Suicide without ideation • Making Families Count

This is a truly miserable subject for a blog, but it feels important, because it is all too easy to overlook the uncomfortable fact of someone taking their own life with no suicidal ideation.

I’ve written elsewhere about the tragic death of my beloved daughter-in-law, Mariana Pinto. She died on 16 October 2016. The Coroner said that whilst her actions were deliberate, she could not rule her death as suicide, because Mariana did not know what she was doing. She was in a psychotic state.

Why does this matter?

A lot of work takes place on suicide prevention, and this work does usually include self-harm, where a person may deliberately self-harm, but not intend to take their own life. Tragically, their actions can also result in death.

But someone in a psychotic state may not intend to take their own life. They may have no history of self-harm. They may be trying to flee from persecutors, they may be trying to find some peace or respite from the turmoil they are experiencing. During the psychosis, they may be paranoid, and desperately frightened, unable to trust anyone. It is really important to talk with people who survive such episodes to appreciate just how terrifying they are, and how suddenly and unexpectedly they can arrive.

Preventing such deaths requires health professionals to take a broader view of risk than ideation. This is also true for tragic homicides by people with acute mental illness. Health professionals need to listen attentively to the concerns of family members, and/or friends. They need to work flexibly to protect people who might well be a danger to themselves and/or to others, even with no ideation, because of their acute mental state.

Making Families is just starting a new project, ‘Life beyond the cubicle’ that aims to address this issue, in order to reduce the deaths of people during acute mental health crises, by enabling professionals to listen, support and assist families to help keep loved ones safe. Watch this space.