December 4 2014
Yesterday, on the day after Ashli’s inquest (see below), a coroner in Manchester delivered a verdict of suicide on a 15-year-old schoolboy.
Bradley Adams (left) was a talented musician. He had experienced bullying and teasing at a previous school, but had moved to another where he was “a lot happier,” and where the head-teacher described him as an “excellent student” and added: “He was very popular with other children and staff.”
In March of this year, Bradley was found hanged in his bedroom. He left a moving suicide note in a school work book addressed to his friends and family. In it he asked them to give his possessions to those less fortunate than him.
The inquest heard that Bradley had been suffering from depression and was receiving “specialist mental health treatment and support.” Whether this “treatment” included medication was not reported.
Coroner Nick Stanage (right) said: “I find, with regret, that the evidence before the court does indicate beyond reasonable doubt that he intended to take his own life.”
Bradley was described by his mother as “the light of everyone’s life” who had been “receiving the correct support and help.”
December 3 2014
In September, 15-year-old Ashli Blake(left) took her life by jumping from a tower in the Hampshire countryside near to her home. Reporting on yesterday’s inquest, various newspapers mentioned that she “was reportedly being bullied at school” and that, in the hours before her death, she had a row with her boyfriend in which she threatened to kill herself.
A pathologist confirmed that “there was no alcohol or drugs” in her system.
Ashli’s mother Canasta told the inquest: “She would have grown up to be a lovely person.” Canasta mentioned that Ashli had suffered from some bullying problems with other girls at her school but that she had not expressed any wish not to attend school because of it. She added that Ashli was working hard at her studies and had told family members she wanted to become an art therapist or an accountant.
In a statement, Dr Charlotte Hillsley (right), Ashli’s GP, said she had suffered from low moods and sleeping problems. She had previously been referred to the Hampshire Child and Adolescent Mental Health Services (CAMHS) but had been discharged. However, in July she had returned to the surgery and was referred again to the clinic and placed on its waiting list. However, the doctor did not appear to mention what treatment she had been provided for Ashli, nor whether she had prescribed any medication for her.
Recording a verdict of suicide, Coroner Grahame Short (left) said: “Ashli was a deeply troubled girl but I find that she chose to end her life.”
At the end of this unsatisfactory inquest, we did not discover whether Ashli took her life because she was troubled, bullied, or merely angry with her boyfriend.
Or, is it a more likely explanation that Ashli’s precious young life was yet another to be cut short by psychiatric medication?
November 28 2014
The BBC reported today that seven mental health patients have killed themselves in England since 2012 after being told there were no hospital beds for them.
One of the seven was referred to as “an unnamed man from Sheffield”, but, of the six who were named in the article, 3 were already on my database as they were confirmed as having been prescribed antidepressants some time before their death.
Pauline Binch, 64 (Nottingham). Hanged
Stephanie Daniels, 32 (Manchester). Hanged
Mandy Peck, 39 (Essex). Jumped from multi-storey car park
I had included the other three names on separate lists entitled “Suffering from Depression”, as newspaper reports of their inquests did not specifically mention antidepressant medication.
Anthony Quigley, 53 (North London). Struck by tube train
Michael Knight, 20 (Norfolk). Hanged
Terence Mullin, 53 (Blackburn). Hanged
The article also mentioned Amanda Vickers, 47 (Cumbria), who hanged herself after being denied a bed in a crisis house, a facility used to treat patients outside hospitals.
In addition, Peter Holboll, 44 (London) fatally stabbed his mother, having been told the previous day that no beds were available. He was subsequently visited by specialist nurses who decided that he did not need to be admitted to hospital “as he had agreed to take his medication.”
The investigation, carried out by Community Care and BBC news, discovered figures showing that more than 2100 mental health beds have been removed since 2011.
The report’s author, Andy McNicoll (right), also revealed that the Health Secretary Jeremy Hunt and NHS England were alerted to danger of delays in admission in December 2013.
A statement from NHS England said that spending on mental health was increasing in real terms. It went on to add that the solution to improving care was not about “beds, or buildings” but “finding the right solution for each patient”.
The policy of handing out antidepressants without actually addressing individual needs is, clearly, not the right solution for any patient.
November 15 2014
Oliver Ruse (left) ran the family butchery business that had been founded five generations ago in the village of Long Melford, Suffolk. He also looked after his four daughters after his marriage to wife Debbie (39) broke down.
According to reports, 37-year-old Oliver was left “heartbroken” after his wife Debbie left him and the children and moved abroad. He was then upset further when she came back and, on her return, requested access to their daughters and demanded a share of the family business.
Yesterday, it appears that Oliver went to the cottage that Debbie (right) was renting in the village, where he killed her with an axe. He then drove to the town of Bury St Edmunds, and jumped to his death from a multi-storey car park.
Oliver’s stepmother Sheelagh said: “Everyone’s devastated. Oliver was a very gentle man and bent over backwards to please Debbie. I don’t know what happened – a breakdown or something. I think he was still in love with her.”
A family friend said that Oliver had been on antidepressants since his wife’s return.
November 7 2014
In 1973, Clive Thomas (left) became Welsh 1500m champion, and 2 years later he was selected for the British athletics team. He went on to coach aspiring athletes while teaching at Millfield, a prestigious private school that specialises in sport.
Some time ago, Clive was treated for prostate cancer. Earlier this year, he was told that his prostate cancer had resurfaced and that he would need to begin chemotherapy.
As an inquest heard yesterday, the 67-year-old then became increasingly paranoid that the antidepressants that he had been prescribed would cause him to harm himself or his loved ones.
Clive’s partner Susan Adams told the inquest that Clive had been talking about having “black thoughts” in the days before his death. One evening in September, after flying into a fit of paranoia and warning Susan to “protect herself” from him, he fled from her home in Basingstoke, Hampshire, and was discovered hours later on the railway tracks near the village of Oakley, about 8 kilometres away.
The inquest heard how Clive had probably jumped from a footbridge in the middle of the night and lay undiscovered until he was struck by an early morning freight train. He was still alive when emergency services arrived on the scene but had suffered devastating head injuries and died on the tracks as paramedics tried to resuscitate him.
Coroner Andrew Bradley (right) said: “He clearly steals away from home in a very agitated state, there are a variety of things he could have done but what he does is go down to the railway line and jumps from the bridge. It’s not immediately outside his house, it’s a journey he had to make … he had a plan.”
