Suicide Prevention in Blackburn with Darwen

I attended a mini conference on suicide prevention at Blackburn Town Hall yesterday. There were representatives from a range of health and social services. I was there with a couple of colleagues from Blackburn College. I noticed that my old employer, The National Probation Service, was missing, which was a shame given that the workshop I attended was on reducing the risk of suicide within the criminal justice system.

The aim of the event was to consider how Blackburn with Darwen Borough Council and our own organisations might respond to The National Suicide Strategy. In workshops we discussed how we could work together to reduce the number of suicides in our town and the dreadful impact that each of those has on our community.

The first speaker was Chief Superintendent Bob Eastwood, Lancashire Constabulary Divisional Commander responsible for policing in East Lancashire. He spoke movingly about a colleague who had committed suicide and the impact of their death on family, friends and colleagues. It was pretty clear that Chief Superintendent Eastwood had been deeply affected by this and by the numerous incidents he'd attended at which someone had taken their own life. The impact of suicide ripples out across society. The other startling point made by Mr Eastwood was that sometimes all of his on-duty officers are engaged looking for or attending to suicidal people. He explained that suicide is traumatic and preventing suicide has significant resource implications for his organisation. 

The next speaker was Emma Thompson, the Borough's population health analyst. She gave a presentation on suicide as a global, national and local problem. In Blackburn with Darwen there were 18 suicides across the Borough in 2010 - thirteen of those were male and five were female. On examining the figures for suicide in Blackburn over the last ten years a number of features emerge. She said that most were under the age of 45, 75% were male, 27% were single, 34% lived alone and 70% could be defined as 'white British'.

In the workshop I attended on suicide and the criminal justice system it became clear that the police are struggling to cope with their role as first responders. Often their appearance exacerbates the situation. A Chief Inspector said his officers really struggled with non-statutory offenders specifically and with distressed and suicidal people in general. He said there was a pressing need for speedy assessment and for a referral pathway. We thought there was a place for volunteers in supporting suicidal people, but the work would be complex and challenging.

Living Works talked to us about the suicide prevention training they offered. They offered three major programmes:

• suicideTalk - awareness raising,  one or two hours duration, groups of 30 to 50
• safeTalk - a step up from suicideTalk, a programme designed to give people the confidence to talk about suicide with people at risk.
• ASIST ... a two day course involving role play, designed to give people the skills to work with suicidal people based on the principles of connecting, understanding and assisting.

The aim of Living Works is to create a network of helpers in the community. They said 'help seeking' is encouraged by open, honest and direct talk about suicide. They also said that the relationship between the helper and the suicidal person is key! The presentation ended on a positive note: 'No matter how despairing someone feels there is always a reason to live'.

The final speaker was Shirley Goodhew, Public Health Development Manager for NHS Blackburn with Darwen, speaking about risk factors for suicide: job loss, debt, social isolation, bereavement (especially for older people), family breakdown and imprisonment. Clearly a key risk factor for suicide was LOSS in its many forms. She said stigma and bullying are aggravating factors.

I left the conference feeling that agencies in the Borough had a long way to go if they were ever to work together effectively to safe-guard those at risk of suicide; but I left feeling that I had a part to play and I intend to book myself onto a Living Works training programme as soon as possible because, as the Chief Inspector said, 'Every life matters'.

David Rennie's Approach: Meta-Communication in Person Centred Counselling - Screencast 2/3

Second of my screencasts highlighting the work of David Rennie. In this presentation I briefly describe the use of meta-communication in person centred counselling.

Taming the Black Dog

A friend and counselling colleague gave me a copy of Taming the Black Dog. I'm often on the look out for self-help books I can recommend to my clients. Something to replace the classic by Susan Jeffers: Feel the Fear and Do it Anyway. Published in 2004 and written by Patrick Ellverton, Taming the Black Dog is a guide to beating depression, the Black Dog of the title.

Ellverton's book does contain a lot of good advice about healthier eating, exercise and the benefits of keeping a daily log. Ellverton recommends finding a mentor and writes admiringly  about his own source of  inspiration, Winston Churchill. There's advice on creating a daily regime of walking and prayer (or meditation) to 'restore the balance' and keep the black dog at bay. There's also advice on alcohol misuse whilst another section contains a twenty minute exercise routine. The guidance I personally found most useful was the recommendation to spend time in the evening planning the next day's tasks.

Ellverton's advice is rooted in a lifetime of coping with depression. Ellverton was an army officer and this too is reflected in his book. You can see from the description I've given that the book has a 'pull yourself up by the bootstraps' quality. He eschews counselling as tending to do more harm than good, though he offers a counselling service on his website.

I suspect Ellverton sees counselling as backward looking - a fruitless examination of unhappy past experiences likely to make depression worse. It's certainly true that rumination is a big part of depression and in my work as a counsellor I don't encourage clients to constantly dwell on their misery. I seek to acknowledge distressing memories and current unhappiness but recognise too the client's heroic side and the possibility of change.

