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	TX: 21.01.05 - Suicide Strategy PRESENTER: LIZ BARCLAY

	THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 麻豆约拍 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. BARCLAY The suicide rate in England has fallen to an all time low and the number of young men killing themselves has dropped to the lowest level for almost 20 years. This has been put down to the government's national suicide prevention strategy for England which was introduced in 2002 to reduce suicides by a fifth by 2010. Despite the downward trend however, there are still 4,500 suicides a year in England, more than the total number of road deaths, so there's more to be done. Two years ago on You and Yours we reported on the opening of the UK's first suicide respite centre called Maytree. It's run as a charity in the borough of Camden in London, which has the highest suicide rate in the country. Suicidal people accepted as suitable spend four days at Maytree's House and are helped through their crisis. It's proven that if people come through that suicidal period the majority never attempt suicide again. Carolyn Atkinson spoke to Rowena, whose life was turned around after she arrived at Maytree on the brink of suicide. ROWENA Everything was so black, the blackness just didn't go. It was like a black tidal wave coming over me and I couldn't swim to the shore, that was how it was. It had been going on for months and nothing appealed to me at all and I'd had depressions before but it just accumulated and got worse and I didn't even want to go to hospital or seek treatment, I didn't want to go through all those procedures. Hospital, I mean in such a bad state, who wants hospital, no thank you. And a few weeks before that I'd seen something about the Maytree in one of the local papers. It interested me that there was a house that you could be looked after without having drugs put on you, that sort of interested me at the time. But I got to a stage I thought well would it be worth a try and just thought well even if I do finish my life I can at least see if this lot were a crazy lot. And part of me really didn't want it to work either, I felt that bad. But I thought oh in the end I'll try, I'll just ring up, there's no harm. ATKINSON So really one call and they'd convinced you that this was possibly something that could help you. ROWENA Exactly, yes they did. ATKINSON And when you got to the point of coming to Maytree were you on the verge of trying to kill yourself? ROWENA I thought I was, I'd planned - if they couldn't help me - I'd planned to just do it, yeah. You think ah well if I take a few pills it'll soon be over, I'll be out of the pain and that would have happened to me, I would have taken an overdose, something - drowning or something you know, I'd come to a point that I would risk the pain of dying to get out of the pain that I had whilst living. ATKINSON So when you got here, you were only here four days, it's a relatively short time so what did they do and how were they able to sort of turn round your thoughts and feelings? ROWENA The day I got here I went to my room, which was lovely, I thought this is a nice room, very pleasant this room anyway. A lady knocked at the door and walked in to put a duvet on my bed, she was so sympathetic. And she started chatting and I felt I wanted to talk to her. I certainly could talk about things I'd never been able to talk to anybody else. Deep things, there were people here that were so receptive, that I could open up and talk about real things that were really bothering me that I've held on to for years. I felt all these people seem to want to know me and that was the - the point of where I got so low and black, I felt nobody wanted to know me and that's why I wanted to commit suicide. When all these people started to come in and want to - I felt like a VIP. ATKINSON So you didn't see yourself as anything or anybody? ROWENA No, not at all, no. Having any value whatsoever - no way. No, it like opened a window onto the wider world because I'd shut that window out. ATKINSON And do you feel really that it's the first thing that's really worked for you? ROWENA I planned to - wanted to commit suicide in depression definitely, definitely. It's lovely to go somewhere and feel so black and negative and come out feeling so positive. And you say how can that happen in five nights, four days - well it happened for me. It can give you more confidence that you've got a right to enjoy life and be happy. They give you the tools to be a captain of your own ship. Can't say life is roses all the time but it's not thorns and if you come across a storm in a rough sea they give you the strength and ability to drive that boat through rapids, so as to speak. So that you don't go under, you get through to the other side and you feel stronger. And they gave me these tools. That's what I carry with me, that I can cope, I can steer my boat through rapids. It's given me a lot to look forward to actually. BARCLAY Rowena was talking to Carolyn Atkinson. Maytree was endorsed in a recent suicide scrutiny report by Camden Council and the local authority's now planning to open a similar respite centre itself. So how do doctors and other health professionals think of this service? Dr Nandy Nwogwugwu, who works at 麻豆约拍rton Hospital's psychiatric emergency clinic in London, has been successfully referring people to Maytree. Dr Nwogwugwu, you're dealing with very vulnerable people who are on the brink of killing themselves, how do you decide who might benefit from something like this respite centre rather than going to hospital or being sent home? NWOGWUGWU Well a lot of the patients who come to us who are suicidal the fact that they come is actually an indication that they're reaching for some kind of help. And so in the course of discussing with them we begin to explore the options available to be able to intervene in whichever crisis they're going through. Now previously the option of going to hospital, some patients don't see it to be quite suitable