A jury ruled that Clive killed himself “whilst the balance of his mind was disturbed.”
October 25 2014
This week, the inquest of 39-year-old Victoria Phelps was held at Gloucestershire Coroner’s Court. Victoria, a mother to two children, took her life in August 2012 by hanging herself in her garage. She had taken antidepressants for years, but, in April 2012, she became more anxious and depressed after a relationship breakdown.
In the month before she died, after an overdose, Victoria was referred to psychiatrist Prakash Muthu for a crisis assessment. Dr Muthu told the inquest that he “assessed her as being of low risk of suicide,” and recommended a change of medication toFluoxetine. However, he denied that there was an increased risk of suicide associated with Fluoxetine, even though the Patient Information Leaflet (PIL) carries a suicide warning.
Dr Muthu also informed the inquest that he had told Victoria that, as part of her risk management, she should contact the Samaritans. Perhaps this was a somewhat bizarre interpretation of the advice in the British National Formularythat: “Patients should be monitored for suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment or if the dose is changed.”
Understandably, Victoria’s family were not happy with the treatment that Victoria had received. Her mother had asked for her to be sectioned, while her brother Brett said: “My sister only started having suicide thoughts and making attempts when she was prescribed Fluoxetine. I’ve been doing some research into the drug and reckon that it was a death sentence for my sister.”
Coroner Katy Skerrett delivered a narrative conclusion, saying that “She made a few suicidal attempts in the weeks preceding her death. However it is unclear whether she had formed a clear intention to die.”
October 21 2014
This year’s book awards by the British Medical Association (BMA) have just been announced, and Peter Gøtzsche’s latestbook ‘Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare’ has been awarded first prizein the “Basis of Medicine” Category.
Peter (left) is Director of the NordicCochrane Centre in Copenhagen, and is also a member of the Council for Evidence-based Psychiatry (CEP).
The BMA reviewer commented that: “I would say that this book should be compulsory reading for medical students and junior doctors to make them aware of these issues…”
The review continued: “The author’s long experience in the field leads to a clear and authoritative view on the failings of the pharmaceutical industry. However he is clear that doctors, their organisations, journals and policy makers also have a role in these failings. I was particularly interested in the entanglement between doctors and the pharmaceutical industry. The use of clear language – fraud, corruption, and criminality – helps show what we would call this behaviour in any other sphere of life. It also refocuses our minds on the impact this behaviour has on patients – medication being the third largest cause of death…
“Prior to reading this I felt I had a good understanding of many of the issues – however this book highlighted many issues which I was not aware of. Some of the industry documents which have been leaked or revealed in court cases are particularly eye-opening…
“I would strongly recommend this book to others both healthcare professionals and those in the general public. The central issue is that we should be focused on patients – whose safety must come before profits.”
September 23 2014
Yesterday, an inquest was held into the death of a 16-year-old schoolgirl from Cambridgeshire.
For two years, the girl had been taking Fluoxetine (Prozac), prescribed by her GP for depression.
A report from her GP stated that, in the month before her death, the girl said that she heard voices in her head and that she felt “depressed the whole time.” Shortly before her death, she asked her doctor if she could change her Fluoxetine, as she felt it was making her worse. The medication was changed but there was no further appointment with the GP before the day in May this year, when she took a fatal overdose of the unnamed antidepressants.
Coroner David Morris (left) recorded a verdict of suicide, saying that the girl “took her own life while suffering from a chronic depressive illness.”
The coroner, however, did not mention the inherent dangers involved in prescribing SSRI antidepressants to children, nor did he mention the fact that those taking SSRIs are particularly at risk when changes are made to the prescription.
September 13 2014
In December 2012, Prince William’s wife Kate was in hospital in London being treated for acute morning sickness. While she was there, the hospital received a prank call from two Australian radio presenters pretending to be the Queen and Prince Charles. The call was taken by 46-year-old Jacintha Saldanha (right), who revealed confidential medical information about the pregnant Duchess before transferring the call to the duty nurse. To the embarrassment of the hospital, the call was broadcast in Australia and made headlines around the world.
Three days later, Jacintha hanged herself in the nurses’ living quarters. Following the tragedy, it was widely reported that Jacintha had been prescribed antidepressants, and had made two suicide attempts while in India the previous year.
The Bristol Post, for example, reported that Jacintha “attempted to commit suicide last December with an overdose of pills during a family visit to India, according to Indian newspaper reports. She survived after being rushed to hospital but tried to commit suicide again just nine days later by apparently jumping from a building. Ms Saldanha spent several days in intensive care before receiving psychiatric treatment and being prescribed a course of powerful antidepressants for nine months.”
This week, the inquest into Jacintha’s death finally took place. One of the first witnesses was Jacintha’s husband, who, when asked a question by coroner Fiona Wilcox (left), confirmed that, to his knowledge, his wife had not suffered any psychiatric illnesses or depression in the past, nor had she made any attempt to harm herself.
No further mention was made of Jacintha’s medical history, and, the following day, Dr Wilcox concluded the inquest by delivering a verdict of suicide, saying: “The hoax call was clearly pressing on her mind.”
Were the original reports completely wide of the mark, or is this just the latest manipulation of an inquest in order to expunge the link between antidepressants and suicide? The answers remain hidden in Jacintha’s medical record and in the pathologist’s toxicology report, both of which would have been available to Dr Wilcox. Yet no reference by the coroner to either of these documents has been reported in the media.
September 10 2014
69-year-old grandmother Carole Millman (right) lived in Egglescliffe, Teesside, with her husband and 97-year-old father.
Carole was described by coroner Malcolm Donnelly as a “very fit lady” who had completed the 20km Great North Run last year. However, the coroner continued by saying that: “What consumed her was the responsibility of her father.”
In May of this year, Carole visited her GP with her husband, and was prescribed medication. Two days later, she placed some bricks in a rucksack and drowned herself in the River Tees. Mr Donnelly recorded a verdict of suicide, adding that it was “so desperately sad.”
The local newspaper reported the inquest under the headline: “Grandmother killed herself after finding burden of looking after elderly dad too much”.
Jonathan McNally (left) was a super-fit 27-year-old personal trainer with an engaging personality, who had recently landed a prominent role in a forthcoming reality TV show set in his home town of Birmingham. In June of this year, he hanged himself in a friend’s garden.
Coroner Louise Hunt recorded a verdict of suicide, but his family said they did not believe he had intended to take his own life and called for improvements in mental health services.
