This week the GMC has determined to suspend Dr Iain Kerr for 6 months following his decision to prescribe to an elderly woman who died from an overdose of prescribed tablets (Temazepam, anti-histamines and painkillers). Dr Kerr had (re)prescribed the Temazepam only three days after a failed overdose suicide attempt. She died 11 days later from a second overdose. The woman was 87.

Dr Kerr said he gave Patient A the sleeping pills as an “insurance policy”.

He told the hearing in Manchester: “She said ‘Give me something that I can take if things get too bad’ and I said yes.” [source]

It’s an issue that needs little introduction. Euthanasia has been on the agenda for some time and has caused significant controversy. However, some places have made up their mind that it’s not so difficult: [Wiki]

As of 2008, some forms of euthanasia are legal in Belgium, Luxemburg, The Netherlands, Switzerland, the U.S. state Oregon, and Thailand.

I’m not sure what the current status of debate is in the big offices where the important people sit and chat about our lives, but there seems to be some discussion about the message this latest sanction sends.

Even the GMC panel rejected a call to strike his name from the medical register.

Campaigners have taken this as a positive sign. Dr Michael Irwin, a former doctor with the United Nations, was struck off by the GMC in 2005 for trying to help a terminally ill friend to die. In the event his friend, who was suffering from prostate cancer, was too ill to take the tablets and died a few days later.

Dr Irwin, once chair of the pro-euthanasia organisation Dignity in Dying, said he felt the decision to suspend Dr Kerr could be interpreted as a positive sign.

He has already written to the Euthanasia Research and Guidance Organisation about the result. “I said, I do not want to sound too optimistic but in the recent past doctors doing the same kind of thing were struck off,” he explained.

He firmly believes that the UK will eventually permit assisted suicide, even predicting a time frame of 20 years, and he thinks Scotland could be first to make the change.

On the other side, there are the anti-euthanasia enthusiasts such as Alex Schadenburg,  executive director of the Euthanasia Prevention Coalition - Canada and the Chairperson of the Euthanasia Prevention Coalition - International who recounts accurate detail but only proffers this opinion:

It is very important that the GMC has given this case the appropriate attention rather than remaining silent our of fear of offending the politically correct.

To be fair, further reading of this site offers a balanced and sensible discussion and appears well worth reading for a non-hysterical PoV.

Care not Killing are more assured of the message this sanction sends:

We welcome this decision. The GMC has sent a strong signal to the profession and society at large that for a doctor to assist a patient’s suicide is both irresponsible and inappropriate and brings the profession into disrepute. Dr Kerr was very fortunate to avoid being struck off or convicted but the GMC have, on the basis of mitigating circumstances, decided in this case to temper justice with mercy. The message is however very clear.

Attempted suicides are almost always a cry for help and the appropriate response to find out why the person feels so desperate and to offer them appropriate treatment and support. Requests for assisted suicide are extremely rare when patients’ physical, social and spiritual needs are properly met.

There are some further interesting reported points to this event tho:

The lady was originally prescribed Sodium Amytal when she requested ’something that I can take in case things get too bad’.

She requested and was prescribed the 30 Sodium Amytal in 1998, yet overdosed in 2005.

Prior to her overdose she disposed of the 30 Sodium Amytal because she was aware Dr Kerr was under scrutiny for his views euthanasia and didn’t want him to get into trouble.

She had originally disclosed to Dr Kerr that she had considered suicide so as not to be a burden on her family.

Patient A was an osteoporosis sufferer who feared becoming a burden upon her family and held Dr Kerr in high regard, her son told the hearing. [source]

Whenever he appears, you know it’s a mental health issue they’re reporting. This time it’s pro-suicide websites. Researchers from Bristol, Oxford and Manchester universities have found that pro-suicide sites are frequently thrown up by a web search for suicide-related information:-

In total, 90 hits (19%) were for dedicated suicide sites, half of which were judged to be encouraging, promoting, or facilitating suicide.

