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Pharmacist Parveen is talking to Ginny Wexford, a customer whose son has recently been diagnosed as schizophrenic

Ginny is clearly upset and words tumble out of her as soon as Parveen shows her into the consulting room. She tells Parveen she is concerned about her 20- year-old son, David, who seems to be struggling with his recent diagnosis of schizophrenia. He keeps saying that his life isn’t worth living, she says, but won’t seek help other than attending his regular medical appointments for his condition. “If someone says they want to kill themselves, is there anything that can be done to talk them round?” she asks.

Answer

This is obviously not a situation to be taken lightly. Ginny’s efforts so far have concentrated on trying to get David to the GP or to contact the community mental health service, but he has resisted all her pleas. Ginny should therefore contact the crisis resolution or home treatment team (depending on local arrangements) to discuss her concerns so they can conduct a same-day specialist assessment at home.

If Ginny doesn’t have the details of these teams, she can obtain them from her local accident and emergency department. Failing all else, Ginny could take David to hospital, ideally voluntarily, although there is scope under the Mental Health Act to arrange compulsory admission if he declines but is considered at high risk of harm to himself or others.

The bigger picture

People with schizophrenia are at an increased risk of premature death and, on average, die 10 years earlier than the general population. One of the main reasons for this is suicide, with one in 10 people with the condition taking their own life. The risk is highest in those recently diagnosed with schizophrenia and in individuals who are socially isolated, depressed or unemployed.

It can be very difficult to deal with a close friend or family member who says they are feeling suicidal. There is a natural instinct to offer solutions and make judgements, but it is better to encourage the individual who is contemplating taking their own life to talk about how they are feeling.

If they are reluctant to talk, perhaps not wanting to burden someone they are close to, they may prefer to contact someone anonymously, such as the Samaritans, which operates a 24-hour, 365-day telephone service.

Extend your learning

• Find out more about which groups of patients with schizophrenia are at increased risk of suicide by reading the discussion of the paper published in the British Journal of Psychiatry 
• Would you recognise that someone might be at risk of suicide? You can find out what the signs are that someone might be struggling emotionally at The Samaritans