According to his sister Gina, Jonathan “had issues with his height from a young age. All through school he was tiny … but he eventually shot up and was around 5ft 7ins (1.70m). Other things added to the way he felt. All this should have been picked up from when he was a child, but it never was.”
Gina said that her brother had been given tablets for his depression but more could have been done. “Jon had gone to the doctors but all he got were tablets,” she explained.
“He heard voices in his head. He wasn’t offered any counselling and I don’t think enough was done to help him or take care of his mental health issues. There was a lack of support.”
The local newspaper reported the inquest under the headline: “Budding TV star killed himself because he was ‘too short’“.
August 27 2014
The inquest of former racehorse trainer Jamie Douglas-Home (right), who held the title Baron Dacre, was reported in this morning’s Daily Mail. 61-year-old Mr Douglas-Home, who was the nephew of former Prime Minister Sir Alec Douglas-Home, shot himself dead in his Oxfordshire home in May of this year.
An inquest yesterday heard that Mr Douglas-Home saw his GP in March. At the time he was attempting to write a book on horse racing, but reported feeling tired and suffering from a lack of drive. In April, he consulted another GP, and was prescribed sleeping tablets and the antidepressant Escitalopram.
On May 7th, Mr Douglas-Home attended a private hospital in London, where he saw Dr Christopher Muller-Pollard (left), a consultant psychiatrist. Dr Muller-Pollard told the inquest: “He told me he was feeling suicidal two days prior to his appointment with me but was no longer feeling suicidal. I explained that some antidepressant medicine could rarely cause an increase in suicidality, but that was more in young people and women.”
Dr Muller-Pollard explained that he offered Mr Douglas-Home a bed at the hospital as it would mean he could “take a break” for a while, but he declined. “Jamie reassured me he didn’t need any supervision as he was not currently suicidal. He would prefer to go home,” he said.
Mr Douglas-Home stayed overnight in London with his daughter, and returned home the following morning. That evening, he was discovered by his sister Sarah Dent, who had come to stay with him.
Mrs Dent told the inquest that her brother had mentioned that he had felt worse after starting his medication and questioned the logic of leaving the decision of whether to admit her brother with him, due to his indecisiveness and mental state.
Before recording a verdict of suicide, Coroner Peter Clark told Mrs Dent: “His apparent preference was to return home. It is clear from the statements that there is this issue that you feel slightly worse before you are meant to feel better, which is a very difficult judgement call to make.”
August 18 2014
Two days ago, the Bradford Telegraph and Argus published a report on the inquest into the tragic death of 35-year-old devoted wife and mother Seemberjeet Kaur, who drowned herself in the River Aire in Leeds. The report had a photo (right) of Seemberjeet and, including the headline, was 401 words long. The report told how Seemberjeet became anxious about the health of her young daughter, then went on to say: “Over time she grew increasingly more anxious, also worrying about other family’s health, and was put on anti-depressants.”
This morning, the online edition of the Daily Mirror published a similar report which included the same photo of Seemberjeet, and, at 610 words long, was about 50% longer than that in the local newspaper. The report included these words from the coroner: “She was placed on anti-depressants for anxiety. She started to think that she was unwell and other family members were unwell. She told her husband she wanted her death to be quick. She clearly appears to have had mental health issues.”
The report in this morning’s online edition of the Daily Mail was the most detailed of the three. As well as the same photo of Seemberjeet, the report also had a photo (left) of the river in Leeds. At 842 words long, it was more than twice the length of that in the local newspaper. However, the report contains no mention at all of antidepressants, although it refers to a “muscle-relaxant” not mentioned in either of the other reports.
In the past few months, the Daily Mail has published two articles about research that showed antidepressants in a positive light. The first concerned pregnancy and breast-feeding, while the second purported to show how suicides had risen since the FDA warned about their use. Both of the articles were published uncritically, as news, but the fact that both research projects have since been thoroughly discredited has never been mentioned in the newspaper.
One has to wonder whether the Daily Mail has recently formulated some sort of policy that antidepressants should be mentioned only in a positive light.
August 15 2014
Anyone who heard Adrian Strain speak on BBC Radio 4 yesterday morning, the day after the funeral of his son, could not help but be impressed by his eloquence, dignity and sincerity. When 34-year-old Martin (right) took sickness leave from work in April, he went to his GP. He was given a repeat prescription for antidepressants, but told that he would have to wait for at least three months before receiving any talking therapy. Earlier this month, Martin took his life.
On the programme, Adrian asked for guidelines that ensured that “within four weeks of a young man, aged 20-40, reporting sick for work, reporting to a GP with stress, that there is an immediate referral for a psychiatric assessment.”
That interview was followed, in contrast, by a totally cynical performance from Simon Wessely (left), president of the Royal College of Psychiatrists, who completely ignored the interviewer’s pertinent differentiation between antidepressants and talking therapy. Instead, he re-iterated his recent assertion that “Less than a third of people with common mental health problems get any treatment at all.”
As an online author asks of Dr Wessely: “Where does this percentage come from? What study was done in order to generate this fantasy? It seems to me to be quite an arbitrary number because there could be no logical, reasonable or scientific way that you could possibly arrive at that figure.”
The author also asks: “Why do you mention ‘treatments’ but fail to illustrate that these treatments are almost always psychiatric drugs with horrendous side effects?”
I shouldn’t think the author known as Truthman expects an answer any more than I do. But at least he’s managed to come up with an appropriate illustration:
July 29 2014
Yesterday the inquest of 51-year-old Liz Fleming took place. Liz was a “dedicated and respected” special needs teacher who lived and worked in Cornwall. Last year, she became anxious about her physical health and the possibility of a forthcoming operation.
On October 21st, Liz consulted her GP, Dr Andrew May (left), who made the fateful decision to prescribe the SSRI antidepressant Sertraline for her anxiety. Just two days later, Liz suffered what Dr May described as “a dramatic adverse reaction” to the medication, which left her in a catatonic state. Dr May said he had never seen such an extreme reaction before.
Liz’s sister Alison said: “I think mentally when it was happening she thought she was dying inside … She expressed suicidal thoughts most days. She wanted to die but she also expressed that she wanted to live as well.”
