Suicidal girl who has had a special care plan created for her

With new specialist carers employed at a cost of £125,000 per year for the additional carers alone plus the additional cost of the time of existing carers, facilities and all other associated costs. Total costing per year including facilities and fixtures and fittings is estimated to be around £300,000 which would be estimated at £19m using average UK life expectancy.

My question is should £300k per year or £19m over the course of somebody's life be spent keeping somebody alive who wants to die?

Does the money matter at all? If it is £50 a year or £5m a year should it make any difference?

If somebody is so insistent on ending their life is it right to stop them? Is it cruel to do so when they so clearly do not want to live?

Should somebody's mental health problems be taken into account?

If keeping the person alive at all costs is the priority and not their enjoyment or happiness then could we not just sedate her forever at a much lower cost?


I don't have the answers to any of the questions. I just thought it was extremely interesting/troubling that somebody is so intent on ending their life that they are on 24/7 suicide watch with such huge costs and realised there is no easy way to avoid it

 

Mmmm....
I have worked in inpatient mental health (from secure services to acute) for a fair number of years and I can tell you all that things have changed significantly over the last 5 years or so.
Unlike before (when we treated patients predominantly with schizophrenia, bipolar disorder and psychotic episodes) we now have our wards filled with people with "personality disorders". I do believe that this is little, if at all recognized in 3rd world countries: it is definitely a western world phenomenon. The majority of people i have worked with with such a diagnosis are female, with around 30% male. The general age is from 16 up to late 40s, then we see a significant improvement: we rarely see an admission after this.
The high incidence of admission of people with personality disorder is crippling mental health services.
All the individuals I have worked with have all claimed they wanted to die. All the individuals make attempts whilst in hospital: rarely with any determination. All the individuals are considered manipulative, constantly dictating which staff they desire and loudly stating those they don't; attempting to split the team. They decide not to eat for days, then do nothing but eat for days. They decide to stay awake at night for a while, then sleep all day. They demand all the attention, constantly sniping at their peers who they perceive are receiving more. Then when they are bored with it all they decide to stop, then get discharged.
Not one individual I have ever worked with with personality disorder has committed suicide, nor died accidentally when living back in the community.
Many people i have worked with have committed suicide, people who have struggled mightily with the impact schizophrenia, bipolar disorder and depressive illness has had on on their lives, and this is terribly sad.
We see many regulars with personality disorders who are fetched in by the police from motorway bridges etc: they have no intention to jump, they desire as much disruption and resource as is humanly possible. The police are now charging these individuals with wasting their time.
Despite all this i can assure you i treat said individuals with as much respect as any other and have indeed built up strong therapeutic relationships with most. It is the most frustrating part of my job. I see young people, people who could with the right support do something with their lives. It is utter madness.
I take no pleasure from what I have wrote here, indeed I feel embarrassed.

 

its not a matter of £300k per year to save 1 person or £300k per year to save numerous people its who decides who lives and is one person more valuable than another

 

It's a difficult subject. I don't believe that people who so desperately die should be made to live, however saying that, there's a very good chance that she isn't going to want to kill herself forever. She could have help and get better at any time, being suicidal doesn't have to be a permanent state (I'm presuming, I know nothing about this particular case).

In the cases @havana red1 speaks of, it is a concern about the number of people who now have personality disorders and it makes me wonder what the true cause is. I can think of many things that may contribute to the rising phenomenon but I do wonder if there are specific things that could be done to prevent it. Of course, they are wasting everyone's time but still there is something that is causing them to feel the need to do that, and as much as they may not be truly suicidal, there's obviously something very wrong that is making them feel and act in that way.

 

Yes you are quite right that there is something wrong. I often say to myself "why do they want to exist like this"? It is not normal. Is it a mental illness though? The DOH have deemed so and there are tens of wards and rehab facilities all over the country which cater for people with personality disorders. The problem with this however is the young one's learn from the experienced.

 

Interesting reading this and thanks for sharing.

Whist there's a reasonable chance that a simplistic conclusion could be jumped to from your observations - I am intrigued as to why this phenomena is being experienced.

It really does look like chronic attention seeking - but it must be born from something.

Do you have any insight into the cause and what treatment there is?


My initial response is to wonder if there;s been a breakdown in the way Maslows heirachy of needs works.

All the base level needs are covered by a society or a parent that simply hands over the basic needs on demand. Many many people simply don't have to put much effort in to survive these days.

Then - when work is simply flipping burgers, or picking parcels, or reading a script off a telephone helpline - the sense of fulfilment in these roles - the ability to express and be creative the sense of earning the right to belong. They become attention seekers and paddy to get attention etc. The sense of community itself is also breaking down. Less and less people know their neighbours etc. We all experience some frustration in this regard - but with an enormous population the extremes - i.e. the people who end up in hospital must be increasing in prevalence.

I'm sure there's some incredibly clever mental health practitioners out there who can explain it - but with you saying that this phenomena doesn't present itself as much in the developing world I'm wondering whether there is a basic wrongness in modern life and how we feel about ourselves.

Maybe some targeted online community computer games with lots of achievements - like World of Warcraft - or the Sims would work for some of these people - or even a football forum where fake chat bots respond to those seeking attention and deliberately allow themselves to be beaten in arguments and making them feel valuable in a different way.

I'm trying not to trivialise it - but I am intrigued as to how society is going to cope with peoples feelings of self worth when there are less and less real jobs providing a sense of self worth as greater automation takes hold.

 

I saw a video by someone once (I'll have to try and find it) who was explaining his take on millennials. Whilst I usually hate these videos as it just a way to slag them all off, his take was actually quite interesting. He was saying that as school and society has had a big push on telling people that they can be anything they want to be and that they should be doing something worthwhile, a lot of people are now unhappy in basic jobs as they are constantly asking themselves if they are making a difference or if they are meeting their full potential. When they realise that they are not really doing either of those things they then become unhappy. Previously, people grew up knowing that they were going to be doing a certain job and people didn't really have higher expectations for themselves or people around them than that so they were fine with it. It's not particularly that they loved their job, just that they accepted it as part of life and did whatever they enjoy doing when they got home. Now, people constantly evaluate their feelings, realise that they're coming up short of whatever goals them or society has set of them and feel crap and worthless.

Whilst a lot of that will be rubbish and won't apply to most people, millennials or otherwise, I find it an interesting idea to at least begin to consider (along with a big pinch of salt of course).

 

As I understand it the girl in question is 17 , a juvenile, who was convicted in Youth Court for offences and given a custodial sentence , after suicide attempts the young offenders institution took the case against against the Youth Offending Board because they wouldn't provide extra funding for more supervision , Judge Munby the lead judge for the Family Courts went all drama queen on the case saying people would have blood on their hands if they didn't provide a more suitable placement , now in a secure unit

 

It would be extremely difficult to pigeon-hole personality disorder patients. Some are from dysfunctional families/backgrounds but many are not. Many are from what would be considered 'low-social backgrounds', but some could definitely be considered middle-class. Incidentally I/we have nursed a handful of our colleagues in the nursing profession too, so it's certainly indiscriminate.
On a ward basis we fundamentally nurse risk: our priority is to keep people safe. There is little or no psychology involved within mental health inpatient acute wards. This is