karen Machin @kmachin to use my influence to do better. I joked that she might be overestimating my potential impact, but I also remembered something.

When I retired from the NHS, I made a promise to others but mainly myself to use the connections I had developed to campaign for improvements for those needing help with their mental health. I do this as an ex-nurse and NHS leader but also someone with my own experiences of mental illness and occasional suicidal thoughts and feelings.

This time last year was not good for me. But not as bad as 2013, the year before I retired, during which I spent months ignoring my increasingly negative thoughts, growing ever more irrational and obsessed with unimportant details before finally breaking down, unable to speak or look other people in the eye because I was consumed by shame and self-hatred. I had no wish to remain alive. On the day things finally fell apart, I came close to crashing my car on purpose, but could not face hurting others because I knew it was only me who was a worthless piece of shit. I was luckily surrounded by love and exceptional care. And slowly, I came through.

Last year was more of a blip than a breakdown. A few things conspired to make me wobble. But at long last I have learned to spot my warning signs before it is too late – disturbed sleep, unexpected tears, irrational thoughts, heightened anxiety, self loathing and suicidal feelings. Fleeting, but suicidal nonetheless. Asking for help will always be difficult for me, because when I am not at my best, I feel that that my place is to help others and to need help myself is self-indulgent and selfish. But when I did, again I got unconditional love and support. A week or so later and I was on the mend. Yes, I remain on medication, but it is about maintenance. Others take statins, I take SSRIs. I also ride my bike, meditate, write, grow and make things, and spend time helping others. When I get the proportions right, this is a therapeutic mix.

One of the ways I help others and myself is by volunteering in suicide prevention via Samaritans and Grassroots Suicide Prevention.

It is a privilege to be there for people experiencing suicidal thoughts and feelings, or who are actively planning suicide. I know I have been dealt a more privileged hand than many, and I am in awe of the courage and fortitude people show in deciding either to keep going in the face of horrific challenges and experiences, or in reaching a decision that is the hardest anyone can make. Grassroots and Samaritans believe in self-determination. At Samaritans our entire purpose is about preventing suicide by giving people a kind and confidential place to share how they feel. We do not judge those who decide to take their own lives. We know that careful listening and compassion at such a time can help even those in the darkest places to find a reason for living after all. And at Grassroots, we believe that in reducing the stigma of suicide and helping friends, neighbours and work colleagues to develop understanding and skills, we can help save more lives. Our training is based on the best international evidence. It works.

Suicide can be an impulsive act by someone not in their right mind. It can also be carefully thought out and planned. Suicide casts a long shadow, not just on those nearest and dearest, but also on professional carers and volunteers who may have done all they can to keep the person alive. Samaritans and Cruse have recently started support groups for people bereaved by suicide. This work is much needed; although suicide has not been a crime since the 1960s, there is sadly still fear and stigma associated with such a death. It can be the most difficult of losses.

So given the complex sadness and what-ifs that accompany a death by suicide, and the guilt and shame felt by people like me who occasionally find ourselves thinking about it, may I ask for your help please? If you hear someone describing a mass murderer as a “suicide bomber” in future, please show them this. And please ask them to choose their words more carefully and reserve the suicide word for those times when it befits the anguish of the person considering it.

For confidential help 24/7 365 days a year call Samaritans on 116 123 or email jo@samaritans.org

For information on suicide prevention training, take a look at Grassroots Suicide Prevention

To download the free Stay Alive suicide prevention app, go here.

Take care. And thank you.

What would Mary Seacole do today?

Mary Seacole Trustees Karen Bonner and Jermaine Sterling

​On International Nurses Day, I have been thinking about what nursing means in our troubled world. And how nurses through the ages and across the planet have devoted their lives to helping others.

It was lovely for the Mary Seacole Trust to be invited by one of our trustees Karen Bonner to hold a stall at St Thomas’ Hospital as part of the Guys and St Thomas’ NHS Foundation Trust’s International Nurses Day celebration. Our display was right by Mary’s beautiful statue. We sold books and badges and signed people up to our mailing list. But most of all we talked with nurses and members of the public about the legacy Mary Seacole has left us. Despite all the challenges she faced, she refused to give up on her mission to help the sick and dying, including soldiers in the Crimea fighting a world war. She knew that nursing, in the 1850s not yet a recognised, respected profession, is so much more than delivering medicine or other treatments. It is about being with people in life and also in death. It is about combining compassion with practicality. And it is about speaking up when something is wrong and fighting for the rights of those at the bottom of the pile.

Mary continues to be a role model for millions of us. As a middle-aged woman of colour, she knew discrimination and hardship. Mary’s mother was a free-woman in around 1805 when Mary was born, having previously been a slave. Mary experienced racism when she came to the UK, as well as many other challenges and setbacks. But through her courage, tenacity and entrepreneurship, she gained recognition and gratitude not just from those she nursed, but also the British government and media, and even Queen Victoria herself. And yet Mary died in penury. It is only recently that her legacy has begun to be recognised.

Some of the skills and knowledge I acquired as a nurse from 1973 – 2000 remain with me, although I would need considerable retraining if I wanted a job in nursing today. The same would apply to Mary. But the core qualities and values needed to be a nurse have not changed. The ability to listen without judging. To see the person not just their disability or disease. To stand up for those who cannot stand up for themselves. Never to give up on anyone. And to seek out and build on the shared humanity that brings us together rather than the differences that can drive us apart.

Were she alive today, on International Nurses Day 2017, I wonder what Mary Seacole would do? And as I look at her statue as she strides calmly but resolutely towards the Houses of Parliament, I can almost hear her telling me and others who have chosen to become nurses never to give up on our fellow humans. Because we are all part of one human race.