Following the adverse reaction, Liz was given Diazepam and an urgent referral to the crisis home treatment team. She was also put into the “care” of consultant psychiatrist Rick Bowers. On December 18th Liz was prescribed yet another drug, Pregabalin. Like Sertraline and Diazepam, Pregabalin (aka Lyrica) has also been linked with suicidal ideation.
On January 2nd of this year, Liz was found hanged at her home.
In his summation, coroner Barrie van den Berg said: “It’s a tragedy. It sounds like an adverse reaction to the Sertraline tipped her situation to a point that she could not deal with.” Nevertheless, he decided that Liz’s actions were “deliberate”, and delivered a verdict of suicide. It is to be hoped that the coroner at least sent a Yellow Card to the Pharma-funded MHRA.
After the inquest, Liz’s sister Alison and her brother Malcolm praised everyone involved in her care.
July 26 2014
Yesterday, the funeral of two brothers took place in County Sligo, Ireland. As well as being brothers, 20-year-old Shane Skeffington and his 9-year-old brother Brandon were also great friends who were often to be seen playing football together. Last Sunday, in an act that was completely out-of-character, Shane fatally stabbed Brandon in the house with a kitchen knife, then hanged himself in a garden shed. Yesterday, the two brothers were buried side by side.
Some time before the tragic event, Shane had returned from a spell in Sligo General Hospital, where he had been receiving “psychiatric treatment”, and was reported to have emerged “a changed man”.
Many Irish newspapers have drawn comparisons between Sunday’s tragedy and the terrible events of almost 5 years ago in Bray, when 22-year-old Shane Clancy (right) used a kitchen knife to stab a male acquaintance before going on to stab himself. The inquest jury at the time decided that Shane’s out-of-character actions were due to an adverse reaction to the antidepressant Citalopram that had been prescribed to him.
On Tuesday, the Irish Mirror interviewed Shane Clancy’s mother Leonie (left), who said about Sunday’s tragedy in Sligo: “It was out of the blue – the neighbours couldn’t believe it. He had only just been released from a psychiatric hospital. The only thing they can do is give pills – they are mind-altering drugs. It needs to be investigated and questions need to be asked of the HSE.”
Immediately following Shane Clancy’s inquest in 2010, a group of Irish psychiatrists led by Patricia Casey (right) made bizarre and ultimately unsuccessful attempts to exonerate Citalopram. Professor Casey also appeared prominently in a rather tacky TV documentary about the events in Bray that was broadcast earlier this year.
Whether Shane Skeffington was prescribed psychiatric medication or not should emerge in due course. However, whatever the outcome, it is evident that Brandon (left), Shane (inset) and their distraught family have been completely failed by the flawed practice of psychiatry.
June 12 2014
The Manchester Evening Newsreported today that 86-year-old Gerard Evans (left) has been left “like a zombie” after being wrongly prescribedSertraline during a stay of almost three weeks at Salford Royal Hospital for breathing problems.
Mr Evans’s wife Shirley said: “He was like a rag doll and couldn’t move, but we didn’t realise he had been on antidepressants until we received a phone call from the pharmacist asking, “How long has he been on antidepressants?”
His hospital discharge note confirms there had been an ‘error in medications’ and advised Mr Evans to ‘reduce the Sertraline with help from a GP.’ He is being weaned off the tablets, which he says have left him “weak and lifeless.”
Mr Evans is sleeping on the settee in the lounge of his home because he can’t climb the stairs. He has to be helped to the bathroom by his wife, who said: “He now looks dead all the time. He is just gone. He went in hospital feeling better than when he came out.”
A director of the hospital stated that: “The error involving Mr Evans’ medication will be thoroughly investigated.”
June 5 2014
The Daily Mail reported yesterday that 38 year-old Peter Anderson attempted to take his life by jumping in front of a train at Leigh Station (right) in Essex last month. Peter was stopped by police officers, and was subsequently prosecuted for trespassing. He pleaded guilty, and was given a three-month conditional discharge.
However, concerns have been raised over whether Peter should have been prosecuted in the first place. A friend said: “This was a cry for help. But all that has happened up until now is he has been given drugs by doctors and pulled up in court rather than talked to or sent to something like rehab and given the help he so desperately needs. It seems like a waste of taxpayers’ money, especially as the clear answer is to give him help.”
In court, Peter’s solicitor explained why Peter had tried to take his own life. She said: “My client has fallen on hard times. He has been out of work for some time now since losing his driving licence and … has struggled to find a new job. This incident was a cry for help and he needs support to get back on the mend.”
A spokeswoman for the Crown Prosecution Service said that the prosecution was in the public interest, as: “In this case, due to the fact the defendant was on prohibited land, namely train tracks, and by his doing so could harm or cause distress to other members of the public and/or their safety it is clear that it was in the public interest to proceed. This course of action we hope would also deter anyone else from acting in the same manner in the future.”
June 3 2014
In January this year, Cumbria Police organised a search for 54-year-old teacher Marian Page (left), who had been reported missing.
Yesterday’s inquest heard that Marian’s body was found in an isolated and exposed spot in the Castle Carrock area, on a flat area exposed to a freezing cold wind, while her rucksack and a number of other items, including her mobile phone and someantidepressant drugs, were in a nearby sheltered gully. There was also a “living will” stating that she did not want to be resuscitated if anybody found her alive. Coroner David Roberts said that he was satisfied that Marian had intended to end her own life.
Among many tributes paid to her by colleagues and students at the time of her death, Marian was described as an inspirational teacher whose kindness and professionalism helped to transform the lives of her pupils.
May 31 2014
In March of last year, 14-year-old schoolboy Jake McGill-Lynch (right) died in Dublin as a result of a self-inflicted gunshot wound. Jake was diagnosed with Asperger’s syndrome in early 2012 and suffered from anxiety issues. In January 2013, his anxiety appeared to be increasing due to his upcoming Junior Certificate. He was referred to consultant child psychiatrist Dr Maria Migone, who prescribed Prozac.
Jake’s mother Stephanie told his inquest yesterday that she would never have agreed to his taking Prozac if she had known the side-effects. She added that she and her husband were not informed that side-effects of Prozac include an increase in suicidal ideation. When they collected the prescription, no patient information leaflet was included. She said that, in the USA, Prozac carries a ‘black label’ warning that it should be given to under-18s with anxiety problems only after all other avenues are exhausted.
“My child is dead. I was not told this could happen. My husband and I were not given any literature . . . if we were, there is no mother in her right mind going to let their child have a drug that can cause suicide and self-harm when they are suffering from those symptoms in the first place. Asperger’s is not an illness, it is a condition that no tablet or medication is going to fix,” she said.
