SCIE opinion - 22 January 2013

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Photograph of Andrea Sutcliffe

Remembering Adrian

From SCIE’s Chief Executive, Andrea Sutcliffe, on the day that the Office for National Statistics reveals that the UK suicide rate increased significantly between 2010 and 2011.

Behind every suicide statistic is a painful, human story.  My youngest brother Adrian was one of 3,131 male suicides in England in 2006.  This is his story – and mine.

Adrian began life as a happy, contented boy loved by his family. But he changed as he grew older - more withdrawn, miserable and on occasion seized by sudden rages. He was in pain but we did not realise and I certainly did not understand why.

In his late teens, Adrian tried to kill himself for the first time, ending up in hospital where his treatment was less than sympathetic.  As he progressed into his twenties he had good times and bad - sometimes at home, sometimes not; sometimes in work, sometimes not.

Adrian moved south, where he made another attempt to kill himself, saved only by the vigilance of a passing police patrol.  This began a difficult period for us all. Officially diagnosed with severe clinical depression, exacerbated by alcohol, he went through periods of remission, before he relapsed and ended up back in hospital.

Our family is grateful to the combined efforts of the local health and social care services and voluntary agencies for keeping him alive for 11 more years. The care he received was not always perfect but Adrian preferred to stay where he was known and supported. 

As he hit his mid-thirties, things seemed to be improving.  He had a job and a girlfriend and seemed much better.  But the warning signs were not picked up.  He stopped taking his medication. Eventually the pharmacy reported that he was not collecting his prescription, but his GP did not act or contact his psychiatrist.  His benefits changed because of the job and he got himself into a complete mess with his finances.  The social services day centre where he might have gone to get advice had closed down.  Three days before he was due in court for non-payment of rent to the housing association, he killed himself.

This is a painful, personal tale shared with the blessing of my family.  But it is also a professional one. I have worked in health and social care since 1986 and last year took up post as Chief Executive of the Social Care Institute for Excellence.

My brother's experience and the impact on my family underpin my approach to what I do and serve as a constant reminder of some important lessons.

First and foremost, each patient or person using services is an individual and should be treated with dignity and respect. That's what I wanted for Adrian, and that's what I want for everyone who needs care and support for whatever reason. 

Second, integration or joined up working is not a meaningless concept, it needs to be rooted in the practical reality of how services are provided for each individual.  There were warning signs that Adrian was getting into difficulty but no-one in health, housing or social care shared that information in a meaningful way.

Thirdly, none of us working in care and support services should underestimate the positive impact of the work we do. Adrian and our family valued the support he received.  We should promote the status of the work we do and make it a positive career choice for people who want to care.

A final point. Mental health problems and suicide are not readily discussed - very often it is a family's "guilty" secret.  This does not help to reduce the stigma, raise awareness or focus the minds of the public and policy makers.  Sharing Adrian's story is difficult and fills me with sadness and regret but I know that on this occasion silence is not golden.

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