Gloucestershire has twice the number of alcohol-related deaths than the regional average. This week we attended the funeral of a client who died because of alcohol-related issues. We are seeing an increasing number of clients who are alcohol dependent.

Our distress at her death is magnified because we believe that it could have been prevented.

People usually become alcohol dependent because they are using alcohol to block out  severe emotional pain, or because they have mental health issues (including depression and PTSD) and are attempting to use alcohol to block out the distressing symptoms. In PTSD these symptoms may include flashbacks of the event. Our client was clinically depressed (and was on anti-depressants) and had severe symptoms of Post Traumatic Stress Disorder. She drank particularly heavily at night to try to block out the terrifying nightmares she had.

She needed help and support with the underlying issues that caused her to drink. However, NHS mental health services will often refuse to provide mental health services if a person is alcohol dependent. Our client was discharged from NHS mental health services in the summer. She was told that they would offer services again when she had been free of alcohol for a month. We expressed our concern that all her risks would increase as a result of this discharge. She was extremely distressed that she had been discharged. Apparently they could not ‘forward plan’ while she was drinking, they said. Our response was “But surely you can still support her? Because we seem to be able to.”

NHS crisis services would not take her onto their caseload. We urged then to, but they didn’t.

At home, alone, clinically depressed and experiencing overwhelming symptoms of PTSD, she was not able to stop drinking.

Ten days before she died of pancreatitis, we emailed statutory services urging them to admit her to residential rehab, and stating very clearly that we were convinced she would die, if they didn’t. We were told that she needed to show motivation to reduce her drinking before she could be considered for this. We emailed back to question how she could show motivation at this time, when she was clinically depressed. A lack of motivation is often a symptom of clinical depression. Shake off your depression, and then we will help you? How does that work? When is that ever possible?

Is this what happens when a person is mentally unwell and then becomes alcohol dependent? Does everyone just stand back and watch it happen? We feel, as a charity, that we have had to watch her die. We could support her but we could not treat her PTSD or clinical depression or her addiction. It needed other services to do that. It is profoundly distressing to us that our client, who we had come to know well, and who we cared about, has died in this manner. We do not want this to happen again.

Our county has twice as many alcohol-related deaths as the regional average, and twice as many suicides as the national average (2010-2012 statistics). What is being done, at county level, to address this?