The inquest has been adjourned for further evidence.
May 14 2014
Police officers in the town of Sparks, Nevada, held a press conference (left) yesterday after concluding their investigation into a shooting incident at the local high school.
The officers told how, less than 10 minutes after his mother dropped him off at school on the morning of October 21stof last year, 12-year-old pupil José Reyes shot dead a maths teacher and wounded two classmates before turning the gun on himself. José had taken his parents’ 9mm Ruger pistol and two magazines of ammunition from a kitchen cabinet.
José (right) had struggled with speech problems since kindergarten, and had told his parents how he had been teased at school, called “gay” and accused of wetting his pants. His mother said that she thought that he had displayed signs of autism.
Just three days before the tragedy, José’s father had taken him to a psychotherapist, who prescribed Prozac.
Police found a note written “to teachers and students,” in which he indicated that he would “get revenge.” On José’s phone, police officers found images of Eric Harris and Dylan Klebold, who shot dead 12 students and a teacher at Columbine High School in 1999, while they, too, were on psychiatric medication.
Sparks Police Chief Brian Allen said that José acted alone and did not communicate his plan to anyone. He concluded: “We will never know the complete motive or intent behind this tragic incident as the only person with the true knowledge felt acting out in violence and taking his own life was the best course of action. That in itself is a tragedy.”
May 4 2014
Under the headline “One simple question will tell us all we need to know about drugs”,Peter Hitchens (left) writes in today’s Mail on Sunday:
“I see that even the slow learners in the media are at last picking up on the mountains of reputable research which show that ‘antidepressants’ are vastly over-prescribed even on their own terms, often have unpleasant side effects, and may not actually be any more effective against ‘depression’ than sugar pills.
“Others all eventually follow where this column has led for years, though, of course, they never admit it.
“So here’s a new challenge for the slow learners. I cannot see how anyone can oppose it. Can we please now have a simple rule for all coroners, magistrates and judges?
“Wherever someone has taken his own life, or wherever someone is accused of taking someone else’s life, or of an act of dangerous violence, the police, doctors and pathologists involved should be required to discover whether that person has ever been a user of mind-altering drugs, whether legally prescribed, or illegal.
“I believe that if this question is asked, it will become plain that there is a frightening correlation between such drugs and such acts. Then, at last, we can do something.”
April 25 2014
The Daily Telegraph published an article this week in which it was revealed that, in England, prescriptions for antidepressants have increased by almost 25% in the last 3 years.
This evoked a response from Professor John Read(right), who is a Clinical Psychologist in the University of Liverpool’s Institute of Psychology, Health and Society. Professor Read has recently published astudy which revealed that over a third of those taking antidepressants reported having suicidal thoughts as a result.
Under the headline Viewpoint: The ‘medicalisation of human distress’ , the University websitepublished Professor Read’s article:
“This bizarre level of the medicalisation of human distress could be considered a national scandal.
“If there really has been that kind of increase in the number of people needing treatment for depression then we should surely be trying to address the causes of that – starting with poverty, in a country with one of the highest levels of inequality in the world.”
Fuelled by drug companies
“I suspect, however, that the increases are largely fuelled by drug companies and psychiatrists with a rather simplistic, biological view of mental health problems, who try to persuade the public that sadness and grief are signs of an ‘illness’ called ‘depression’ which somehow causes our sadness and grief.
“Drug company advertising is particularly targeted at women, who are twice as likely to be prescribed antidepressants as men.
“Our 2009 survey of depression websites found that the 42% that are drug company funded promulgated an illness model of depression.
“Our 2014 survey of nearly 2,000 people taking antidepressants found the following rates of adverse effects: sexual difficulties – 62%, emotional numbing – 60%, drowsiness – 58%, reduced positive feelings – 42%, and, of particular concern, suicidality 39%.”
No more effective than a placebo
“Furthermore these drugs have been shown to be no more effective than a placebo for all but a small minority of the most severely depressed people, meaning that the vast majority are being exposed to these adverse effects without receiving any benefit beyond the placebo effects of hope and expectation.
“The situation is likely to become even worse if doctors deploy the new diagnostic criteria for depression in the recently published fifth edition of the `Diagnostic and Statistical Manual’ which reduces the time of ‘normal’ grieving after the loss of a loved one from two months to two weeks, after which time one supposedly has a disorder in need of treatment.”
April 9 2014
The bodies of 55-year-old Stephen Dohoney and his 86-year-old mother Olwyn (right) were discovered at their Manchester home last November.
This week, their joint inquest heard that Stephen was a former graduate of Exeter University who had worked for the Department of Pensions. When his older brother Kenneth died from leukaemia a year earlier, Stephen, described as a “devoted son”, took a career break to look after his housebound mother.
At some point after this time, Stephen began to become increasingly worried about his own health. He was frightened that he had cancer and stopped going out with his friends.
In fact, Stephen did not have any form of cancer. However, he had been diagnosed with depression and anxiety and was on medication, including Citalopram.
Olwyn’s body was found in her bed. She had been repeatedly stabbed in the chest and neck. On her body, Stephen had placed a note alongside three photographs – one of her, one of Kenneth, and one of her late husband Jack, his father. His note read: “I wanted to die. I can’t cope with life anymore. I’m going to have another breakdown. Mum would not have survived without me and would have said it was her fault so I have sent her to Heaven. We have lived together all our lives so we should die together.”
Stephen then hanged himself in the loft space. A knife was found by his body and he had arranged his personal effects.
In his summing-up, coroner Nigel Meadows (left) did not refer to the medication when hesaid: “I suspect he did have some form of mental health problem. Obviously that does not give him any right to try and harm anyone else, particularly his mother. He may have been doing so for in his mind trying to do the best he could for his mum but that is unlawful.”
March 28 2014
An inquest in Gloucestershire heard yesterday that 15-year-old Joseph Gwilliam hanged himself at home on August 22nd last year. He was a talented artist, and was described as “bright, brave, modest, forgiving, polite and unique” by his parents.
Joe developed necrotising enterocolitis as a newborn baby, necessitating surgery. Joseph spent much of his childhood in and out of various hospitals for treatment for his gastro-intestinal problems, and was awaiting an in-patient colonoscopy. He had been prescribed Gabapentin.
