"When we came to update the strategy a few years ago, the Government wanted as few changes as possible." - UK's leading Suicide Prevention expert, Louis Appleby
I've previously written about the UK's leading Suicide Prevention expert, Louis Appleby,
here. It's important you read my previous post first, particularly if you are unfamiliar with the issues raised.
Appleby had been embroiled in controversy after he seemingly joined forces with former UKIP press secretary, Jasna Badzak. Appleby had retweeted Badzak's claim that drug safety advocates enquiring about iatrogenic deaths and akathisia are nothing more than,
"a dangerous cult".
He has since removed the offending post from his timeline but offered no apology to those he offended.
Appleby has also been repeatedly asked by drug safety advocates on both Twitter and via email to investigate
iatrogenic deaths. He's either ignored these requests or blocked those asking the question.
Patient advocate, Dee Doherty, 43, Wexford, recently emailed Appleby and the correspondence is jaw-dropping.
Dee has kindly passed on the emails to me and they are published here for the first time.
Appleby can complain that they are private emails if he wishes but he is a public figure and the public has a right to know his claims regarding antidepressant use, suicide prevention and the UK government.
What is immediately striking, to me at least is that Appleby passes the buck and asks a patient advocate to do what he should be doing. Maybe I'm misreading what he is relaying to Dee Doherty in these series of emails, but you can be the judge.
It is also striking his final admittance, albeit privately, that SSRIs can cause akathisia which, in his own words,
"can make people feel desperate and suicidal." If this is the case then why is he advising a patient safety advocate to contact the departments he should be contacting?
Contrast his private statement to Dee to the one he made publicly in the
Suicide Prevention Interim Report (2016-17)
“Whilst we heard concerns in some written submissions about the role of drug treatments and suicide, the evidence we heard from Professor Louis Appleby, Chair of the Government’s suicide prevention advisory group, and Professor Carmine Pariante of the Institute of Psychiatry was that there is greater risk from not using medication where appropriate, provided that this is following evidence-based guidelines.”
Did Appleby raise the issue of akathisia back then or, indeed, did he stress that akathisia
"can make people feel desperate and suicidal."?
Reading through the 26-page draft it appears that neither he or
Professor Carmine Pariante raised the issue of antidepressant-induced akathisia making people feel desperate and suicidal.
Pariante, in 2017, claimed that he told Suicide Prevention Interim Report committee members,
"In a nutshell, there is evidence that some antidepressants may increase the risk of suicidality, especially in children and adolescents, but there is no evidence that antidepressants increase the risk of suicide, neither in adults nor in children and adolescents." Parianted added,
"Suicide is the act of purposely ending one's life. Suicidality is a set of thoughts and behaviours that are related to suicide but are less likely to be lethal; it includes thoughts and preoccupations about suicide as well as acts of self-harm such as cutting." (
Source)
Bizarrely, in 2019 Pariante told me in an interview,
"I accept that it is possible that some patients might have died as a consequence of taking antidepressants, and my heart goes to them and to their families." (
See here)
Louis Appleby
Why is Appleby saying one thing behind closed doors (in a private email) and another thing publically? Why is he blocking patient safety advocates on Twitter who raise the issue of antidepressant-induced akathisia? Could it possibly be that he doesn't want to talk about this issue under public scrutiny because he will be asked why he is, seemingly, failing to reduce the UK's suicide statistics?
Appleby needs to open up to the government and the public about his stance on antidepressant use. He needs to publically declare what he has told Dee Doherty in the series of emails below. Because he hasn't, I feel I should. Keeping akathisia and antidepressant-induced suicides 'in-house' shows signs of incredible weakness. It also puts the public at risk.
I'd like to take this opportunity to thank Dee Doherty for passing the correspondence on to me so we, the public, can finally get a window into how the UK government and, indeed, Louis Appleby, are steering the ship, or not, as the case may be.