Some 43 hits contained personal or other accounts of suicide methods, providing information and discussing pros and cons but without direct encouragement; and two sites portrayed suicide or self harm in fashionable terms.

A further 44 (9%) hits were sites or pages that provided information about suicide methods in a purely factual (24), partly joking (12), or completely joking (eight) fashion.

Twelve hits were chat rooms or discussion boards that talked about methods of suicide.

In contrast, sites focusing on suicide prevention accounted for 62 hits (13%), and those forbidding or discouraging suicide accounted 59 hits (12%).

In other countries, pro-suicide sites are illegal. Presumably those who own and run them can be prosecuted in much the same way as people who own and run - say - child porn portals. It is illegal in this country to incite someone to kill themselves, but you have to actually have knowledge of, or assist at, the suicide to be prosecuted for it. Someone running a pro-suicide website would be able to claim that they had no knowledge that a specific person was going to kill themselves as a result of reading the information on their site, and as they provided no active assistance, could not be held responsible.

That law was drafted in 1961, a time when not everyone in the country had a television, or even a telephone, and when the kind of access to information and ease of communication offered by the internet couldn’t possibly have been envisaged outside the pages of science fiction. The government has committed itself to suicide reduction, particularly among young people who are probably most at risk from such online incitement. Reform of the Act would seem to be necessary if vulnerable, lonely people are reaching out for help only to find themselves being advised on the best ways of ending their lives. As far as I can see, providing this sort of information, in some cases, is the same as handing the person the pills or tying the noose for them.

An article in the Telegraph today caught my eye reporting on suicide in kids. The first thing that I notice, probably displaying my unfortunate mental health cynicism was the expert opinion of;

Dr Dylan Griffiths, an adolescent psychiatrist at the Priory Ticehurst House Hospital, explains that it is often down to the interplay between our internal and external worlds, the point where our internal circuitry is affected by external triggers.

Kind of astute. Suicide occurs where the external real world doesn’t mix well with the inner egocentric world. Or, there’s an incompatibility between life and existing in it.

I’m further encouraged by his assuredness that there is no typical characteristic….

There is no typical characteristic among those who choose to harm themselves - although if any generalisation can be made, it is sometimes said that the sufferer will be a tall thin boy who doesn’t do well socially.”

…except for anyone resembling Rodney Trotter.

I guess, the point of my post, other than to offer people an opportunity to dig at me for being so callous on such an emotive issue, is; why do we:

1. recognise so many childhood issues (including sexual abuse);

2. understand them to either result in suicide or ongoing mental health life issues (including allegedly “untreatable personalities”);

3. can patently see that there’s a real problem in certain areas;

4. yet continue to treat it as something we constantly drip drip drip services into and are still only dealing with the symptoms of the issues and not the causalities?

(To Z: This should be right up your Ritalin Road… )

I decided to stay at home (no surprise) although I’ve got kindof mixed feelings about this. Although I feel very relieved at not being forced to go into hospital I’m still really struggling to keep myself “safe”. I don’t really know how to describe what I’m thinking of (and don’t want to give anyone else “ideas”) It kindof feels like I’m walking a tightrope just now (without a safety net or harness!!)…… sometimes it scares me that I’ll “fall”, at other times I hope I’ll “fall” and at other times I feel compelled to make sure I “fall”. I don’t feel able to continue manage this myself safely although don’t really know what would help me to manage this. For the most part I have no interest in keeping myself “safe” for me (in fact it’s not what I want at all) but have massive guilt at what not staying “safe” will do to my family. Having woken up to the consequences and impact of my last attempt, I can’t pretend to myself that it’d be ok to do this. Although still there’s terrible temptation. Having stayed at home I have access to the following “support”

