Dr. Anne Jeffers:

On the issue of all doctors being linked to approved centres, our submission states that this issue needs to be examined. Not every maternity hospital has a psychiatrist working in the unit and this issue needs to be addressed.

The general practitioner is of great importance. As general adult psychiatrists, we work very closely with GPs and we believe it would be sufficient where it states that one of the psychiatrists would contact and discuss with the general practitioner. We will discuss with the GP in these cases at any rate.

On the issue of prejudgment, as we stated, at an individual level we do not judge before we have listened to and heard the individual's story and account of his or her difficulties.

On the survey, I was sent a copy of the survey and, likewise, my concern was the way in which the questions were posed. It was difficult to answer in a reliable way. As psychiatrists, we are trained to evaluate evidence and the literature and we drum it into our trainees that we have to be very aware of bias. We must look at who are the authors of the study and what their thinking may have been. We also have to be aware that when we are reading the literature we put our own biases on what we read and we often remember and zone in on something that already supports what we believe.

On the practical issues, all psychiatrists would be very competent at assessing suicide.

On the capacity to consent, I emphasise that, other than in cases of psychosis which has been referred to, most people with mental illnesses have capacity and are able to make informed decisions.

On the accuracy of our decisions, in psychiatry our predictions are often more accurate than in other areas of medicine. Our work is about understanding where the individual is coming from. That is what improves the accuracy in assessing suicidal risk.