We should all applaud patient advocates like Dee Doherty. Her tenacity in getting to the truth is highly commendable and by going public she is very brave.
*
Emphasis has been added by me in some of Appleby's email replies.
Here are the emails...
--
Deirdre Doherty <xxxxxxxxxx@gmail.com>
Mon, Sep 23, 2019 at 7:10 PM
To: Louis.Appleby@manchester.ac.uk, rebeccahilsenrath@equalityhumanrights.com
Dear Professor Appleby,
I am writing to you and the Human Rights Ombudsman regarding your position as UK Head of Suicide Prevention and how, as the Head of Suicide Prevention in the UK, a paid Public Official, Informed Consent and Human Rights laws must pertain to the role.
Where a Head of Suicide Prevention must be aware that likely over 500 medications including SSRIs, antipsychotics, some antibiotics, acne medications, heart medications – and in rising prescription rates for these drugs can cause the Adverse Drug Effect akathisia which can cause self-harm or suicide even in healthy people, I am providing some literature on akathisia for others who may be less well versed.
Further, at a time when ADRS more generally are the 4th leading cause of death ‐ in hospitals alone and where there is someone to observe.
www.einnews.com/pr_news/496883426/international-akathisia-awareness-day-spotlights-criticaladverse-drug-effects
rxisk.org/akathisia
rxisk.org/500-drugs-that-cause-depression-and-suicide-aka-akathisia/
https://missd.co/
https://missd.learnupon.com/users/sign_in?next=%2Fdashboard
Briefly, I am a former teacher, published writer, and a potentially litigating Seroxat victim now disabled.
Prior to a needless and catastrophic prescription for Seroxat in 1999 in Belfast, I was healthy, generally happy by nature, well educated, highly qualified and highly ambitious.
As pertains, I suffered from akathisia a few times without warning & almost lost my life to it. Twenty years later my stepdaughter, a teenager, was prescribed Sertraline – also without Informed Consent to her parents regarding the possibility of akathisia – much less what to do that may save her life in this event.
Non-blood related, you can imagine my horror to see the child agitated, pacing, waling, unable to sit still or even in the same room, and demanding her parents help her kill herself: after missing one pill.
Both bewildered parents witnessed this “scare”.
It took me some time to process. Not least that 20 years later this could happen, and to a child, without warning nor remotely adequate training in doctors to recognise this potentially life-threatening, under-recognised Adverse Drug Effect.
To be clear, I am not in any way anti‐medications. This is often claimed, of many apparent tactics, to avoid addressing critical evidence-based issues costing lives.
After suffering many horrific Informed Consent and Human Rights abuses which caused irreparable damage to me as a young adult, I am however Pro-Informed Consent and Human Rights as established in UK Courts, Supreme Courts, and in accordance with Medical Council Directives. And as I would have assumed a Head of Suicide Prevention would be also.
Yet I believe both the UK Head of Suicide Prevention and the Head of the Royal College of Psychiatrists have repeatedly refused to answer a respectfully made simple Informed Consent and Human Rights question by Bob Fiddaman and Kristina K Gerhki, who lost a child to iatrogenic suicide, as to whether SSRIs can cause self-harm and suicide?
Other bereaved parents are compassionately respected by you.
I am dismayed that the leads in Suicide Prevention are happy to allow preventable deaths, and in children, to a rarely warned of, under-recognised, but treatable Adverse Drug Effect of likely 500 medications.
The continued negligence and, despite the evidence, appeals to reason and humanity, are surely bordering on intent at this stage and in rising rates of self-harm and suicide in the young.
Further where there exists a Free Accredited Course in Akathisia to reduce preventable deaths to akathisia for doctors, psychiatrists, parents, carers, patients. And where patients, some doctors and some trainee doctors have said to the Royal College that they would like to be more educated in this ADR towards saving lives and preventing misdiagnosis.
Also, a time when severe withdrawal from SSRIs, which alone raises the risk of suicide beyond the raised risk of akathisia, has now been somewhat recognised in the UK.