1. I see my GP (although as I go as infrequently as possible – monthly for sicklines)
2. I’ m being encouraged/made to see the psychiatrist weekly for review. I find this difficult as I get scared of going to see him and don’t talk to him. The psychiatrist tends to ask me what he can do to help/support me when I see him but this is an impossible question to answer as he doesn’t tend to say what services could be provided. (I think I’m supposed to know because I work in a related field)
3. I am “allowed” to phone the “crisis team” for support although haven’t found this particularly helpful. I phoned last week on a REALLY bad day where I felt unable to resist making myself “fall” off the tightrope that I’m walking and was advised to “take a bubble bath, use aromatherapy oils or flick through a glossy magazine” I knew that I could phone back later if I felt worse but just didn’t think there was any point so acted on the stuff I was thinking of before the call.

I do know as well that my attitude to going to hospital and seeing the GP and seeing the psychiatrist isn’t helpful and will try not to be such a nightmare about this.

I really don’t know what to do or what would help me to stay “safe” at home although maybe nothing will. I would appreciate ANY advice (if at all possible, please don’t tell me to avoid killing myself by having a bubble bath though). L

I’ve been “ill” (altho that doesn’t seem like the right word) for the past 11mths with PTSD and depression and have felt suicidal to a greater or lesser extent for alot of that time. Things get a little better then MUCH worse and it seems like I’m heading towards worse.

3mths ago I was detained briefly after being assessed by ASW, psychiatrist and GP as being a risk to myself in terms of self neglect and ?suicide. Being in hospital was a nightmare that I’d wish to avoid for a number of reasons - one being that I work as a SW in the city that I was detained in (altho am obviously off sick) and was unfortunately in a locked ward with two of my clients (not great for me or them)While in hospital I overdosed on saved meds from home altho much to my regret was found in time.

I’m really aware that how I’m feeling and what I’m thinking of probably makes me as much a risk as before (insight into MH act from work makes me worry about this)and altho I know that hospital is a safe place I don’t feel it’s the answer. Is there any way to avoid going into hospital when acutely suicidal or any alternative support I could ask for? If I do have to go to hospital does anyone think I’d have any say in not being placed somewhere I work

Hi i have an interview next month, for my nursing diploma, i have wanted this for so many yrs. I have suffered bouts of depression for yrs, due to a bad childhood, but always worked through them, and carried on working. But last year i had a personal tragedy, the worst thing that could happen to a mother, i stayed strong for couple of months but then cracked. had a breakdown and tried suicide. I have never felt this feeling of despair ever in 40yrs of life. A monster took over me, i am now in therapy and feeling much better, i now look forward to the future again. I have been in college doing a-levels in all this trauma, so i know i can do it, i am so determined, i just had a flash of weakness. Anyway what i want to know, does my doctor have to give all my details like the suicide, as i am so ashamed now. I know OH have to look up records, but to what extent, and should i wait till it comes up to explain, or discuss it in the interview. Please help i am really worried, because i have done so much to get this far.

Thanks Calligas

Similar posts can be found here:

Mental Nurse - Help Wanted and also here.

What`s my point ?. I can`t help thinking that we`re going in circles. Human beings are quite ingenious, if you deny people one option in terms of taking their own life, they will quickly conjure up another. Of course, I`m not for one moment suggesting that we give up on managing the risk of suicide. I`m simply suggesting the time has come to think a little more smartly about it.

I`ve worked in two single storey units now. Fair enough that has eliminated the possibility of anyone jumping out of a window to their deaths. However, we`ve also simultaneously created a whole new spectrum of problems and risks. Anything can very easily be passed in through any of the windows. The buildings are also uncomfortably warm in summer and cold in winter. This means various cleaning fluids cannot be stored safely. The wards cannot be cleaned effectively. Yet another risk profile is generated.

How much has been spent on removing potential ligature points ?. A good move in many ways but it too has its problems. Frail and elderly patients struggle to grasp and turn the new doorknobs. I`ve lost count of the number of times I`ve had to release a panic stricken patient from a room. How are you supposed to shower down someone who`s been incontinent when the shower head is fixed ?. We use a watering can on our ward. How degrading is that ?

