This is an important article that should be shared with all parents, teachers, and individuals who work with youth…
Source: When a Child Dies by Suicide – Richmond Family Magazine
Research studies focusing on the critical patient safety are increasing. The flaws in the system and human factors are the main cause of adverse events. The complexity of the factors that contribute to health care risk required to deep through its analysis, in order to establish strategies for improvement in one of the key of quality dimensions .
The Iatroref study has been published online first this month in Intensive Care Medicine, the Journal of ESICM. In 31 French ICUs, the authors show that depression of professionals in intensive care units impacts negatively on the safety of the patient, increasing the risk of medical errors and adverse events.
The main objective of this study was to evaluate the potential association between factors such as depression, burnout, the culture of security and organizational characteristics of these units, and the occurrence of certain adverse events.
The authors show their results in how depression is a factor to take into account, not only because of its significant prevalence (18.8% of physicians and 15.6% in nurses), but by interacting significantly with a greater number of medical errors and adverse events (RR 2.07). Burnout is not related to increased medical risk and safety culture influenced limited in the occurrence of adverse events.
This article is an excerpt from the upcoming book: Journey’s End: Death, Dying, and the End of Life, written, compiled, and edited by Victoria Brewster, MSW and Julie Saeger Nierenberg, MA Ed with an anticipated release date of Spring 2015.
Our 17-year-old daughter and only child, Casey, was the center of our universe. Adopted from a Polish orphanage at fourteen months in 1991, she grew from a weak, underdeveloped infant into a beautiful, smart, popular young lady accepted at elite Bennington College in Vermont for the fall, 2008 semester. We had our challenges with her to be sure. She tended to be high-strung, headstrong,argumentative, and almost impervious to discipline. Repeated trips to therapists brought the same advice – she’ll grow out of it; just be tougher with her.
One weekend in January 2008, my wife and I had a big fight with her. There was yelling, crying, slamming doors, saying ugly things we didn’t really mean – in other words, a typical teenage power struggle. I left her in a puddle of tears in her room cursing me, practically counting the days until she went off to Bennington. She seemed to revel in the notion that she’d be free of us, but I didn’t take it personally. Just another teen mouthing off to her parents, trying to get under our skin. We were actually really proud of her for getting into such a great school.
My wife Erika and I retired to our bedroom, exhausted from the shouting and Casey’s seemingly endless wailing. Later that evening, I went to the kitchen for a glass of wine, passing her in the living room. She sat on the burgundy leather sofa, watching America’s Next Top Model, pounding away on her iBook, probably chatting with a friend about her despicable parents. We shot each other icy glares, saying nothing.
And that was the last time I saw her.
I awoke the next morning to find her room neat as a pin, but Casey was gone. On her desk was a note: The car is parked at the Golden Gate Bridge. I’m sorry. I froze. The blood drained from my face. A frantic search by the local police, California Highway Patrol, Golden Gate Bridge Patrol, and Coast Guard revealed events beyond our worst nightmare. Casey had driven to the bridge at dawn, walked out onto the span, hopped the four-foot railing and jumped. The world we once knew, the most precious person in our lives – our only child – was lost that morning. Her body was never found. I wanted my life to end that day. I couldn’t possibly survive this.
I thought that losing my father suddenly to pancreatic cancer several years before was the worst possible thing that could happen to us. His death left a huge void in our family. But nothing prepared me for the loss of my own child, and at her own hand. Dad’s death, by comparison, was a speed bump.
When you lose your child, it’s like a firestorm that destroys the very fabric of your life. When she was your only child, it’s as if you’ve completely lost your identity as a parent – something I’d yearned for more than anything in life. You are no longer the person you once were. There is an emptiness of mind, body, and soul. Death by suicide leaves you with a gaping wound that never heals, and an unbearable guilt from your failure to protect her from herself. When there are no remains to lay to rest there is never closure. You’re not supposed to lay your child to rest before yourself; it’s all out-of-order. For over six years since her suicide, I’ve drifted through life in a fog, partially dead and partially alive.
January 29th has become our personal 9/11. Life is now divided into the before and after. Before this happened, we never had a close encounter with suicide. We were vaguely aware that people leapt from the Golden Gate Bridge, but it was just a random thought. The bridge was nothing more than the blissful high point of my daily commute. Now it’s a reminder of my unspeakable loss as I pass the hoards of oblivious, smiling tourists, photographers, cyclists and joggers who only see the bridge as their spectacular postcard icon.
Longtime friends drifted away, seemingly pretending that Casey Brooks never existed. She was never discussed and remained the elephant in the room. Other friends, well-meaning as they were, believed that they could help us “get over it and move on.” Read this book! Listen to this inspirational tape! Say this affirmation! Seek your higher power! Know that she exercised her free will to advance to a better place! Then you’ll feel better. Unfortunately, none of them had lost a child and couldn’t grasp that the grief and guilt are your constant companions. Members of our church mostly turned away. Like everyone else they didn’t know what to say, so they said nothing. My minister remarked that in a way I’d become “holy”, which he believed could be either positive or negative. Personally, I’ve found “holiness” to be a terrible and isolating burden.
With a few exceptions, co-workers were equally silent until I confronted them to say something, anything. I completely disconnected from work. Money, things, status, career meant nothing to me anymore. About a year after Casey died, I was relieved to learn that my entire department at a major bank was let go in the financial meltdown that led to the Great Recession. I haven’t bothered to look for a new job since. After all, how would I handle the part of the interview when asked, “So tell me about your family.”