Beyond the wilful refusal of a Head of Suicide Prevention to answer a simple Informed Consent question respectfully made to him many times by a mother bereaved to iatrogenic suicide, adding to her suffering as you have added to mine, and that of many other Informed Consent and Patient Safety advocates, a new low in professionalism, ethics, and morality was also reached yesterday.
On a post by the UK Head of Suicide Prevention on Twitter yesterday, it was alleged that it was not owing to the topic that you blocked so many valid and well-evidenced concerns about what you were doing to prevent iatrogenic suicides also. But that you had done so as you wished to protect distressed bereaved parents (excluding the iatrogenically bereaved), for abuse & harassment (of you presumably), their behaviour.
I personally believe that avoiding critical issues and valid evidence-based concerns regarding a known cause of self-harm and suicide which is not being responsibly addressed in rising rates of self-harm and suicide rates, by pitting bereaved parents against bereaved parents is unconscionable. I don’t know what you were referring to but I believe this allegation was well addressed by others in other relevant threads.
Sufficiently distressed and concerned for my teen stepdaughter, neither did I engage in any of the behaviours you have used as an excuse to block me and my concerns also I assume.
I hope a Court may consider any anger and dismay at your refusal to recognise Informed Consent and Human Rights laws or to do anything to also help prevent Iatrogenic suicides in rising rates of suicide and under your remit, regarding your role and behaviour, as legitimate.
Both my stepdaughter and I were only lucky to have survived akathisia.
We are just one family.
With likely over 500 medications which can cause akathisia or drug-induced suicide and in rising prescription rates for these drugs, I, like too many who suffered this torture, remain kept awake at night wondering God knows how many people, including children, you are allowing to die agonising preventable deaths every day – correlative with accessed data and Independent Evidence-Based Studies, data from many Independent sources.
Up to eight people will be heavily impacted by every suicide. And further for families of iatrogenic suicide by no validation, no compassion nor support for people like Dr Peter Gordon by his own colleagues. Nor for Antony who died after suffering from akathisia and severe withdrawal from Seroxat. Nor for his bereaved mother burying him next week and who had requested recognition.
https://holeousia.com/2019/09/04/antony/
Further to blocking me and others with valid complaints and concerns for other families, you then justified doing publicly so by posting a tweet from a woman (had you done your research) who had been reported for wilfully misrepresenting and abusing an iatrogenically disabled Senior Citizen recognised Patient Safety Advocate.
Not least as “anti‐medicine”, “the Leader of an Anti‐Medicine Cult”, a “Scientologist”, “bots”, “stupid”, “idiots” etc, for many weeks before the Head of Suicide Prevention in the UK decided to repost this woman’s attitude towards bereaved and harmed Informed Consent and Patient Safety advocates with valid and well-evidenced concerns on his own account. And as justification for his own misleading and shameful behaviour.
This woman had been fact-checked regarding medical myths she perpetuated and regarding false allegations made to no avail and had been reported a week prior. I am unsure if she remains a convicted fraud.
More generally, you will be more than aware that the disabled, including the iatrogenically disabled, are also at greater risk of suicide.
You will also be well aware that disbelief, invalidation, stigma, social isolation, and marginalisation, re‐victimisation, particularly by trusted bodies, also raises suicide risks. Further where many have already suffered disability owing to a lack of Informed Consent, inadequate concerns for Patient safety, loss of career, relationships, finances, trust ‐ already raised known suicide risks.
In rising rates of self-harm and suicide in the young, many contributory causes, of course, no doubt, common sense and your job would dictate that all causes of self-harm and suicide must be considered and that the aim must be to reduce self-harm and suicide and iatrogenic self-harm and iatrogenic suicide if rates are to be reduced.
Avoiding this long-overdue critical issue causing preventable deaths any longer, whatever the motivation, must by now surely be bordering on Human Rights abuses: if it didn’t already. Not least akathisia, no one immune, Russian Roulette, is recognised as a form of mental torture.