What`s the upshot of all this investment ?. It just seems to me that as we close one door another one opens. Is it me or are overdoses becoming a lot more common?. Our local A and E now has a machine to measure paracetamol levels in the blood. They do it that regularly that it`s quicker to do the measurement themselves rather than send a blood sample to pathology. I could cite other examples too, I won`t, the door may be ajar but I`m not going to open it online.

The stormtroopers of the Health and Safety Gestapo, having spent considerable sums of taxpayers money, haven`t really got cause to look as smug as they do. We`ve a long way to go on this one.

So after a few weeks of Crisis In The Community she turns up in the police cells after shouting and screaming in the street. Just boyfriend trouble but it spilled out and the neighbours got involved and there’s a touch of arson and a bit of self harm….anyway upshot is, she’s in the cells and then gets assessed and ends up voluntarily on the ward. Boyfriend wants nothing to do with her now. Its over, he’s had enough. Remember that.

Maria makes friends quite quickly on the ward. This makes staff suspicious. They report that she doesn’t need to be there. But she’s now homeless. She’s taking up a much needed bed. Gradually she has no input from staff and spends her days doing her own thing. Only sleeping in the ward and bringing Macdonald’s in for some of the other patients. A CMHT member is on the case for housing. Eventually a hostel place is found. She’s discharged. Remember that.

Maria makes a big fuss at the hostel, there’s lots of trouble, it’s not working out. She goes to the CMHT. She’s been discharged. She needs a referral letter. A&E phone the CMHT a couple of hours latter. She’s there. A mild overdose and drunk. They’re very concerned. They want to discharge her to the CMHT. She’s not on the books. Remember that.

A&E need to make a referral. No - they want a psychiatric assessment before she’s discharged. There is no agreement between the Hospital Trust and The Mental Health Trust about who pays for this. Maria can take herself to the Mental Health Assessment Unit when she’s sober. SHO at A&E isn’t happy but has no choice. Sends Maria by ambulance for assessment. Once assessed she is referred to Crisis Team – but she has been discharged from hospital – not mentally ill therefore not eligible. Remember that.

Referral sent on to Psychology, except Psychology only sees people who are mentally ill these days, she’s not for them. Are you remembering?

Referral sent back to Crisis Team. Crisis Team write to GP –Days later the GP phones the CMHT – furious! He wants her seen – pointless ranting, no joy, but routine referral accepted. Maria is discussed in Team Meeting. Decision: this is a not a secondary care case. Needs Primary Care counselling. Outcome fed back to GP, in the full knowledge that there is no Primary Care Mental Health Service because the PCT haven’t commissioned one. Manager explains – “the more we send back the more chance there is they will stump up the cash – this is war!” CMHT starts getting brave – referring back to GP’s with abandon. A stamp is bought – NOT FOR SECONDARY CARE! It is ker-clunked on to GP’s letters and couriered back to them. Team morale is high. The war is being won.

Remember Maria? She is dead of course. Drowned herself in a river. The GP let the Team know, out of anger more than politeness.

“Unprofessional really, to let emotions show like that,” says the Team Manager.

A second post on the subject of service user death. This one is a bit more selfish than the last, preoccupied as it is with how managers (at least mine at the time) didn’t care about the people they employed.

I’d worked with Leo Yates for a couple of years (the joy of email spam is that I get all these names sent to me that I can use as nom de plumes). Leo, in his previous life, before the anxiety, panic and depression had overtaken him had been a STRONG MAN. A proper edge of the city type, hard and rough around the edges, a working man without skills but a definite motivation to do the best for his family, even if it meant playing rough now and again with those who sought to mess with them. It had fallen apart when his wife divorced him and took his daughter, leaving him alone in the house with his 18 year-old son, who was trying to carve his way out of the families’ lifestyle. Leo didn’t play the Psychiatry Game. It was poncey, soft and all about drugs and feelings. All professionals were useless and he complained and fought his way both into and out of hospital. As desperate as he felt he would sort out these weird feelings his way, which of course meant fighting the anxiety and depression and never showing it weakness. Never giving in. He would beat it.

