Jade, aged 15

JadeKosanlavit

Yet again, I find myself writing about the tragic self-inflicted death of a child that that is linked to, and in all probability induced by, the taking of antidepressants.

PortSunlight15-year-old Jade Kosanlavit (above) was a talented and hardworking schoolgirl who, on November 10th last year, sent a “goodbye” text message to friends and family saying she loved them, moments before running in front of a train at Port Sunlight station (right) on the Wirral.

ElaineCoganFollowing Jade’s death, the headteacher of Wirral Grammar School for Girls, Elaine Cogan (left), said: “It is with great regret and sadness that we learned of Jade’s death, she was a talented and hardworking pupil at the school. Jade was an articulate and gifted Year 11 pupil, popular with both pupils’ and staff alike. Jade had a strong friendship group at school and received strong and unwavering support at home.

“She had a great love of music and will be particularly remembered as a gifted musician. Jade was an accomplished player of three instruments, took an active role in school recitals and music evenings, and recently toured Austria to perform with music department. There is a strong sense of loss across the whole school.”

JadeKosanlavit1Six weeks before she died, Jade (right) took an overdose of paracetamol. She was then prescribed Fluoxetine, which she took until her death.

Jade attended meetings at school with the aim of getting her back into her lessons – particularly her favourite science and music classes. A mental health nurse who met with Jade three times said she spoke negatively about herself but held her relationships with her peers in high regard, saying friends would describe her as “loyal”.

Jade’s uncle Chris Proudman told the inquest that her family had concerns about the medication. He cited research which he said showed that Fluoxetine had an increased suicide risk of 64%.

Mr Proudman added: “I think the whole family just find it difficult to understand that medication with this increased risk of suicide as an outcome is still being given in spite of this sort of evidence suggesting that children or adolescents can be pushed over the brink.”

AndreRebelloCoroner Andre Rebello (left), however, told Jade’s family that he was satisfied that medication was prescribed in accordance with what is expected in child and adolescent psychiatry across England.

In making such a judgement, the coroner disregarded Clinical Guideline 28 (CG28), entitled Depression in Children and Young People, published by NICE in 2005.

NICE-CG28-1In Section 1.6 of this document, it states that: “Children and young people with moderate to severe depression should be offered, as a first-line treatment, a specific psychological therapy (individual cognitive behaviour therapy [CBT], interpersonal therapy or shorter-term family therapy); it is suggested that this should be of at least 3 months’ duration … If there is no response to a specific psychological therapy within four to six sessions, then review and consider alternative or additional psychological therapies for coexisting problems. Consider combining psychological therapy with Fluoxetine (cautiously in younger children).”

Although the coroner said that Jade was receiving “supportive therapy,” this was provided alongside the medication, whereas NICE stipulates that a specific level of therapy should be carried out for at least four sessions before Fluoxetine is prescribed.

Mr Rebello recorded a verdict that Jade took her own life while suffering from a depressive illness. He said: “I can’t say that without medication, this wouldn’t have happened. What I can say is that it happened in spite of the medication.”

The question needs to be asked: “In spite of” … or “because of”?

JadeKosanFlowers

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