Common sense and compassion would also dictate that all bereaved parents, all traumatised survivors of suicide attempts, be they non-iatrogenically or iatrogenically caused, are afforded equal compassion and equal rights.
Our confusion and despair, on the evidence, and well over twenty years after well-documented warnings of akathisia risks and of withdrawal risks extend to despair for science, humanity, human rights, the “caring” profession with a duty of care.
We will have to continue, unpaid and both my stepdaughter and I now on Disability, grateful and indebted to the extraordinary hard work of so many organisations and advocates you ignore, or you have blocked, for saving my own life from iatrogenic suicide. And for educating me sufficiently to be able to educate the parents of my stepdaughter where her doctors did not, of the risk of akathisia ‐ and what we should do in this event.
Where Informed Consent and Human Rights laws exist, it was already a terrible indictment on you that we and so many affected and bereaved feel compelled to do so at all.
I trust we may be afforded a response where distress has already been caused ‐ and specifically to each issue raised here.
If not and whatever the motivation of a Head of Suicide Prevention may be to refuse to also help to prevent the needless loss of life, including children’s lives, to an under-recognised but treatable ADR of hundreds of common medications, it cannot be the case that you are above Informed Consent laws, Human Rights laws, Medical Directives, or your paid for by the public job description.
As this issue should be paramount in many declared Public Health Crises and in rising self-harm and suicide rates, I hope there will be an enquiry regarding potential Human Rights abuses and that this may be found. And where you do use your Twitter account to keep the public abreast of Suicide related issues and Suicide Prevention news.
Yours Sincerely,
Deirdre Doherty
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Mon, Sep 30, 2019 at 10:30 AM
To: Deirdre Doherty <xxxxxxxx@gmail.com>
Dear Mrs Doherty
I want to let you know I’ve deleted that tweet, given your concern about it. After all, my comment on it was actually about ensuring a positive atmosphere on my timeline.
I can assure you the safety of antidepressants is seen as an important issue in suicide prevention.
Caution over suicide risk is in NICE guidance and the
side effect of restlessness is referred to in the national suicide prevention strategy.
With best wishes
Louis Appleby
--
Deirdre Doherty <xxxxxxxx@gmail.com>
Mon, Sep 30, 2019 at 11:43 PM
To: Louis Appleby <Louis.Appleby@manchester.ac.uk>
Dear Professor Appleby,
I, with great distress caused to my family and others, no responsibility taken; no apology; no addressing all the issues; no unblocking (unless you have evidence that I was distressing bereaved families, harassed and abused bereaved families – or you?) Will I at least be reassured that you don't think of myself and my teen stepdaughter (aware that I was reaching out to you with her concern for herself and for others after her experience of missing one Sertraline pill) and of others - as part of a "dangerous cult"?
More crucially, I do not understand your response on the far more critical issue of akathisia at all, particularly in rising rates of Self Harm and Suicide?
This remains urgent, and for my family:
Despite the fact that I was a Study 329 victim, the mother of my teen stepdaughter thinks I'm a Conspiracy Theorist.
The child is now withdrawing, not with me, and I am very concerned after her previous experience upon missing one pill - already related to you in my letter.
Can SSRIs (along with many other medications) induce death by self-harm so the teen’s mother may take it from you, whom I had sought confirmation from?
I don’t want to have to keep asking this valid question also.
Please imagine if it were your child.
Sincerely,
Deirdre Doherty
--
Deirdre Doherty <xxxxxxxxxx@gmail.com> Tue,
Oct 1, 2019 at 12:55 PM
To: Louis Appleby <Louis.Appleby@manchester.ac.uk>
Dear Professor Appleby
My apologies, I neglected to request where "restlessness" as a side effect appears and regarding SSRIs, in the Govt Suicide Prevention Strategy and this has been requested by others.