Nothing I tried seemed to work but Leo and I developed a good relationship based on his refusal to try anything I suggested and the fact that I found that amusing, and he seemed to like the company for an hour or two once a week. He knew I was keeping an eye on him, and every now and again he would taunt me with his reserve option – to take himself out of life when he had had enough of it all, so I’d do what needed to be done and get him seen urgently, sometimes admitted for a few days and then he’d start fighting again and go home. But nothing really changed for him.

As is the way (which must drive service users mad) I decided to move on to pastures new in a different team in the same borough. I was (Oldschool will be pleased to hear) having a cup of coffee in the kitchen when the phone call came through to me.

It was Debbie, the Chief Executive’s PA on the other end of the line. I vaguely knew her and we exchanged polite pleasantries and a bit of banter. And then:

“Its about the Leo Yates investigation……”

“Oh that’s blast from the past” Still chirpy was I. “Has he complained again?” I laughed.

There was a very long silence.

“Have you not heard?”

“What?”

“He killed himself 2 months ago…………I thought you would have been told………………I’m………….sorry to have to break the news to you.”

It was quite clear that she was very sorry. Debbie was lovely but she was an administrator – she wasn’t there to break this sort of news. I could hear her voice shaking as she tried to tell me I needed to attend the investigation and give me the dates and times etc, while in my mind I was trying to make sense of what I was hearing, and feeling a growing swell of anger rising up as I realised how disgusting it was that no-one with authority had taken the responsibility to talk to me, and that Debbie had been placed in this position too.

Heartless.

When I put the phone down I felt pretty heartless too. In my anger I forgot all about Leo. Got defensive and decided that I worked for an awful organisation, decided that there would be no more goodwill working if this is how we were treated. From now on it was do the job and go home. Told everyone how insensitively this had been handled and ranted and raved to all and sundry.

Until that evening at home I remembered Leo and shed a little tear.

I guess the point I’m trying to make is that it’s really important to have compassion in the NHS. Over the years I’ve heard Service Users and their Families and Carers talk about heartless staff who “don’t care”, and been first shocked, then mystified, and then sadly accepting of their views. But there but for the grace of my god, go I. Like lots of things, compassion comes from the top and people should be led by example. Heartlessness breeds heartlessness.

Safe clothes & blankets for suicidal inmates in jails and prisons.

Link found on Mental Illness Casually.

Though looking again it makes some of my ideas look a bit more palatable. I was considering special velcro soled shoes and velcro carpets at the exits ?

“What should I do next ?”

The question came up while trying to convince my partner that the Muppet Show had hidden depths, it does. Trying to make me stop talking about Muppets the issue of Mental Nurse was raised. I asked the above question.

“Do something serious”

Was the suggestion. I was shocked. Serious ? More serious than the cynic’s guide to job adverts or the psychiatric hotline.

“Write about something that affected you deeply.”

This did not sound good.

“You mean ..?”

I said.

“Yes.”

So here it is. A brief snippet of my worst shift ever and a little about the effect nursing had on me. I strongly suggest you don’t read it.

Really don’t read I don’t come out well. Somewhat whiny and weak willed on the whole.

How Acute Mental Health Nursing Broke Me

My first job was in a busy acute ward in a distant part of the country. There was a very rapid turnover of staff. After a fairly rocky start I settled into the job well. I enjoyed it. I liked the patients the other staff. It was a ward where you had to sink or swim, sinking was not an option so the whole team pulled together to make sure people had all the support they needed.