Coroner Katy Skerrett said she had requested further information about the drug when she opened the inquest last December, after noting a link between Gabapentin and side-effects of suicidal inclinations.
That same month, the U.S. Supreme Court rejected Pfizer’s appeal against a $142 million award for the illegal marketing of Neurontin. The ruling paves the way for a class-action suit seeking damages on behalf of insurers, union funds and employers who paid for ineffective dosages of Neurontin.
Neurontin is also known by the generic name of Gabapentin. It was originally developed to treat epilepsy, but was also marketed by Pfizer for the relief of bipolar disorders, neuropathic pain and migraines. Pfizer was found to have suppressed or misrepresented clinical studies which showed that the drug was ineffective for those treatments. Internal Pfizer documents showed that the company knew that the drug was ineffective, and referred to it as “the ‘snake oil’ of the 20th century.”
As Mrs Skerrett pointed out, Neurontin has been associated with suicidal thoughts. Earlier this year, the family of Michael Hatcher (left) from Worcestershire blamed Neurontin for his suicide.
Nevertheless, Mrs Skerrett stated: “I am now satisfied that this allegation is undermined by further studies and it is the chronic pain itself which can lead to suicidal thoughts.”
“He has had a lifelong history of pain and health problems and missed a great deal of school as a result of this, which led to him perhaps feeling somewhat isolated,” said the coroner, recording a verdict of suicide.
March 25 2014
A judge in Winnipeg, Canada, ruled last week that a 15-year-old boy who fatally stabbed a close friend did so because of the effects of Prozac.
The boy had been prescribed Prozac in July 2009. When his parents subsequently voiced concerns about his deteriorating behaviour, specialists in Winnipeg responded by actually increasing the dose. “On Prozac he was becoming more irrational and aggressive,” said Mr. Brodsky, the boy’s lawyer. “That should have been a warning. That warning wasn’t heeded.” On September 20th 2009, while at home with two male friends, he stabbed one of them with a kitchen knife.
Dr Peter Breggin (right), who has testified in a number of cases in the USA where antidepressants have led to murder or other violence, and who reviewed the Winnipeg case, said: “These drugs produce a stimulant or activation continuum. That continuum includes aggression, hostility, loss of impulse control … all of which are a prescription for violence.”
The official “product monograph” approved by Health Canada for Prozac says that the drugs are not recommended for use on adolescents, and warns that agitation, hostility and aggression might ensue. Doctors are, however, allowed to prescribe medications “off label” to patients even when the approval does not expressly permit it.
Judge Heinrich concluded that the prescription of Prozac set off a steady deterioration in the boy’s behaviour. “He had become irritable, restless, agitated, aggressive and unclear in his thinking,” the judge said. “It was while in that state that he overreacted in an impulsive, explosive and violent way. Now that his body and mind are free and clear of any effects of Prozac, he is simply not the same youth in behaviour or character.”
Although the boy pleaded guilty to second-degree murder, the judge cited the drug’s side-effects as a reason not to raise the case to adult court, and to mete out a sentence of just 10 months, on top of two years already spent in prison.
March 19 2014
Following an inquest yesterday, Norfolk Coroner Jacqueline Lake (right) is going to write to NHS England to voice concern that patients need clearer information on the side-effects of antidepressant drugs.
65-year-old Susan Poore from Sheringham, known to her friends as Dena, was a retired payroll administrator and mother of two children. She was prescribed Fluoxetine (Prozac) and Mirtazapine around 5 weeks before her death.
On April 24th last year, Mrs Poore (left) had forced a train to perform an emergency stop. The train driver reported someone inches from the line but, after he stopped, he saw the person walking away. The following week, on May 3rd, Mrs Poore returned the same spot near East Runton, stood on the tracks with her back to the train and there was nothing the driver could do.
Mrs Poore had been in good health until a flu vaccination in October 2011 led to a series of complaints including insomnia. This prevented her from enjoying the rural walks and trips to visit family that she had undertaken previously, and began to impact on her mental health.
Her heartbroken family said she had been acting completely out of character in the lead-up to the tragedy, and that the drugs had changed her personality.
Mrs Poore was first prescribed antidepressants by her GP on March 29th. Mrs Lake said that it was a “proper” decision to prescribe the drugs and that the mother-of-two displayed signs of depression before she began the course of medication.
But she said that Mrs Poore’s mental health deteriorated after the prescription, and voiced concern that patients were not given enough warning of “possible side-effects of taking these medications in the initial stages.”
In a short narrative conclusion, Mrs Lake said: “Mrs Poore stepped in front of a train and suffered fatal injuries. At the time Mrs Poore was taking antidepressant medication.”
Mrs Poore’s daughter, Katie Silvester, 44, said that she was pleased concerns were being raised with NHS England. “People think if you take antidepressants they will make you happier,” she said. “But it’s such a strong drug and can have the opposite effect, and if you’re depressed and start feeling suicidal. If patients were told to look out for it, it might be a different story. She could have stopped taking the drugs. I hope it will contribute towards this not happening in the future.”
March 17 2014
A recent study carried out by Liverpool University revealed that over a third of those taking antidepressants reported having suicidal thoughts as a result.
The study was carried out in New Zealand, and all of the 1829 participants had been on antidepressants in the last five years. Each person completed an online questionnaire which asked about 20 adverse effects. The survey factored in people’s levels of depression and asked them to report on how they had felt while taking the medication.
Over half of people aged 18 to 25 in the study reported suicidal feelings, and in the total sample there were large percentages of people suffering from ‘sexual difficulties’ (62%) and ‘feeling emotionally numb’ (60%). Percentages for other effects included: ‘feeling not like myself’ (52%), ‘reduction in positive feelings’ (42%), ‘caring less about others’ (39%) and ‘withdrawal effects’ (55%).
Psychologist and lead researcher, Professor John Read (right), from Liverpool University’s Institute of Psychology, Health and Society, said: “The medicalisation of sadness and distress has reached bizarre levels. One in ten people in some countries are now prescribed antidepressants each year.
“While the biological side-effects of antidepressants, such as weight gain and nausea, are well documented, the psychological and interpersonal effects have been largely ignored or denied. They appear to be alarmingly common.”
Professor Read concluded: “Effects such as feeling emotionally numb and caring less about other people are of major concern. Our study also found that people are not being told about this when prescribed the drugs.
“Our finding that over a third of respondents reported suicidality ‘as a result of taking the antidepressants’ suggests that earlier studies may have underestimated the problem.”