As I struggle with cognitive impairments direction or sharing would be great. I am very confused and with different information from the FDA in 2007 and Montgomery Informed Consent Laws.
Thank you and for any appreciation of our family circumstances,
Deirdre Doherty
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Wed, Oct 2, 2019 at 7:19 PM
To: Deirdre Doherty <xxxxxxxx@gmail.com>
Dear Mrs Doherty
Thanks for replying. I want to try to answer your questions in the most helpful way, so it makes sense to start with my understanding of the main issue you have raised.
SSRI antidepressants can cause akathisia. I have seen many patients with akathisia, caused by different drugs, and
it is an extremely unpleasant condition that at its most severe can make people feel desperate and suicidal.
It's hard to estimate how often it causes suicide or self-harm, partly because what makes people suicidal is often a mixture of problems - it is rarely caused by one thing. However,
the risk is sufficiently concerning for us to be cautious at all times, especially when starting or stopping treatment.
It's essential that the doctor who prescribes SSRIs should inform the patient about this risk, as you say, though
I do understand that doctors don't want to put a patient off taking treatment & getting the balanced message of risks and benefits right can be hard.
On the national suicide prevention strategy, I need to explain a little of the background.
When we came to update the strategy a few years ago, the Government wanted as few changes as possible. We were keen to add something about antidepressants after hearing from families who felt strongly about this and
we thought it was best done in the section on treatment of depression in primary care which was mainly about the risks of getting no treatment. So we added a line to the key messages of this section, as follows:
"There are also risks in the early stages of drug treatment when some patients
feel more agitated." (page 27).
This may not sound a lot but at the time it seemed an important and unusual acknowledgement to appear in a Government strategy.
We used "agitated" because it was a document for the general public rather than clinical guidance for doctors - that's the job of NICE - or information for patients, which is overseen by the regulator, the MHRA. Current NICE guidance says something more specific about the need for careful monitoring in the early period of treatment, especially in younger people, because of suicide risk.
I'm sorry to hear about the difficulties your step-daughter has faced. If she has had severe akathisia on withdrawal,
it's an important point of safety to withdraw more slowly, to avoid the distress I've mentioned.
Most people can come off antidepressants if it's done over the right time period, and that can vary for different people.
I hope I've answered what you were asking about your step-daughter but if I've misunderstood please feel able to come back to me. Of course, I've "unblocked" you - happy to do this - but being in touch by email is a lot better than twitter.
With best wishes
Louis Appleby
--
Deirdre Doherty <xxxxxxxxxxxx@gmail.com>
Fri, Oct 4, 2019 at 4:04 PM
To: Louis Appleby <Louis.Appleby@manchester.ac.uk>
Dear Prof. Appleby,
From what I can understand, and of UK legislation, especially as akathisia is an adverse drug effect of so many increasingly prescribed medications and as suicide rates may be reduced with greater awareness both of the signs of suicide and of the signs of akathisia, would you kindly support an Informed Consent & Patient Safety petition regarding the material risk of akathisia?
The petition would go something like this:
We, the undersigned, were aghast to learn via recent communication with Prof. Louis Appleby, a UK Suicide Prevention expert, that the government are restricting safety information in suicide prevention strategies. We find this incomprehensible, given the admittance by Prof. Appleby that "SSRI antidepressants can cause akathisia." Adding further, "it is an extremely unpleasant condition that at its most severe can make people feel desperate and suicidal."
Do we have your backing on this, Prof. Appleby?
Thanks for taking this very seriously,
Deirdre Doherty
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Wed, Oct 9, 2019 at 6:43 PM
To: Deirdre Doherty <xxxxxxxx@gmail.com>
Dear Mrs Doherty
I'm approaching this in a slightly different way but I hope it's helpful.
The problem of petitioning the Government is that they will see this as a clinical issue, something that falls within NICE's independent remit.
