New study reveals link between suicide and chronic and terminal illness

The suffering of people whose chronic and terminal illnesses is so severe that they take their own lives has been laid bare in a new report which found that they account for almost one in 10 suicide cases seen by Norfolk's coroner.

While the link between mental illness and suicide is well documented, the new research adds to a growing body of evidence that physical ill health is also a major factor behind suicides. In one Norwich case an elderly man, who took an overdose because he had chronic leg problems that were causing him considerable pain, wrote in his suicide note: 'I want to be able to control when I die and be spared the indignity.'

In May this year Norfolk coroner William Armstong gave permission for researchers to examine his district's suicide records for a five-year period from May 2006 to December 2010. The results revealed that 25 sucides, out of a total 259 – 9.7pc – involved a person with a diagnosed terminal or chronic illness.

In 44pc of these 25 cases, the deceased person had a condition that was progressive and expected to worsen.

Medical conditions identified in the inquest records included Parkinson's disease, motor neurone disease, ME, chronic arthritis, Huntington's disease, Alzheimer's and cancer.

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The researchers' report says: 'It is often assumed that mental illness, as opposed to physical illness, is the more salient factor in cases of suicide.Therefore it is worth noting at this point that in just over half of the 25 cases (57pc), there was no evidence in the inquest records that the deceased had a previous history of mental illness.'

It goes on to say this means they may not have had any current of pre-existing contact with mental health services and in many cases GPs and other health professionals may be best-placed to identify people with serious illness who may be having suicidal thoughts and be in need of additional support.

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The new report – The Truth About Suicide – was put together by researchers from the national think-tank Demos and said this hidden trend was being neglected.

Its author, Louise Bazalgette, said the 'lack of attention paid to people with terminal or chronic illness committing suicide is a gross dereliction of duty on the part of the government and health services.'

One case in the Norwich district records was of a 43-year-old man diagnosed with Huntington's disease 13 years earlier. He had seen family members die of the disease and his own health condition started to deteriorate. He did not want to die like his father and took his life by jumping out of a window. An 81-year-old man who hanged himself left a note saying: 'I have taken my life. I have Parkinson's disease and have become a burden on others'.

While for some cases there was no known history of mental health problems, in others there was clear evidence of depression brought about by serious illness and the report concluded that 'it will be important that we develop a better understanding of this complex relationship between physical and mental health if we are to develop a more effective police response to suicide'.

Mr Armstrong said last night: 'The prediction and prevention of suicide is a very complex subject because often a number of factors are involved. This report provides hard objective evidence that people suffering from chronic and terminal illness are at greater risk of taking their own lives than other people.

'Health professionals and others need to pay attention to this group of people to try to make sure they are given as much help and support as possible. But it must be remembered there are also lots of people with chronic and terminal illness who have no wish to take their lives and would be offended to be thought at risk of suicide because they have a seriously disabling illness.'

Mr Armstrong said he allowed the researchers to look at the cases because he wanted to do all he could to prevent suicide. He said: 'I see very regularly the pain and anguish suffered by the survivors of bereavement by suicide and it's something that makes a deep impression on me.

'I hope the government will look at the recommendations in this report.'

The report recommends that as part of the coalition government's ongoing consultation on preventing suicide they should consider making local suicide audits compulsory and coroners' duty to share information should be formalised.

It said: 'Suicide in the context of serious physical illness has become an increasingly important focus of public attention in recent years, as growing numbers of UK citizens with chronic or terminal conditions travel to Dignitas in Switzerland to receive assistance with suicide.'

Linda Hillman, consultant in Public Health for Mental Health services at NHS Norfolk, said: 'Preventing suicide in our area is a key public health priority. We already regularly audit local suicides. We look in detail at the proportion of our residents for whom suicide has been linked to physical and chronic illness and feed back to all GPs to highlight the risks and prevent further cases.

'We will be using the new Government Consultation on Preventing Suicide in England and the Demos work published today to ensure our suicide work in Norfolk is up to date and as effective as possible.'

Samaritans is available for anyone in any type of distress on 08457 90 90 90 in the UK.

Norwich widow Vickie Payne wants to see people diagnosed with chronic and terminal illnesses offered a complete package of care from a single clinic.

This could include occupational therapy, counselling and even alternative ways to cope with pain, for example using complementary therapies or cognitive behavioural therapy.

In May 2009 her 55-year-old husband Andrew Goodall took his own life because he was suffering from an inoperable tumour which was causing him great pain.

Mrs Payne, 54, an office manager at the University of East Anglia, said: 'I think there are links to the physical side as well as the mental side of coping with chronic illness.

'With Andrew's case it was the unbearable pain that caused him to feel the way he did as well.'

The mother-of-two said she thought more could have been done to help her husband to cope with the pain.

She said: 'His type of tumour didn't fit the norm because it was rare and they weren't set up for it. He was unable to receive chemotherapy or radiotherapy and there was no treatment.

'He went to the pain clinic a couple of weeks but I don't think there was a support network in place. He attended a number of times throughout his illness but it did not seem to help in the long-term to reduce the pain.

'I would like to see an overall clinic where there is a support service, a counselling service, a pain management service and where it's all in one place.'

She added that health professionals often only got a short period of time with patients and while they were aware that depression could be a symptom of a chronic or terminal illness, they were not necessarily able to access easily the support for this for their patients.

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