Below is a letter that was sent to me as well as my Doctor. I obviously came across as though didn't need any more help... I assessed her on 23.01.08 following several presentations to ED with self harming behaviour. The last time was after an overdose of aprox 60 mixed pills and 2 bottles of wine. She explained to me that she had brought the pills ealier in the day when she had not consumed alcohol but was intoxicated at time of OD. She did leave a note but can not remember what she wrote on it. It was explained to me that at the time she wanted everything to end and had clear thoughts of dying. She did believe the pills would kill her. The first OD was taken in sept 07 but had began cutting before this. She also took an OD just before xmas 07 and one earlier in Jan 2008. She explained taht self harming behaviour due to chronic low mood which she has experienced since at least 2006. She expressed some regret following the OD but she said this was probably as it was not successful. She continues to have suicidal ideation and although has no clear plans can not guarentee will not happen again. (Obviously I didn;t tell her that if things got worse I would def do it again - and I did). She was well presented and seemed to be managing her self-care, was alert and able to establish good raport. Was emotionally reactive and speech was normal in tone and rate. Although there are symptoms of depressive low mood there are no indicators of significant mental illness - (so why the hell do I feel like I do when there are no reasons). I would identify the risk factors as ongoing self harm behaviour, excessive alcohol intake (which has now decreased a hell of a lot and still no change) and the fact she lives alone and may be experiencing some isolation - (I have no time to my self and I love living on my own - which I said as I like my space) and also chronic low mood with no triggers. I feel that she us high risk of further self harm but low risk of suicide (yeh well it was only 2 weeks later and I tried again). Well seems as though she got it wrong. Maybe when i go back to the doc I will tell him. it may be best that I print off what I have written on here so he can see how I feel. I can't go to him and tell him where as if he knows everything I can talk about it. It is 2 hard for me to turn round and say I am feeling like I wanna die 80% of the time and that there are occasions where I plan it and I research it on line like what I need to take and how much and what I can mix toegther, what I can do to make it look like an accident etc. So what the hell do I do now. I was waiting on this letter to get to the doc so that he would be able to suggest where to go from next. All she says is continue to see counsellor. Well obviously that isnt working as have been seeing counsellor since April and if anything things have gotton worse. The counsellor is good for getting things off my chest and just having a general chat with but I dont think I get anything out of it.