I think it would be better to go direct to NICE - they are the main source of guidance to GPs and other health professionals. I've been in touch with them about the best way for you to do this, as they are still working on their depression guideline.
NICE depression guidance currently advises careful monitoring when people, especially young people, first start antidepressants because of suicide risk
but it doesn't link this risk to agitation or akathisia. The depression guidance for children & adolescents, 18 & younger, is very cautious about the use of antidepressants at all and stresses the importance of patients being fully informed, and keeping a written record of this.
Given the points you've raised with me, your request to NICE could be that (1)
it could include a reference to agitation/akathisia as a warning sign of suicide risk (2) the recording of informed consent
could be extended to cover young adults in the adult guidance.
One way to do this is to write to NICE at this email, either personally or via any organisation you work with, to say that you want to provide information about safety:
DepressionInAdultsUpdate@nice.org.uk
The other thing is to open a NICE account to receive information & comment on guidelines when they are out for consultation. Link here: https://accounts.nice.org.uk
It may sound a bit bureaucratic but all this is part of
NICE being strictly independent, doing everything by the book.
If you find you aren't getting the right response, come back to me & I'll contact them again.
With best wishes
Louis Appleby
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Thu, Oct 10, 2019 at 10:49 AM
To: Deirdre Doherty <xxxxxxx@gmail.com>
Dear Mrs Doherty
I meant to add that the other way to approach this is via the Royal College of General Practitioners who oversee training for GPs. They are the main prescribers of SSRIs and
getting your messages into their training would reach a lot of people. Let me know if you want to follow this up.
I'm conscious this is taking you into the way the various national health care bodies work & that can seem complicated if it is unfamiliar. Come back to me if you want me to clarify any of this.
With best wishes
Louis Appleby
--
Deirdre Doherty <xxxxxxxxx@gmail.com>
Thu, Oct 10, 2019 at 4:28 PM
To: Louis Appleby <Louis.Appleby@manchester.ac.uk>
Dear Professor Appleby
Thank you for all these different suggestions to follow up. Yes, I am understandably confused about how these different processes work but I’m happy you will help me help others be more aware of the suicide risks related to akathisia. My family was left in the dark and we are lucky we survived akathisia at its worst.
It’s not good for me or our efforts that I appear like a lone wolf in wanting to clearly communicate akathisia and the big differences between akathisia and agitation. I would feel more comfortable following up on your suggestions if I can talk with someone who is already familiar with your previous efforts to add akathisia to the national suicide prevention strategy. Can you please give me the names and contact info of those who you previously spoke with when you tried to make these changes so I can also seek their support?
Akathisia awareness has really increased since you last worked with the government to add akathisia info and related suicide risks to the national strategy. I don’t think the word akathisia should continue to be left out because of some out-dated, false assumption that it is too clinical a word for families to understand. I will do my best to work with you and other professionals in this field to make these needed changes to the national strategy, to NICE and to all doctors’ training. Other families need to be better informed than my family was.
I feel sorry that you’ve received so much negative flak on Twitter given that I now know you made previous efforts to include akathisia risks in the national strategy. I think the best way forward is to petition the government and include the dilemmas you faced when trying to improve suicide prevention strategy. If the public can see the government are not supporting a suicide prevention expert, more people will probably support a petition. Also, since I’m still suffering from adverse drug effects, I’m hopeful a petition will bring new people with different skills who can work with us towards these goals.
Best wishes,
Deirdre Doherty
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Thu, Oct 17, 2019 at 10:43 AM
To: Deirdre Doherty <xxxxxxxxx@gmail.com>
Dear Mrs Doherty
Sorry not to reply before now, I've been away.
To clarify, the Government doesn't make decisions about clinical practice or training. It delegates these issues to expert bodies that are independent and have the necessary expertise. NICE are the body that puts out clinical guidance to health professionals. Royal Colleges oversee training. These are the organisations that can change practice in the way you want.
