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View our Confidentiality Policy
"There are clearly times when mental health service practitioners, in dealing with a person at risk of suicide, may need to inform the family about aspects of risk to help keep the patient safe."
Preventing Suicide in England, A Cross-Government Outcomes Strategy to Save Lives, Department of Health 2012, section 4, 19
PAPYRUS Trustee Don, and wife Lynne Hart, suggest there are lessons to be learned in medical confidentiality.
Our youngest son, Dave, took his own life last November at the age of 17. He had seemed to his friends to be the ‘life and soul of the party’. He hadn’t displayed the ‘classic’ symptoms of depression - he was doing well at college, was planning to take up an apprenticeship, he was intelligent with a vibrant sense of humour and someone others confided in.
In April 2012 we received a letter from the Coroner offering a ‘read-only’ inquest. He had reviewed the reports and had concluded that Dave had taken his own life. We initially accepted the offer, but elected to see the various reports. It was then that we realised there had been numerous errors in procedures by GPs and Mental Health Services and also discovered that the GPs had been aware that Dave had already attempted suicide.
When Dave was 16 he went to see a GP. Dave was feeling unhappy about school having been bullied and following the breakup with his girlfriend. What we didn’t know was that Dave had told the doctor that he had already attempted suicide.
The response to his GP’s ‘urgent referral’ to CAMHS took more than three weeks to arrive asking Dave to make an appointment. He never did. No attempt was made to contact Dave by telephone and we were unaware of his state of mind. Yet, this important information was out there.
Eighteen months later, Dave went to a different GP. Again, what we didn’t know was that he had told the GP that he had attempted suicide just five days before. In another three weeks Dave was dead. Had we known about the recent attempt we could have done something, but we were parenting in the dark.
We discovered a few months later that Dave had been online, searching for ‘how to commit suicide easily and efficiently.’ We are pleased that PAPYRUS is active in this area of concern.
Dave’s inquest was successful in addressing the issues and the Coroner used his powers under Rule 43 of the 2009 Coroner’s Act to draw attention to some of the failings in the system. A Serious Untoward Incident Report and Somerset’s Child Death Review Panel resulted in similar findings. It is encouraging to know that changes will be made to help save other young lives.
The main question remains: ‘Can confidential information ever be justifiably withheld from people who can help when there is clear risk of death?’ Keeping such information ‘confidential’ can feel like a denial of our parental right to safeguard the child and can feel like asking us to parent with both hands tied behind our backs.
As parents, we believe that young lives are being lost as a result of the fear of breaking confidentiality within the NHS. GMC Guidelines for working with Young People are very clear - it is vital to break confidentiality when there is risk of death, even if the patient is not in agreement. We want to highlight that these guidelines are not always implemented.
Surely our young people deserve better.
Ed: After Dave died his family released a song he had written when he was 16 with his friend Jake called ‘Home’ to raise money for PAPYRUS. It is still available on Amazonmp3 and itunes.