Thomas Kingston, whose wife is Lady Gabriella Windsor, took his life in February last year (Image: David Bennett / Getty)
Last year, 8.7 million people in England were prescribed anti-depressants. Such medication has become increasingly commonplace, used successfully by many patients to keep their lives on track. But the suicide last year of Thomas Kingston has raised alarming questions about the safety of these powerful drugs.
Mr Kingston, 45, the husband of Prince and Princess Michael of Kent’s daughter, Lady Gabriella Kingston, died from a self-inflicted head injury on February 25 last year at his parents’ home in the Cotswolds. A gun was found near his body.
The inquest into his death heard that he was not seen as suicidal by any of those who knew him well.
Katy Skerrett, senior coroner for Gloucestershire, said he might have been suffering adverse effects from the anti-depressants he had been prescribed – possibly because he stopped taking them too suddenly.
She issued a warning over the risk to patients prescribed SSRIs (Selective Serotonin Reuptake Inhibitors – a specific type of anti-depressant).
But this ignores the underlying problem of GPs rather than specialist mental health professionals largely doing the prescribing.
In my opinion as a practicing clinical psychiatrist, the real culprit is the lack of proper specialist medical supervision – a widespread failing in NHS mental health care.
On the day of his death, Mr Kingston’s mother said he was perfectly normal. “He was fun. We were laughing about various things,” she recalled. The family spent the day relaxing, reading and sitting by the fire.
Today Mr Kingston’s parents are campaigning for patients to sign documents confirming they’ve been told about the possible problems of going on – and coming off – anti-depressant medications. This could include the patient being informed that, in extreme cases, they could lead to suicidal thoughts and behaviours.
Nationwide, it may come as a shock to realise that many more anti-depressant prescriptions are issued by hard-pressed GPs, who are not specialists, than actual psychiatrists.
In many cases, they have a mere 10 minutes to diagnose and remedy a patient’s mental health needs.
With resources for psychological services often limited due to costs or huge waiting lists, many will feel the simplest solution is to offer relief in a daily anti-depressant. And many patients may welcome that as a quick fix – without considering the various possible side-effects, or other avenues of support available to them.
In recent years, mental health care in the NHS has basically been delegated away from expensive specialists, to cheaper family doctors.
A key reason people come to see me privately (many save for months for the appointment because they are not wealthy) is that it is now basically practically impossible to get an appointment with a psychiatrist in the NHS.
Mr Kingston does not appear to have been prescribed his medication or been supervised by an NHS psychiatrist, maybe because the waiting lists are too long. The real problem might not lie just in the tablet, but instead the lack of specialist supervision of the treatment.
The management of all serious mental health issues should involve a package of care, including regular personal communication with at least one specialist – where an understanding relationship can develop – as well as, potentially, some medication. But you can’t encapsulate proper mental health care in a capsule alone.
And in reality, NHS psychiatry doesn’t exist anymore for millions of ordinary people, whose own individual tragedies would never attract media attention.
I’ve been battling with the NHS bureaucracy as an NHS psychiatrist for almost 40 years. If cancer care was this bad (and it is pretty awful, but no NHS manager would dare suggest a GP prescribed chemotherapy) it would cause a national outcry.
The ethnic group in the UK with the highest rate of suicidal thoughts is white British, with figures showing one in five (predominantly men) have such thoughts at some time in their lives.
National campaigns have been mounted to battle the mental illness stigma and urge us all to go to our GPs, as “it’s good to talk”. But when you do pluck up the courage to do so, it’s highly likely that what you will get is not a conversation, but merely chemistry.
- Dr Raj Persaud FRCPsych is a Harley Street Consultant Psychiatrist and publisher The Mental Vaccine for -19