It was quite unusual for the national strategy to include a specific clinical point. In that sense the Dept of Health supported me, it wouldn't be correct to suggest otherwise. A national strategy is an overall statement about the importance of an issue such as suicide prevention, intended to support and inform the NHS, local authorities, etc. It doesn't instruct them on what to do - that is decided in each local area.
I can see you would like to influence the Government on the issue of akathisia but their response is likely to be that this is the role of NICE. Of course, it's your decision how to proceed - I'm just concerned you could put a lot of effort into pursuing this in a way that would, in the end, be frustrating for you.
In the meantime, I'll assume you want me to approach the RCGP, as I mentioned in my previous email, and I'll now do this.
With best wishes
Louis Appleby
--
Deirdre Doherty <xxxxxxxx@gmail.com>
Thu, Oct 17, 2019 at 4:10 PM
To: Louis Appleby <Louis.Appleby@manchester.ac.uk>
Dear Professor Appleby,
I will organise the Petition with my original wording.
Can you confirm in writing that you support the Petition or are you now saying the Government never imposed restrictions?
I'm confused.
We, the undersigned, were aghast to learn via recent communication with Prof. Louis Appleby, a UK Suicide Prevention expert, that the Government are restricting Safety Information in Suicide Prevention strategies. We find this incomprehensible, given the admittance by Prof. Appleby that "SSRI antidepressants can cause akathisia." Adding further, "it is an extremely unpleasant condition that at its most severe can make people feel desperate and suicidal."
We learned that the Suicide Strategy Plan is severely lacking in concise information. Prof Appleby, via correspondence, told us, "When we came to update the strategy a few years ago, the Government wanted as few changes as possible."
We urge the Government to rethink their stance and demand to know why they feel few changes are needed.
Best wishes,
Deirdre Doherty
--
Louis Appleby <Louis.Appleby@manchester.ac.uk>
Sun, Oct 20, 2019 at 8:24 PM
To: Deirdre Doherty <xxxxxxx@gmail.com>
Dear Mrs Doherty
I'm very willing to help but
there's a misunderstanding here about the role of the Government. It might help if I explained a bit more.
The Government at that time had a policy of supporting local independence, so it wasn't keen on national strategies which were seen as "top-down", ie telling local people what their priorities should be.
We did get agreement to relaunch the national suicide prevention strategy but it had to be an update, not a new strategy.
It's very important to know what a strategy like this is for. It is a broad statement of how we should approach a problem, it is not a detailed list of actions that people should take. Organisations like the NHS or local government are expected to respond by providing the detail for their staff.
It isn't the role of the national strategy to issue clinical advice to doctors - that is for NICE or the regulator, the MHRA.
So
the Government did not restrict safety advice or fail to support me. In fact, it went beyond its remit by allowing me to refer to the risk on starting treatment for depression after people had raised this with me. I told you about this so that you would know
that their concerns, which are similar to yours,
were not ignored.
My advice is to focus on what matters most to you, the problem of akathisia and the importance of informed consent, where you are making a powerful point. The main issue could get lost if the petition is about the Government.
Of course, it's your decision. The help I can give is more about how to get through to the organisations that actually influence prescribing practice, such as NICE and the Royal Colleges. I can also advise you on how our complex health system works - I do understand it must seem confusing.
With best wishes
Louis Appleby
--
CORRESPONDENCE ENDS
Bob Fiddaman
Further Reading
Platonic Lies ~ Louis Appleby responds to mother regarding the death of her son.
Akathisia and suicide ~ Email from Dr Peter Gordon to Louis Appleby and Wendy Burn.
National Suicide Prevention Strategy ~ Louis Appleby makes claims of feeling 'threatened'.
Suicide Prevention: ~ Oral evidence given to the House of Commons by Louis Appleby and Carmine Pariante
Kindness, attention and respect ~ Appleby, Gerada, Wessley all singing from the same hymnsheet
Q&A with Carmine Pariante ~ Communication breakdown