Time passed after a year and a half I was one of the most experienced staff on the ward. I told you there was rapid turnover. I taught students, covered the psychiatric hotline (a serious one), carried the bleeps on night, did nursey stuff, did vast amounts of extra hours as always there was something requiring extra staff.

We worked with people on their way down from Broadmoor, working their way up to Broadmoor, depressed people, very broken people, people seeking benefits, people avoiding court, manic people, anorexic people, nice people, nasty people, young, old, violent, timid … a wide part of the psychiatric spectrum.

Often many of the above categories could be found in one person.

I was tired a lot of the time. I couldn’t sleep. I was far from home and had little life outside of work. I was having dreams about work. Not nice fluffy dreams.

One of the dreams I named ‘The One With The Room Full Of Hanging Dead People‘, I titled them as if they were episodes of Friends.

Once a nightmare had woken me up I couldn’t go back to sleep, because I would return to the same nightmare or one worse. The nightmares were awful. Lets just describe them as every horror movie you’ve ever seen mixed with things I had picked up from mad people being very unwell in a psychiatric ward.

This was an award winning psychiatric ward.

I liked it, it was a good ward.

We had a patient, John.

John was well known to us. Very depressed, responded fairly well to antidepressants when compliant, loving family, occasional game playing. John was admitted as he felt very suicidal, a fairly standard presentation.

I was John’s nurse.

John and I got on well. We spent quite a lot of time talking, I invested a lot of myself.

John had been making suicide attempts on the ward. Generally with some warning and in places where he could reliably expect to be found fairly quickly. We increased the observation levels though to be on the safe side. John was very depressed, he may have wanted to be found but part of him did want to die.

Eventually I thought we had begun to turn a corner. John was picking up. Seeing a future again, making plans.

Hooray !

To be on the safe side John was kept on the highest level of observations below constant, which would have required one member of staff to follow him about all the time, very intrusive. John location was checked at least every few minutes by a dedicated member of staff.

To cut a short story short he hanged himself with a piece of cord. I can still see it clearly in my minds eye.

He was found within minutes, the alarm was raised. I stood there frozen as my colleagues began CPR, I snapped out of it and started getting ready for the crash team and ambulance. Sending staff to do various jobs around the ward that needed doing.

Eventually John was taken to the general hospital and put on a ventilator in an intensive care ward.

Everybody on the ward was debriefed by management. Which was good. I was stunned, I was useless, I had frozen. What if it happened again ? What if I froze again ?

People complimented me on the job I had done. If only they knew I had frozen, I thought. I had probably only paused for a few seconds, it felt like hours.

John died some days later without ever regaining consciousness. His family were with him.

I don’t remember much of what happened next. There was a big review of what had happened. There was an inquest.

I had the pleasure of reading and checking all the notes I had made heading towards Johns death. A particular highlight was discussing John’s decades long history of depression and attempted suicide; we agreed that if in all the time he had not actually killed himself chances were, that even when depressed, a part of him wanted to live, John agreed.

Inside my head I am still screaming idiot! at myself.

There is a danger point when a deep depression lifts that the motivation to to something returns a bit quicker than the mood returning to ‘normal’. So what happens in you get a deeply depressed person with the motivation to do something about it.

We came through the inquest, as far as I know the family never blamed us.

But I knew I had failed. I was broken as an acute mental health nurse.

I might have been able to fix myself but I didn’t want to. The dreams were not getting any better.

The next patient that asked if he could go out, simply out of politeness, was almost refused for no reason other than my own fear. Discussion of raising peoples observation levels were likewise biased.

It was time to go job hunting. Luckily I found one that did not involve people regularly trying to kill themselves. To this day I consider a shift with no dead people at the end of it to be satisfactory. Almost all other problems can at least be attempted to be solved.

Death on the other hand is final. Unless my dream about the zombies turns out to be true !

To put this into perspective I know plenty of nurses who deal with the above situations and continue to love acute nursing. They are affected by it but learn from it. The grow, develop and become brilliant nurses. I know nurses who have faced worse and coped with it.

