I first heard of my daughter Lauren’s disappearance in the early hours of the morning on 1 March 2017. Her car was found abandoned near a beach in Devon after she had been reported missing from her job in the A&E department of a NHS trust.
I remember suddenly feeling old, helpless and awfully afraid. Lauren was 26 and in her third year as a junior doctor in the south-west of England; I am a senior hospital doctor, approaching retirement and working in the midlands. It took only days to come to the inescapable but shocking conclusion that Lauren had taken her own life. Something I thought was unthinkable and only happened to other people had happened to me.
In the weeks afterward a new normality emerged from the unbearable and primal pain of the first few days – there are only so many nights you can lie, awake and crying, before exhaustion brings relief. Messages of support and sympathy arrived by text and WhatsApp; I was swathed in goodwill and empathy by family, friends and colleagues.
I wondered why and how someone successful, solvent, resilient and outwardly happy could reach such a state of despair. How did I, her father, not know that Lauren was in such a dark and hopeless place? She was resilient, but resilience alone cannot counter the isolation and depression that comes from the repeated hits of inflexible rotas, hostile working environments and assaults by patients.
From the moment they start, all newly qualified doctors encounter sexism, racism and verbal, physical and sexual abuse, as well as extremes of distress, rage and despair. They are in a highly stressful working environment where mistakes may prove fatal to their patients and career.
Young trainees are individuals with differing life experiences, resulting in varying strengths and vulnerabilities; some will need shielding from certain situations at the start of their careers. If we are lucky enough to identify someone in a crisis we should not merely signpost the route to help, but guide and accompany them along the path to recovery.
I returned to work after three months. Being involved in healthcare has given me a feeling of legitimacy in being able to comment on the welfare and mental wellbeing issues facing junior doctors in general, and Lauren in particular.
Prompted by my own experience and other junior doctor suicides, colleagues and I constructed a wellbeing and resilience training day for foundation year doctors at our trust. It was delivered by senior doctors with a responsibility and interest in junior doctor training and supervision, and was quite separate from the already congested induction programme. I introduced them to Lauren through a video telling her story. Then there were lectures and roleplay sessions about coping with stress and talking about mental health and suicide.
Feedback has been very positive – one person told us: “Thank you for caring.” Most importantly, we are raising awareness of the importance of mental wellbeing among all our new starters and enlisting their help. They are the ones best placed to recognise peers who are struggling, to ask whether they are thinking about suicide, and to offer their hand in friendship. If we can only equip them to make that approach and ask that vital question, then nobody need die believing they are worthless, beyond help, a burden, or that no one cares. We are the caring profession and we can do this.
I do feel optimistic for the future. There has been an increase in media coverage of mental health issues in the past 12-18 months. Royals, athletes and celebrities have spoken openly and frankly about their struggles with mental health, which has helped to raise awareness and reduce stigma. The topics of wellbeing and mindfulness are addressed in leading medical journals, and major conferences include sessions and workshops around mental welfare and supporting those in difficulty. There is a real recognition that this is a subject that has been largely overlooked in the past, and there is an urgency to do something about it.
In my trust, World Mental Health Day is being marked with talks, stands and people who can tell employees what help is available locally and nationally to maintain their mental health. I have just completed my mental health first aid training (provided free by the trust), and have already had enquiries from colleagues asking how they can apply.
Life will always be less certain than it was, more fragile and of diminished value. It is a path I tread warily. Every day I yearn to see Lauren again. Two and a half years on, the grief is unending.
The British Medical Association offers free, confidential support to doctors and medical students on 0330 123 1245. In the UK, Samaritans can be contacted on 116 123 or email email@example.com. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.