because of sometimes they attach stigma to being in a place where otherwise society would view as for mad people. BARCLAY Indeed, as Rowena said - who wants hospital. NWOGWUGWU Yeah. And then we have like another option of maybe sending them home and engaging them with our crisis resolution team who visit them at home. But then sometimes the stresses could be in the home environment. So with the opportunity of a place like the Maytree it offers an alternative intervention strategy, which is not so to speak a hospital based thing. So when we offer them these options some actually reach for it and naturally they decide in the end. BARCLAY But it was an untried concept as far as you were concerned, how did you have the confidence to make that first referral? NWOGWUGWU Yes it was untried but we - the Maytree sent us their brochure, we went through it - the concept obviously is quite appealing, having a place of respite that is not hospital based, that doesn't have the attached stigma. So it was more or less a trial thing and obviously the feedbacks were quite encouraging. BARCLAY What is that feedback? Rowena said it's the first time that anything like this has ever worked for her, is all the feedback that positive from your patients? NWOGWUGWU Well like some patients we don't hear from them again. Some come back for some other thing and we realise yes that this person came once and was very suicidal and they say yes it was quite useful - a useful experience for them. BARCLAY To what extent do you think something like this is contributing to the overall fall in the suicide rates that we've been hearing about today? NWOGWUGWU I can't really make any comments about statistics but I do believe in general that it would make - it would add to the fall in the suicide rates, yes I do. BARCLAY So do you think we should be rolling things like this out around the country? NWOGWUGWU Yes I think so. BARCLAY Dr Nandy Nwogwugwu thank you for joining us. Professor Louis Appleby is the national director of mental health. Professor Appleby, to what extent do you think innovations like this are helping towards the downward trend? APPLEBY I think in general they're making a major contribution. There's some quite important elements of what people need in the way that the Maytree was described. For example, it provided prompt availability in a crisis and a lot of people who are suicidal talk about the need to seek help, the need to get help straightaway, not to wait for it over a period of days. It was obviously - it's a service which seems to enjoy good working between the non-statutory sector and conventional mental health services, so when that happens you get a service that's based on what people need, rather than the way that services operate. And then of course it sounded like it was emphasising self worth and one of the things that goes wrong for people who become suicidal is that they start to feel hopeless, so that nothing will ever change, nothing will get better but also that they themselves are unworthy and they're worthless people. And if you can directly affect that pattern of thinking then you have a better chance of preventing suicides in people in crisis. BARCLAY Now we know from today's report that overall the suicide rate in England is down again, it has fallen to an all time low, and that fewer young men are killing themselves. In what other categories are we seeing successes? APPLEBY That's right, the general population suicide rate has fallen. The rate of suicide in young men has fallen. We've highlighted that because that's been particularly resistant in the past to the kind of prevention measures that have been employed. In fact the rate in men overall has come down and the rate in older women, over a period of years, has come down. The other group is people who are under mental health care - the number of suicides by current psychiatric patients has fallen and in particular the number of deaths on inpatient wards has dropped from about 200 five or six years ago to around 150 per year. BARCLAY So to what extent would you say this is a success? I mean the target is to reduce the suicide rate by 20% by 2010, and according to Professor Keith Hawton at the Oxford University Centre for Suicide Research that would mean approximately 1,000 fewer suicides per year, so there's a lot of reduction still to be done, are we saying we are facing success? APPLEBY Well it's - I think the signs are positive. I think we have to be a little bit cautious because suicide rates do fluctuate and sometimes it's hard to predict how they're going to change. But the last few years has seen a consistent year on year fall in the number of suicides, from a recent peak in around 1998-99 up until now the reduction has been 500 deaths per year. Now that's quite a big change in the number. But of course we need to repeat that between now and 2010 before we can say that we've reached the original target. BARCLAY Are we leading the way, do you think? Yes Europe still has a higher suicide rate than a lot of the rest of the world - Eastern Europe particularly. But in Britain we do seem to be - we do seem to be getting to the nub of this matter - are we leading the way? APPLEBY Well I think we're doing as well as any other country and better than most. If you look at other countries in Europe there are several countries in which the suicide rate has fallen in the last few years. But what's different about this country is that our starting point was really not all that high in comparison to other parts of Europe. So we take Denmark, for example, there's been a big fall in the suicide rate in Denmark but they started at a very high level, so the scope for reduction was much greater. In Britain we started off at - what in European terms was a relatively low suicide rate and yet we've still been able to bring it down further, so that's more difficult and therefore I think we should be more - happier about that. BARCLAY Professor Louis Appleby, director of mental health, thank you. 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