My wife and I were hesitant about social situations with new people. Idle cocktail chatter would inevitably turn to the elephant in the room. “So do you have any children?” To say no would mean to deny that our Casey never existed, but to explain what happened would invite blank stares and a quick excuse to use the bathroom, refill a wine glass, anything to escape the discomfort of listening to our story.
In addition to our army of therapists and buckets of anti-depressants to simply cope with the emptiness of life, we tried grief groups. Compassionate Friends is one such group, a fine organization for parents who’ve lost children. Erika and I sat in a circle with other broken parents listening to their stories. We were the only ones in the circle who had lost our teenage daughter and only child to suicide, just another reminder of how suicide is treated differently from boating accidents or illnesses, not that the other parents’ grief was any easier than ours. We looked for suicide survivor groups in Marin County where we live, but there were none.
It wasn’t until we joined an advocacy group, The Bridgerail Foundation, dedicated to erecting a suicide barrier on the Golden Gate Bridge, we found a community of others who’d lost children and loved ones to that bridge. But in making our story public, we became painfully aware of the lack of compassion or understanding of suicide and its victims. Meetings with Bridge Board members and state legislators were met with mostly more blank stares. The public draws a firm distinction between those who “want to die” and those whose death was unintentional. It’s a taboo subject, much like AIDS, rape, substance abuse and reckless driving. Suicide victims and their families are often blamed rather than consoled.
Ironically, while many of our own friends distanced themselves from us, Casey’s friends, to our surprise, stuck with us. They were clearly as devastated by her loss as we were, and volunteered everything they knew in an effort to understand why Casey – with so much to live for – would take her life. We swapped stories and pictures, many of which we were never supposed to see. We laughed together over their shenanigans, the same shenanigans I indulged in at their age. To this day we have an annual date – December 23rd – when we invite them to our house to be together, and each year we’re astonished to see 20 to 30 of them show up.
Everyone who has suffered a catastrophic loss of a child grieves and copes differently. Some have better coping skills than others. Many engage in activities to give meaning to their child’s life – foundations, advocacy, lobbying for new protective laws, speaking out to the public. I did much of that while writing a book. Published in February, The Girl Behind The Door is about my search for answers to Casey’s suicide. I work with a teen group in Marin County that speaks to high school and middle school students about vital mental health issues, such as depression and suicide. And the Bridgerail Foundation’s perseverance has finally paid off. After being treated slightly better than lepers for years we have succeeded in gaining approval for a barrier and funding. Sometime hopefully soon, the Golden Gate Bridge will no longer be the deadliest structure on earth for suicide.
We’ve also connected with another couple that tragically lost their daughter in the same way that we lost Casey. Gabriella was a high achieving “perfect daughter,” a senior at Redwood High School just like Casey. In August of 2013, she apparently snapped and jumped. As heartbreaking as it has been to see her parents in so much pain, we can bring our experience to bear where others in their lives cannot. When asked how to handle suicide survivors, my advice is:
- Don’t try to fix them. They just want you to listen.
- Don’t say you know how they feel if you haven’t experienced their loss.
- If you know their loved one tell them that you miss them too.
While these activities have been a welcome distraction to my grief, I still find myself seeking yet more structure in a life I still find empty. Without my Casey there is still little to look forward to. So dealing with grief becomes, literally, a matter of taking one hour and one day at a time.
I’ll never have another Casey, and I look forward to the day when I can rejoin her on the other side. But make no mistake. Despite the difficulties of adopting and raising her and the pain of her loss, I feel like the luckiest guy in the world to have been Casey’s dad.
John Brooks, Father; His blog is: http://parentingandattachment.com/
A special thank you to John for allowing us to publish this excerpt.
by Victoria Brewster, MSW & Julie Saeger Nierenberg, MA Ed
by Victoria Brewster, MSW
Thanks to LinkedIn, I came across an article on Grief/Bereavement and Depression in the NY Times. As a professional with an MSW, this article causes me to pause and to express concern. Grief/Bereavement is normal after the death of a loved one. As one who works with older adults, I have experienced the reality for many older adults, after a certain age it is more likely, that one is faced with death on a regular basis.
Depression has been underdiagnosed in older adults. When one’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? The DSM-IV clearly distinguishes between normal and expected grief after loss from the more persistent and severe symptoms of clinical depression.
Grief usually runs its course within 2-6 months and typically does not require treatment with medications. Those suffering from grief report symptoms that are also symptoms of major depression; sadness, tearfulness, insomnia and decreased appetite. But, researchers have noted, grief rarely produces the symptoms of depression, such as low self-esteem or feelings of worthlessness.
“Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.” – Eric Widera, Geriatrician
The 5th edition of the DSM , which is due out this year, would characterize bereavement as a depressive disorder.
In removing the ‘bereavement exclusion’, the DSM-5 encourages clinicians to diagnose major depression in persons with normal symptoms of bereavement after only 2 weeks of mild depressive symptoms.
This gives me the feeling that depression may become overdiagnosed and anti-depressants overprescribed for what should be ‘normal’ grief. What are your thoughts on this?
“Up to one in three people who have a stroke develop depression,” states Dr. Amytis Towfighi, a member of the American Academy of Neurology.
I came across this article from an Aging newsletter I receive.
WebMD states in an article from December 31, 2012 that: “Now, a new study suggests that rather than being a cause of memory decline, depression in older people may be an early symptom of dementia.”
This makes one pause and think.
The article further states, “The new research shows that having mild cognitive impairment along with depression doubled the risk of developing full-blown dementia.”