Sadly I know a few who have faced too much. Something inside burns out. The world view becomes warped, compassion becomes twisted by paranoia. Best to avoid that I thought.

Well that was cathartic

Well lets review what was said.

Bleak … yes.

Optimistic … no.

Excellent; an ideal Mental Nurse article.

I promise next time to tell the tale of the Boy Who Was Cured By The System.

It brings a tear to my eye.

Mental Nurse

I was reading Stupidity Costs Lives from Bloom. It reminded me of my introduction to stupidity in the work place. The following tale involve Ethel & Doris. While both Ethel & Doris were psychiatric inpatients neither of them were incapable of rational thought. Both were more than capable of understanding cause and effect and using common sense.

Well you would have thought so.

Ethel & Doris were ward friends. They had both often been inpatients and knew one another as well as can be expected for people that only met on the ward.

Doris decides to take an overdose. She has stored up a fair number of tablets, easily done with bit of effort. She decides to take them all at once and wash them down with a puny cup of hospital tea. Most people are not mad enough to drink hospital coffee.

Either just before or just after Doris does this she tells Ethel.

Ethel does nothing with this information.

Eventually Doris shows signs of ‘not being quite right’, a technical nursing diagnosis. We move into action and undertake a thorough investigation as follows:

Mental: (sighing) Right then. What have you done Doris ?

Doris: (looking very guilty) Nothing !

Mental: (silence)(hard stare)

Doris: (sheepish) Taken a whopping overdose.

We leap into action phoning ambulances and getting Doris admitted to hospital. She get carted off to the general hospital and it’s comfier beds. Doris leaves the story now, she was fine.

Doris is not the stupid one here. I have no problem understanding why some people want to end their lives. Working in mental health gets one used to almost anything.

Ethel see Doris taken away in the ambulance and comes to speak to us some hours later.

Ethel: How is Doris ?

Mental: (spider sense tingling) Fine … why ?

Ethel: (sheepish) I saw her being taken away in the ambulance.

Mental: (silence)(hard stare)

Ethel: (looking at own feet) She told me she had taken a massive overdose.

Mental: When ?

Ethel: Some hours before going away in an ambulance.

Mental: Why did you not tell us ?

Ethel: I did not want to grass her up.

Mental: (brain implodes)(gritted teeth)(hard stare) Pardon ?

I will spare you the rest of the conversation. Suffice to say I did not do much to make Ethel feel better. She deserved to feel guilty. I may have pointed out to her she was not a child any more and she was not at primary school. I think there was a five minute rant in a closed office following the above incident.

I could not believe a grown adult would put someone else’s life at risk for such a petty reason.

The latest figures show that people in Scotland are twice as the latest figures show that people in Scotland are twice as likely to kill themselves as in the rest of UK.

Why are people so much more likely to kill themselves in Scotland. Is it due to the longer winters. Or down to rubbish diets leading to more suicidal babies being born ?

Babies weighing 2kg or less were more than twice as likely to commit suicide as adults than those weighing between 3.25kg and 3.75kg, according to the findings published in The Lancet medical journal.

Or maybe even teenage mothers ?

Children born to mothers under 19 years old were also more than twice as likely to commit suicide as those born to women aged 20 to 29.

In England suicide rates under labour were the lowest since 1973.

Adult suicide rates are the lowest they have been for 30 years, according to new government figures.

Unless you live in Blackpool where the rate is twice the national average.

Luckily the courts are there to help the distressed

A woman who has attempted suicide four times has been banned from jumping into rivers, canals or onto railway lines.

That will stop her !

23 March 2005

This weeks nursing times takes about a thousand words to say that criminalising the mentally distressed is a controversial decision.

Current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt, independent of prior depression and substance use disorders

Of course from the looks of this you might end up dead by your own hand before ling cancer becomes a problem. Every cloud, silver lining.