Depression: so few places to find help

by ROBERT CHESSHYRE, Evening Standard

Peter Archer suffered from depression from the age of 15. When he was first diagnosed, he was sent to a "halfway house! for young people with mental problems, where he was "petrifiedî by the behaviour of the other residents - most of whom had criminal records. His mother said: "One boy tried to knife another; another set fire to the building; there was continuous glue-sniffing."

Peter (not his real name) was finally allowed home on condition that the family underwent joint therapy. Since one of his problems was that he and his stepfather were at loggerheads, this proved disastrous.

During therapy things were said (and left in the air) that would have been better left unsaid, further poisoning the atmosphere. He was later assigned a psychiatrist, who - according to Peter himself - never passed comment. Peter believed that at times the shrink dozed off.

His mother had been unhappy that the GP practice kept her at arm's length. "I wanted to talk to someone about how best I could help, whatI was supposed to do as a parent.î She was told that Peter was an adult, and that he, not she, was the patient. "In other words, they were saying, 'Keep off.' "At one stage, Peter was prescribed a drug, which, he said, made him feel like "beating people up".

When he was 29, Peter gassed himself. After his death, his mother visited his psychiatrist who told her: "Oh, I always wondered about Peter, but I thought he was stronger than that." Peter had requested another appointment. The letter was sent to the wrong address and he never received it - the appointment had been for two days before he died.

His mother said: "Despite everything, I didn't think it was actually possible that Peter would take his life. Afterwards, I saw the signs as if they had been written in neon lights."

In the case of Neil Firth - the 18-year-old from Bradford, w hose death we reported yesterday - there was no medical intervention. Three months before he took his own life, he did see his GP but only to complain of a "headache". In retrospect, this "headache" visit was the only clue he might have been depressed.

Like everyone, he had the occasional headache - he spent hours at his computer composing music - and usually sorted himself out with a painkiller. So what led him to make an unheralded visit to the doctor for such an apparently minor complaint? Was he in fact hoping against hope that she would draw from him the fact that he was depressed, even desperate, and wanted someone to know and intervene?

As with all illnesses, the GP is the gatekeeper, the first port of call for people suffering from depression. There are "spontaneousî suicides, spur-of-the-moment decisions (though even these are often rooted in well-disguised depression), but two-thirds to three-quarters of those who kill themselves are at the time (or found subsequently to have been) clinically depressed.

Young men are notoriously loath to go to the doctor under any circumstances, and especially reluctant to discuss their emotional health.

One mother said: "Quite often GPs are a stumbling block and people can't get beyond them. They either aren't picking up or are rejecting w hat they are being told." Patrick A

cheson-Gray, whose son Charles - as we reported yesterday - took his own life earlier this year, said: "The professionals, it seems to us, can no more than guess at their patients' real states of mind. Sadly, the nature of the illness may lead the patient to be unhelpful or positively deceptive."

If the toll of young male suicides is to be cut (they arefour times more likely than young women to take their own lives), awareness of depression must be promoted among young people; among professionals like youth workers and teachers; and among GPs. Many young men, like Neil Firth, sidle into the surgery and complain of something vague and never hint at the depression that is really troubling them.

Organisations - often born out of individual tragedies - are springing up to increase awareness. A group called Calm (Campaign against living miserably), funded by the Health Department, encourages young men to seek help at the onset of depression rather than when they feel suicidal - by when it may be too late to intercept tragedy.

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