1. 1 Depression suicide and the Samaritans

2. What is depression? Depression becomes an illness when our moods are serious and prolonged, and are accompanied by other symptoms and disturbances of our daily routine

3. Clinical features of depression Depressed mood Loss of interest and enjoyment Reduced energy: tiredness, decreased activity Reduced attention, concentration Ideas of guilt, worthlessness Low self-esteem Hopelessness Suicidal ideation / actions

4. How common is depression? 5% of population suffers from a depressive illness at any one time 12% of adults at some time in life experience depression severe enough to warrant treatment

5. How common is depression? More common in females Most common between the ages of 25 and 44 years 15-20% of cases run a chronic course Accounts for up to one-third of psychiatric admissions

6. What causes depression? Life events / personal experiences Family breakdown: marital separation, divorce Bereavement: death or loss of a loved one Neglect Abuse Bullying Physical illness Depression can be triggered if too many changes happen in life too quickly

7. What causes depression? Risk factors Stress Isolation: no one with whom to share worries Perceived lack of practical support

8. Depression as an illness: conclusion Very common Distressing and disabling for patient and family Potentially serious consequences Very treatable An illness which should bear no stigma

9. Depression as an illness: conclusion Very common Distressing and disabling for patient and family Potentially serious consequences Very treatable An illness which should bear no stigma

10. Suicide The intentional ending of one’s own life

11. The Samaritans The founder of the Samaritans was an Anglican clergyman called Chad Varah

12. The Samaritans In 1953 he became the vicar of St Stephen Walbrook in the city of London.

13. Origin of the Samaritans One of his first duties was to officiate at the funeral of a 14-year old girl. Inquiries revealed that she had committed suicide - shocked at discovery of the first visible signs of puberty, she had nobody with whom she could discuss these symptoms and became convinced that she was suffering from a dreadful and incurable illness.

14. Origin of the Samaritans He decided to use the church as a centre which could be visited by those who were in despair and for people who were considering taking their own lives.

15. The Samaritans He put a small advertisement in the local paper and in the first week he had 27 calls. Soon he was listening and advising people 12 hours a day. There were so many people waiting in his outer office to see him that he asked some of his congregation to come and provide cups of tea for them.

16. The Samaritans Then he found that often people who had come into the outer office in great distress had become different people by the time they reached him, and some did not even wait to see him because one of the helpers had befriended them.

17. The Samaritans So he decided to train a group of his congregation so that they could be more helpful in the way they befriended the clients. The Samaritans were formed.

18. The Samaritans His work grew but he thought he could be even more effective if he allowed people in need to telephone for help He managed to obtain a memorable number Mansion House 9000

19. The Samaritans The Samaritans' phone service for people feeling depressed and suicidal is widely known, and the need for the service is clear. A suicide takes place every 79 minutes in the UK and Ireland.

20. Who is most at risk of suicide? Young men Mental health and personality problems Following stressful event – usually relationship problems Serious problems with the police, family or school for a long time Abusing drugs or alcohol: highest risk of death by suicide Some will already be seeing a counsellor, psychiatrist or social worker Others have refused normal forms of help: trying to run away from their problems? sometimes the young person will have shown no previous signs of mental health problems

21. Why do young people try to kill themselves? Feeling sad and lonely; as if no one really likes you Feeling that you are a failure Feeling that you just upset people Feeling that no one would care if you were dead Feeling angry but unable to say so Feeling hopeless about the future

22. Why do young people try to kill themselves? Trying to cope independently with very upset feelings, or difficult problems, for the first time Don’t know how to solve their problems, or lack the support they need to cope with a big upset Feel overwhelmed and see no other way out

23. Increased risk of suicide in a young person Depression or serious mental illness; risk can be greatly reduced by treatment Using drugs or alcohol when upset Previous attempts Planning how to die without being saved A relative or friend who tried to kill themselves

24. Why do young people try to kill themselves? Often, several upsetting things have happened over a short time and one more upset or rejection is the ‘last straw’  An argument with parents  Breaking up with a friend  Being in trouble

25. The Samaritans