Ellverton sees medication as a way of managing the symptoms of depression in the short-term whilst the depressed person makes changes to his or her thinking, behaviour and lifestyle. I have sympathy with that view and the need for lifestyle changes.

So Ellverton advocates a set of new habits: walking, exercise, playing a musical instrument, prayer, healthy eating and sobriety 'to keep the black dog in its kennel'. Anyone who likes this approach and can follow his prescription will find Ellverton's book helpful - replacing the behaviours that maintain depression with new behaviours that promote good mental health. The only problem is that depression tends to take away the motivation and will power needed to  make these changes. If that's the case for you then maybe some kind of therapy might be helpful.

Taming the Black Dog is available on Amazon here 

NLP In Blackburn

I facilitated three days training in Neuro Linguistic Programming (NLP) last weekend. I was with my friend and fellow NLPer Cath Birtwistle at the University Centre at Blackburn College. We got some great feedback from our trainees in what turned out to be a fantastic training experience on a hot and sunny weekend. Coming home in the evenings to see our Olympians win multiple gold medals was surely the icing on the cake! In this post I want to publish some links to my favourite NLP resources on the Web.

NLP Links

Andy Bradbury has provided a collection of insightful NLP book reviews at Honest Abe's NLP Emporium

The Anglo-American Book Company is a good place to go for NLP books including those by Crown House Publishing

The Association of NLP is one of the UK's leading organisations for the promotion and regulation of NLP

INLPTA is the International NLP Trainers Association and certify training around the world

I learnt most about modelling from David Gordon, his website is here: Expanding Your World

One of the wonderful out-growths of NLP is Symbolic Modelling and Clean Language, modelled on the work of the late David Grove by Penny Tompkins and James Lawley.

For NLP training in Lancashire - Diploma, Practitioner and Master Practitioner courses - you can check out Chris and Glenda Grimsley at: The Insit2te for NLP for Public Services

Robert Dilts the NLP developer has published lots of resources at his NLP University website.

My friend Fran Burgess, author of The NLP Cookbook has a website called The NLP Kitchen

Another friend, Chris Mitchell has successfully used NLP with disaffected young people and you can see how by reading her book The Behaviour Management Toolkit

Another of NLP's developers is Steve Andreas, you can see some of his videos at his YouTube site: NLPComprehensive

Jon Richardson and OCD

Just some thoughts on Jon Richardson's excellent Channel Four programme on Obsessive Compulsive Disorder this week. Jon did a great job investigating the problem of OCD; coming at it from the perspective of someone living with mild obsessions and compulsions himself. Diagnostic tests towards the end of the documentary suggested his difficulties were not sufficiently severe or distressing to attract a clinical diagnosis of OCD. But his experience of what he called 'quirks' gave him a great deal of empathy for those who did live with the disorder in its severe and debiliating forms.

Jon interviewed three individuals living with the disorder and it was distressing to see the torment these individuals were experiencing. First of all Jon met a young man, aged fifteen, whose life was becoming increasingly populated with obsessions and compulsions, expressing themselves as rituals about where and how he placed his feet and how many times he touched things. He perfectly expressed the bind at the heart of his OCD: 'If I don't perform the rituals then I experience distress that leads to more rituals and more OCD'.

Another person living with OCD was unable to let Jon into her home. Her OCD showed itself as a fear of contamination and to ward off the fear of inhaling dust and being 'permanently contaminated' she cleaned and cleaned. One of her rooms was sealed and dust free. Her partner was on the point of leaving, unable to cope with her relentless pursuit of safety through cleanliness.

A third visit was to a women who lived with OCD, ordering her life to prevent dirt and dust entering her home. When she or her husband entered the house they each showered and changed their clothes. This preserved the inside of the house from contaminants and allowed her some peace of mind. Further tragedy was revealed when she began to tell the story of her son. A truly gifted engineering student so tormented by obsessions and compulsions that he poisoned himself to death by blending twigs and leaves from a Yew tree and drinking the result. It was a sobering thing to see obsessive compulsive disorder on the death certificate. Sad to see the grief as she carefully removed her son's suicide note and other documents from its dust free folder. She regarded OCD as a blight on the family.

There is evidence of OCD being inherited, with early onset at age seven and late onset in the early twenties. Jon talked about his perfectionism, and his mother commented on the delight Jon experienced when book shelves were orderly. Perfectionism certainly seems a character trait associated with OCD. But Jon and the people he visited sometimes linked OCD with stressful, even traumatic experiences.

So it seems some individuals are susceptible to OCD. Risk factors including genetics, personality traits, and environmental factors, such as whether or not other family members have OCD. Then there are triggers - stress and distress. OCD's positive intention is to manage the resulting anxiety, setting in train a self-maintaining system of obsessions and compulsions with the potential to take over an individual's whole life and being.

Jon Richardson's programme left one feeling a bit hopeless. Each visit ended with Jon more aware of how debilitating the disorder can be. The hospital he visited used medication and exposure and response prevention to treat very severe cases with an 80% recovery rate. That was more hopeful; another programme showing how people recover from OCD would be most welcome.