Quote of the week.

One of less pleasant duties I have is to give a lecture on suicide to the medical students. The most recent controversy here helped: I could find the screenshots of papers by checking the most recent post on this.

I am quoting extensively from the Spectator. Julia Gillard was the Prime Minister of Australia in the last Labor government, until she was white anted by Kevin Rudd.

She has no professional background in mental health. She has no research credentials. But she is good at publicity.

This silence isn’t golden, Julia – it’s blue. Beyond blue, actually.

Gillard has been speaking out about mental health in her new role as chair of mental health organisation Beyond Blue, but she’s still suspiciously silent on the male suicide crisis.

Furthermore, worryingly, she doesn’t appear to have been briefed thoroughly…

On 29 March, the ABC published a speech she gave at Adelaide University.

In it she said, “We still have a long way to go in fighting the stigma and discrimination that surrounds mental health. Language, images, discussion, communication and education all play an extraordinary role in shaping a better future.”

The truth is, the stigma around suicide has shifted. It used to be that people were too terrified to speak up about depression and anxiety, that’s certainly changing.

What hasn’t shifted, however, is acknowledgement that it is men in particular who are vulnerable.

In her speech, she focuses on depression and anxiety saying, “We know that untreated depression is one of the leading causes of suicide.”

Who briefed her?

Where the hell are the experts with genuine insights?

Aha, look, I’ve found one.

“A ten-year study in Queensland, the Queensland Suicide Registry, is the best overall insight we have into causes of suicide as it relates to relationship breakdown in Australia”, Pete Nicholls of Parents Beyond Breakup tells me.

“The findings relate only to Queensland, but it’s by far the most detailed data on the subject. If we extrapolate the findings across Australia, we find that of the 44 men that commit suicide each week, 11 or so of those will have done so specifically due to relationship conflict, relationship separation or child custody issues. That’s 25 per cent or one in four of all male suicides, a statistic rarely seen in the media and certainly not well known amongst the public. The fact is, relationship separation is one of the greatest risk factors for suicidal men, particularly when children are involved.”

Interesting, hey Ms Gillard?

Nicholls continues, “Our grassroots work with men experiencing these challenges is about intervening in real time, in the real world. To address their ‘situational distress’ and to provide practical solutions that take the option of suicide off the table. For example, we know from research into the farming community that four out five suicides are based on acute situational distress, where suicide appears to be the best and only solution; and only one out of five of these suicides were down to mental health related causes. Bottom line, pills and therapy can only go so far in addressing a level of suicidality when it’s actually based on external drivers, and really what many of these men need is someone to help them address their very real and seemingly insurmountable challenges.”

In her speech, Ms Gillard highlights two areas in which Beyond Blue “will be striving to make a major difference in the next few years. The first is preventing suicide.”

She lists statistics – no mention of men.

She talks about Indigenous and LGBTI communities – no mention of men. Here she notes these communities “are at even greater risk with rates more than double that of the broader population.” No mention of men.

She says many people who are discharged will “try again in the days, weeks and months following discharge from hospital. And too many will be discharged right back to exactly the lives and circumstances that may have contributed to their attempt – and with no active follow-up or on-going support.”

Circumstances like being homeless after a relationship breakdown?

Circumstances like days, nights, weeks, months, years passing without being able to speak to or hug their children?

Circumstances like sliding into addiction to numb the agony of parental alienation?

Circumstances like the Family Court slowing churning its cogs, taking years to reunite fathers with their children?

Say it, Ms Gillard; the connection between your political legacy and the increasing suicide rate among men in Australia is undeniable.

You made mental health about politics.

Clear up your mess.

I hope that this tactic works. Beyond Blue has done some good work. However, the appointment of Gillard indicates that it has become converged, is part of the narrative, and will now do much less good. I worry that the obnoxious monomaniacs who generally come up with the breakthrough ideas will get short shrift.

Because the official approaches have done less good for people with depression, lately. There is a reason that Ketamine and ECT are making a comeback, and I am now teaching melancholia and reactive depression. The current model does not work.

One thought on “Quote of the week.

  1. In further response to my long comment chain on the previous post about this topic, the monoamine adjusters probably make the situation worse. Medications that help those in truly terrible mental/physical situations, when moved to the “normals”, have some nasty effects. The suicide rate increases starting in the 80s likely has something to do with that. (Though probably more in the under-20 rate than the over-20 rate.)

    For those in the high-likelihood categories would probably be better served with direct anxiolytic approach rather than anti-depressant/monoamine control approaches. Also, on a retrospective look, the power of Institutionalization is probably as much about controlling the patient’s diet than any other intervention. (One of those many little details in life that as we get more “efficient”, we find out we’re actually less efficient in totality than being more efficient in specifics.)

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