‘The problem with brushing things under the carpet is they are still there, and one day someone is going to lift that carpet up and all you are going to feel is shame and embarrassment.’
These are the final words written by Caroline Flack, who took her own life last week.
They have haunted me since I read them after the TV presenter’s family released the unpublished Instagram post, in which the 40-year-old movingly articulated the torment she’d been experiencing and the struggle to come to terms with her problems.
When someone takes their own life, the first question for those left behind is why. And when that person is perceived as beautiful, talented, successful, wealthy and loved, the tragedy can seem even more inexplicable.
The second, agonising question for the bereaved is: was there anything I could have done to stop it?
The final words written by Caroline Flack, who took her own life last week, have haunted me since I read them after the TV presenter’s family released the unpublished Instagram post
The widespread assumption is that Caroline’s suicide was a response to her impending trial — she was accused of assaulting her boyfriend Lewis Burton — and the subsequent fallout which had seen her step down from her job on Love Island, ITV’s hugely successful show with which she had become synonymous.
Her somewhat chequered love life and the impact of social media — the trolling and critical comments her high-profile role attracted over the years — have also been discussed as a factor.
But I have one message for readers based on my clinical experience of talking to scores of people who feel suicidal and to their bereaved families: never assume anything about what drives someone to take their own life.
Yes, Caroline was a public figure whom millions of people — most of them young — had welcomed into their lives. But we didn’t know her and it is presumptuous to think we can understand her mental turmoil and the reasons for it.
The widespread assumption is that Caroline’s suicide was a response to her impending trial — she was accused of assaulting her boyfriend Lewis Burton — and the subsequent fallout
Speculation as to why someone takes his or her life is dangerous, because it provides an over-simplified narrative of cause and effect.
Indeed, the Samaritans warn against conjecture on social media or in the Press, because there is a wealth of strong evidence that shows suicide can be ‘catching’ — it can trigger copycat behaviour.
This doesn’t mean we should shy away from discussing suicide, far from it. But it must be handled carefully so vulnerable people do not take the wrong message from often good-intentioned attempts to shine a spotlight on suicide.
And I do worry how people with suicidal tendencies might react to the wall-to-wall coverage — understandable though it might be — of Caroline’s death.
Suicidal feelings are horrible and crippling, but they do pass. Treatment and support is available, and people need to know where to find it. And while they may feel sometimes that their friends or family will be better off without them, the bleak reality is that the impact of suicide on loved ones is devastating and can cause long-term suffering to those left behind.
For many years I’ve worked in A&E talking to and assessing suicidal people. When I started, I was wary and reticent.
What if I said something insensitive or stupid? What would I do if they told me they were thinking of harming themselves?
But over time I came to appreciate that a great deal of good can be done by talking about it — people will drop the pretence and be honest about how they feel.
Sometimes that’s all they need. Simply talking about those feelings is enough.
Every A&E department has access to mental health professionals, 24 hours a day, every day of the year. Anyone who feels vulnerable to self-harm or is experiencing suicidal thoughts can walk in and ask to speak to someone.
I believe absolutely that there is always another option to suicide, no matter how desperate, isolated, worried, distressed or overwhelmed a person might feel.
They just need to know where to find help — and that is a responsibility all of us share in looking out for others.
Finally, perhaps we should heed the advice in another of Caroline’s Instagram posts: ‘In a world where you can be anything, be kind.’
For confidential support, call the Samaritans on 116 123, visit a branch or see samaritans.org.
It’s not so wise to kick out patients
As a doctor who has been assaulted several times, I welcome robust responses from managers to ensure staff safety.
Health Secretary Matt Hancock announced this week that NHS staff can refuse to treat patients who show sexist, homophobic or racist behaviour from April.
This comes as figures show staff who have experienced bullying, harassment or abuse has risen by a quarter in five years.
On duty, I’ve been spat at, shouted at, punched, kicked and even held hostage. I’ve also been on the receiving end of homophobic abuse.
Health Secretary Matt Hancock announced this week that NHS staff can refuse to treat patients who show sexist, homophobic or racist behaviour from April
Violence towards staff is not tolerated in the NHS and perpetrators need to know their behaviour is not acceptable.
But refusing to treat them isn’t always the answer.
Once in A&E I overheard a patient verbally abusing a gay nurse. Other staff intervened and the nurse was ushered away, while someone else stepped in to care for the man.
Staff acted professionally, but made clear their disapproval.
The man clearly felt awkward. After his treatment, the nurse he’d abused came and sat next to him. They had a heartfelt discussion and the patient ended up apologising profusely.
When he was discharged, he hugged the nurse and returned later with chocolates. Would the same have happened if he had been kicked out?
Why the human touch is essential
I’ve written on these pages before how important human contact, especially touch, is for our mental wellbeing and physical health.
So I was not surprised by research presented at the American Association for the Advancement of Science meeting this week that showed newborn babies deprived of human touch can experience problems as they grow up, even into adulthood.
Newborns who need to be kept in an incubator may struggle with sleep, stress and emotions later in life — yet babies with similar treatment needs, but who also receive some skin-to-skin contact, or ‘kangaroo care’, do not face the same issues.
While this is an important factor to consider in treatment plans for babies, I also wonder what impact human touch has on the elderly, particularly those in care homes who don’t get many visits from their relatives.
Their need for touch is entirely neglected — reduced to being washed, dressed, changed or turned by nurses who are often wearing gloves.
We think about these patients’ physical needs, but what about their emotional needs?
Dr Max prescribes… The Happy Place podcast with Fearne Cotton
Presenter Fearne Cotton’s podcast is a breath of fresh air. She interviews well-known people about their mental health, focusing on what makes them happy.
From Hillary and Chelsea Clinton, to Dame Kelly Holmes, Fearne’s podcast is riveting and, at times, incredibly moving.
It gives a real insight into the human condition while being ultimately uplifting and life-affirming.
Presenter Fearne Cotton’s podcast is a breath of fresh air. She interviews well-known people about their mental health, focusing on what makes them happy
Ban the quacks
I welcome the move by the Professional Standards Authority (PSA) to ban homeopaths who offer quack treatments for autism.
NHS medical director Stephen Powis has gone one step further, saying the Society of Homeopaths shouldn’t offer medical advice at all.
While I don’t believe in homeopathy — a pseudo- scientific system of alternative medicine — I’ve nothing against people using it if they choose to.
The problem here is that the ‘treatment’ of autism some homeopaths offer is based on a belief that vaccinations cause it.
This idea came in a now-discredited study by disgraced doctor Andrew Wakefield, who suggested that the MMR jab was behind a rise in autism.
It is only right that people who peddle such myths are barred from practising.