February 26 2014
78-year-old Northamptonshire farmer and ex-haulage company owner Donald Knight and his 77-year-old wife Margaret were described as “a couple who loved each other’s company.” They were said to be devoted to one another and enjoyed going on 3-month cruises.
And yet, on Margaret’s birthday, May 1st last year, Donald shot her dead with a rifle, then shot their dog, before shooting himself with a shotgun.
Yesterday’s inquest heard that Donald thought that he had cancer, and that he was in financial trouble, neither of which were true. On a visit to his GP in the previous month, Donald told her that he had trouble sleeping and he was feeling low and unable to manage the farm. Donald was prescribed antidepressants.
Summing up the inquest, Coroner Anne Pember completely ignored the possibility that Donald’s actions may well have been the result of an adverse reaction to his medication, when she said: “I believe when Mr Knight was feeling low and depressed, not only did he take his own life, I believe he made a decision that his wife, of whom he was the main carer, that she should die as well on her birthday.”
February 21 2014
Former hotel manager Claire Turpin (right) longed to have children but had struggled to conceive. Eventually, at the age of 42, and after lengthy fertility treatment, she gave birth to twins Jack and Eliza.
Although Claire looked after the children to an ‘extremely high standard’, she developed an irrational belief that she was not good enough to care for them. Her GP prescribed antidepressants, and she was subsequently referred to a mental health team after talking about self-harming.
Three months after the birth, Claire jumped from the top of the multi-storey car park at John Lewis in Sheffield.
At Claire’s inquest this week, her mother Kath Sugden rightly criticised the medical support that her daughter was given, telling the hearing: “All that happened was that Claire went to the doctor and came home with another batch of tablets.”
Recording a suicide verdict, Sheffield coroner Julian Fox said that while treatment was ‘ultimately ineffective’, he believed it was offered ‘promptly and appropriately’.
I would suggest to the coroner that treating post-natal depression with antidepressants is not appropriate. As I have mentioned elsewhere on this site, PND is completely different from clinical depression, and should not be treated as such. And, although the number of young mothers who take their lives continues to grow, I am still yet to find a single inquest where the suicide of a young mother was attributed to unmedicated post-natal depression.
January 30 2014
Lee Bonsall (left) returned from Afghanistan in October 2006, traumatised by a tour of duty in which his best friend had been killed. He took sick leave and requested early release, but was asked to “stick it out” for another 6 months. Lee was not assessed until May 2007, when an MOD psychiatrist concluded that Lee did not have PTSD, but was nevertheless classed as “temporarily unsuitable.” Lee was administratively discharged 4 months later after attempting self-harm.
Lee moved from Nottinghamshire to Tenby after meeting his Pembrokeshire-born wife Serena. He took a job as a sales assistant in a local supermarket.
Shortly before his death, Lee visited a local GP as he was suffering from a low mood. Therapy was considered “unviable” as there was a 10-month waiting list, and Lee was given a repeat prescription for Citalopram.
On March 3 2012, Serena found Lee hanged at their home. He was just 24 years old. At today’s inquest, Pembrokeshire coroner Mark Layton recorded a narrative verdict, and is to ask for a review of mental health procedures for soldiers. The coroner will also petition the Minister for Health over “the practice of allowing repeat prescriptions for the antidepressant drug Citalopram.”
Serena (right, with Lee) appeared last July in the BBC Panorama documentary Broken by Battle. My article which followed the programme featured a number of ex-soldiers who had taken their lives after having been prescribed antidepressants.
Prescribing antidepressants for PTSD does not comply with NICE guidelines, and many specialists agree that it is likely to do more harm than good. For somebody who is recovering from traumatic experiences, exposure to mind-changing medication can have tragic consequences.
Serena is at present raising money for Combat Stress, the Ex-Services Mental Welfare Society.
January 22 2014
Peter Gøtzsche (left) is a prominent medical researcher, and leader of the Nordic Cochrane Centre in Copenhagen. He is a specialist in internal medicine, and has been researching antidepressants for several years.
He recently wrote an article in which he set out to dispel a number of the most erroneous myths about medicating depression, which he said were “harmful to patients”:
Myth 1: Your disease is caused by a chemical imbalance in the brain
Myth 2: It’s no problem to stop treatment with antidepressants
Myth 3: Psychotropic drugs for mental illness are like insulin for diabetes
Myth 4: Psychotropic drugs reduce the number of chronically ill patients
Myth 5: Happy pills do not cause suicide in children and adolescents
Myth 6: Happy pills have no side effects
Myth 7: Happy pills are not addictive
Myth 8: The prevalence of depression has increased a lot
Myth 9: The main problem is not over-treatment, but under-treatment
Myth 10: Antipsychotics prevent brain damage
Peter explains just why each of these myths is so harmful in the full article, which can be found at the website of Dr David Healy, one of the world’s leading experts in psychiatric medication. It is well worth reading.
January 21 2014
Andrew Phrydas (right), 23, a talented artist and car enthusiast, was killed last June at Finsbury Park tube station when he was struck by a Piccadilly Line train after running into a Victoria Line tunnel.
The London Evening Standard revealed today that, at an inquest in November, Transport for London (TfL) was criticised by a coroner after staff had switched the power off on the Victoria Line but not on the Piccadilly Line, which runs alongside and intersects the other.
In March 2012, Andrew had been treated at mental health units at before he was discharged in April and received care at home. On the day of his death, Andrew was travelling to Ilford to buy a car. At Finsbury Park, a passenger became alarmed that Andrew was about to jump in front of a train and tried to pull him back from the platform edge.
Andrew’s family believe he ran away because he feared he would be re-admitted to a secure mental unit. They insist he was not a suicide risk. The inquest heard that a member of staff had shouted to the man: “Let go of him, the power is off. The trains have stopped.” His father Chris said: “Andrew must have heard that the power was cut off. The question is: why did he go into the tunnel? Andrew was not a stupid person.”
Andrew’s 25-year-old sister Andrea said that the actions of TfL and the NHS had “dealt Andrew an injustice”. She said: “I see them as being both to blame.”
Another sister, Niki, 29, who is a counsellor, said: “I hope that other young vulnerable individuals who may be going through a completely normal difficulty within their life gain an awareness from this story that antidepressants carry with them adverse side effects which can considerably worsen how you feel.”
The inquest jury returned a narrative conclusion and said that Andrew’s intentions were “unclear at the time of his death.”
