In the city where I live there has been a coronial inquest going on into the death of Charmaine Dragun who apparently suffered depression for a number of years most of it in silence. She was a high profile, pretty, young news reader who had the world at her feet. However it all came to an end with her dying by her own hand last year.
This is getting considerable press coverage which seems reasonable because of her profile and the fact that she is one of their own. The problem is that her mother Estelle Dragun who has been very vocal and widely reported in her direct criticisms of how the suicidal are managed in Australia. She has been continuously reported as saying there needs to be more monitoring of the suicidal, more breaking of confidentiality and more hospitalisations of depressed and suicidal people.
With her ongoing criticisms of the medical and psychology professions in this way does she think she is the first to have come up with such ideas. Of course it would be an advantage to have more public money spent on such fragile people, but its not that simple.
I have worked with very suicidal people over the past 25 years and for 3 years co-ordinated a suicide assessment and management program in the prison system. I would be very interested to hear Estelle Dragun’s views on how such monitoring should take place that is not already being done. She has been very public in her criticisms and very lean on any detail about how she thinks it could be improved.
And on her call for more hospitalisations, one needs to be careful with such simplistic solutions. All a hospitalisation does is move a suicidal person geographically from one location to another. If the person is quite isolated then that can indeed be helpful but it can also make matters worse.
Some people don’t want to be removed from their home environment and become even more distressed when they are. Some people do not want all the fuss that goes along with a hospitalisation. Hospitals are simply buildings full of people. There is a view in the community by some and some in the hospital system that self harming and suicidal people improperly use up limited hospital resources. Hospitals are meant to be for real patients who are there due to either disease or accidents. Some cultures in some helping insitutions can be a bit difficult and then there can be just simple personality clashes as well.
Managing a suicidal person is not as simple as just putting them in a hospital and Estelle Dragun’s vocal criticisms hopefully will not result in the coroners recommending more people be forced or pressured into hospitalisation unless other factors agree with that happening.
As for depression and what Mrs Dragun says about how such people should be monitored more so. There are many out there already who are doing a very good job doing precisely that already. Of course giving them more money will help but again dealing with a depressed or suicidal person is not a simple venture. It is often grey and murky where one works on hunches.
Firstly when getting information from a suicidal person you can never assume you are being told the truth. I am not suggesting they are a group of pathological liars but they are very unhappy people who sometimes do not make good decisions. They will tell untruths and certainly not the full truth at times which of course makes monitoring difficult. If anyone has ways by which such monitoring of the truth can be improved I would be very interested to hear it instead of global criticisms of current monitoring.
Then there is the depressed and the suicidal as Charmaine Dragun reportedly was. 50% of depressed people are not suicidal at all. They do not even think about it let alone plan anything. The research hovers around the 7% and 8% mark for depressed people who will die by suicide. Charmaine Dragun was in a small group of depressed people who will complete a suicide. Then of course there are all those who aren’t depressed and still yet suicidal.
More money would help but monitoring is not an easy thing to do. There is also this thing called the suicide secret. The research says that about 75% of people will disclose to others about their suicidal thoughts prior to an attempt so monitoring could help here. This means of course that 25% don’t disclose. 1 in 4 will keep the suicide secret and do not disclose to others their desire to die prior to a suicide attempt. How one monitors them is often an oblique and beclouded exercise.