January 14 2014
An inquest heard today that a retired police inspector from Devizes, Wiltshire, shot his ex-girlfriend with a shotgun before turning the gun on himself.
Bill Dowling (left), 59, had struggled with grief following the death of his mother in 2011 and had separated from Mrs Victoria Rose, a 58-year-old Ministry of Defence assistant and mother-of-two, in the following year.
Concerns had also been raised about Mr Dowling’s performance as one of the “highest paid” senior civil servants working in the local MoD office. On February 12 2013, three weeks before the shootings, Mr Dowling visited his GP and was signed off work with depression and insomnia. He was prescribed antidepressants, which he had stopped taking by the time he attended a follow-up appointment on February 22, when a sleeping tablet was prescribed.
He revisited the GP’s surgery on February 25, accompanied by Mrs Rose (right), and enquired about being admitted to hospital, but the GP decided that it was not appropriate.
The day before the deaths, on March 1, Mr Dowling attended another appointment with the GP and was prescribed a different antidepressant.
That evening, Mr Dowling drafted three messages in his mobile phone – two to Mrs Rose and one to another friend. Each read: “Tablets driving me mad. Can’t go on. Please tell boys to forgive me. Tell police I’m in rear garden. Much love xxx”
At around 8 the following morning, he called Mrs Rose at home and asked her to visit him as he was coughing up blood. When Mrs Rose entered the porch, Mr Dowling shot her twice in the head, and, immediately afterwards, shot himself.
Toxicology tests showed Mr Dowling had not consumed drugs or alcohol before the incident, though he had a small quantity of an antidepressant in his system.
Coroner David Ridley ruled that Mr Dowling took his own life, with Mrs Rose killed unlawfully.
January 10 2014
Joanne Bingley died in April 2010 when she stepped in front of a train near her Huddersfield home. Her daughter Emily was just 10 weeks old.
At the inquest in October 2011, Joanne’s husband Chris had said that 39-year-old Joanne, a nurse with 20 years experience, was struggling to cope following the birth of the couple’s longed-for first child. Joanne was prescribed Prozac and sleeping pills, from which she later withdrew. Joanne’s post-natal depression escalated, and she told medics she wanted to end her life.
Chris and Joanne both felt that she should have been put in hospital, but a doctor had advised that Joanne would be better off being cared for at home. At the inquest, Chris said: “It is my belief that, if I had been provided with the information necessary to make an informed decision, my wife could well have been given appropriate care and treatment which would have prevented her death.”
After Joanne’s death, Chris set up the The Joanne Bingley Memorial Foundation, which aims to help women and their families by raising awareness and providing information about postnatal depression. Today, 45-year-old accountant Chris (right) is a single father. He went bankrupt and lost his home paying out half a million pounds in his fight for answers into his wife’s death.
This week, more than three years after the tragedy, South West Yorkshire Partnership NHS Foundation Trust finally admitted that Joanne may not have taken her own life if she had been offered a mental health facility during the time after Emily was born.
January 8 2014
The inquest into the death of David Rathband (left) concluded today with a verdict of suicide. David was the police officer who was shot and blinded by Raoul Moat, who had already wounded his ex-girlfriend and killed her new boyfriend on his release from prison. Mr Moat eventually shot himself in a stand-off with Police.
After the first day of the inquest, the Daily Mail report included a statement by David’s sister that, on the evening before David hanged himself, she had received a text from David’s wife in which she had written that: “she had just seen David and he was not eating and he had taken too much medication.” By the following morning, this sentence had been removed from the Daily Mail’’s online report, and did not appear in the newspaper version.
The only other local or national newspaper to mention medication that I found was the Metro, which said that David’s wife “last saw her husband the evening before he died and found him looking ‘awful’ having hardly eaten and taken too much medication.”
Raoul Moat (right), incidentally, had had his prescription of antidepressants withdrawn before he was released from prison.
January 7 2014
Denmark’s health agency, Sundhedsstyrelsen, has decided to make it harder for doctors to prescribe antidepressants to 18 to 24-year-olds following the suicide of a young man.
In 2011, Danilo Terrida (left), 20, a naval student, hanged himself eleven days after he was prescribed Sertraline following an eight-minute-long telephone conversation with a doctor. The doctor failed to arrange a follow-up appointment, and was found responsible for Danilo’s suicide by the National Agency for Patients’ Rights and Complaints.
From now on, young patients will have to face an assessment and an in-depth conversation with a doctor before antidepressants can be prescribed.
“Along with the Danilo case, there have been other cases that we, as the oversight authority, are not satisfied with. That is why we are now tightening the rules for this vulnerable group,” said Sundhedsstyrelsen spokesperson Anne Mette Dons.
The case has sparked a debate about the dangers of psychiatric drugs, and in the newspaper Politiken, Peter Gøtzsche (right), medical researcher and leader of the Nordic Cochrane Centre at Copenhagen’s Rigshospitalet, wrote that antidepressants have caused healthy people to commit suicide.
“It is true that depression increases the risk of suicide, but antidepressants increase it even more, at least up until the age of 40,” he wrote.
He added that psychiatric medication often does more harm than good and that patients would often be better off without medication. “Doctors cannot cope with the paradox that drugs that can be useful for short-term treatment can be highly dangerous when used for years and even create the illnesses that they were supposed to prevent, or even bring on an even worse illness.”
January 6 2014
The Norfolk and Suffolk NHS Foundation Trust has paid an undisclosed amount to the family of Peter Bane (left) in an out-of-court settlement.
The inquest in 2011 heard that 47-year-old Mr Bane, a senior railway engineer from Happisburgh, Norfolk, originally sought assistance from his GP because he had suddenly developed very strong urges to take his life by walking in front of a train. His GP assessed that he was at a “very high” risk of self-harm and arranged for the psychiatric services to undertake an urgent assessment at Mr Bane’s home. However, a home assessment did not take place and instead Mr Bane was telephoned by the psychiatric services.
Mr Bane repeated that he felt unsafe at home and that he wanted to take his life by walking in front of a train. He requested to be admitted to hospital but his requests were refused and he was advised that he only required a change in his medication. Mr Bane attended the follow-up appointment on 15 February 2010, and was given an increase in his medication, but no further action was taken in relation to a hospital admission.
Mr Bane went to work on the following morning but left shortly afterwards and, with a suicide note in his pocket, walked in front of a train.