Paragraph 10 reads: "Medical guidelines laid out by the National Institute for Clinical Excellence (NICE) indicate better results are achieved if patients are offered therapeutic counselling rather than relying on antidepressants. Yet Rose's condition was managed almost solely with antidepressant drugs and no psychotherapy was ever offered. "
All the doctors ever did was give Rose drugs - I can't believe they let my beautiful sister kill herself says Blake's Humphrey Berney
By Mark Anstead Last updated at 12:44 PM on 24th October 2010
Looking out over a sea of adoring fans as he performed at this year's Classical Brits in the Royal Albert Hall in May, Humphrey Berney felt an ache of loneliness.
It should have been his finest hour - in 18 months since the 30-year-old tenor joined 'opera hunks' Blake, the group had opened Wimbledon, performed at Buckingham Palace and completed a 14-date tour of the UK.
Yet the one person Humphrey wants more than any other to share in these glorious moments will never be able to. His older sister Rose, whom he calls 'a soul mate', took her own life in 2005 after a lengthy battle with mental illness.
Rose Berney (with her nephew Sky) took her own life in 2005 after a lengthy battle with mental illness. She was the older sister of Blake singer Humphrey Berney
'Rose and I were incredibly close and before she became ill you would never have found a more exuberant, fun-loving person,' says Humphrey, his voice cracking.
'We used to sing together - she had a pure voice and was a BBC Choirgirl of the Year finalist. I wish she could see me now - I carry her memory with me always, particularly when I am on stage.'
In the years since Rose died, Humphrey has grieved, wept and raged. Today he is speaking for the first time about the ordeal because he still seethes with anger at how she 'slipped through the net' of NHS mental health services.
'If the psychiatric services had been better, my beautiful sister would still be alive,' he says. 'But her case was very badly handled. Rose was 28 when she died and had so much life left to live.'
Research shows that one in ten of the population will suffer a depressive episode at some point. Typical symptoms include tearfulness, withdrawal, fatigue and anxiety.
Medical guidelines laid out by the National Institute for Clinical Excellence (NICE) indicate better results are achieved if patients are offered therapeutic counselling rather than relying on antidepressants. Yet Rose's condition was managed almost solely with antidepressant drugs and no psychotherapy was ever offered.
'Rose and I were incredibly close and before she became ill you would never have found a more exuberant, fun-loving person,' said Humphrey
The average age for a first episode of major depression is the mid-20s and is twice as likely in women. Although the chances of full recovery are good, half go on to have at least one more episode. Nearly two-thirds of the 6,000 suicides in the UK each year are linked to a diagnosis of depression.
Raised on a farm in Dereham, Norfolk, Humphrey was the youngest of three children - Rose was three years older and Oliver five years older. Born to loving parents and educated at private schools, all three had an idyllic childhood until their father Ralph, now 59, and mother Susan, 57, divorced in 1991.
Rose, who was 13 and at boarding school at the time, stopped eating. Her weight plummeted from eight stone to four-and-a-half, and a year later she was sent to a clinic in Chelmsford, Essex, for treatment for anorexia nervosa.
Humphrey says: 'We all found my parents' divorce difficult but Rose took it hardest. Mum worked really hard to get her through it and thankfully she made a full recovery by the age of 16.'
After their parents' divorce, the children stayed living with their mother, who later remarried.
But when Rose went to Edinburgh University to study English, she developed depression in her second year.
'She lost motivation in her studies for a while,' says Humphrey. 'I think it was triggered by falling in with a crowd who were experimenting with recreational drugs. There is no way someone as sensitive as Rose should have been exposed to things like that - it had a very negative effect on her and brought her low.
'I was naive, not having any experience of that stuff. Mum didn't realise either. I was surprised, and shocked. I believe it contributed to her problems,' he says.
Rose then found the support she needed by converting to Christianity and attending meetings run by an evangelical group. 'I didn't share her faith,' says Humphrey. 'But I was glad about the positive influence of her new friends.'
After university in 2002, Rose worked in New Zealand. But a new episode of depression began a year later after she hit her head in a bike accident, and she returned to London.
'From then on she seemed a bit lost,' says Humphrey, who by then was studying at the Royal Academy of Music in London.
'She thought she might have ME and went for tests, but doctors said it wasn't that. After Christmas 2004 she started crying a lot and said she couldn't sleep.'
By early 2005, Rose gave up her job working in London with a charity and moved back to the family home in Norfolk. Susan says she arrived looking exhausted. She was persuaded to visit a GP, who prescribed the antidepressant citalopram. She found she couldn't sleep and was switched to another antidepressant, mirtazapine, but her mother says it made her 'manic'.
'She would sit and pick furiously at the skin on the back of her hands,' Humphrey says. 'And she would talk in rapid bursts saying, "It's the drugs, it's the drugs, I'm not really like this, it's the drugs." I told her that if she would just hang on in there, it would get better.'
In July 2005, Rose took some scissors and went to a local river where she cut her wrist, although she made only a superficial wound. It was a cry for help - she phoned home to say what she had done and her stepfather, Robert, went to find her. Her GP surgery referred her to Norwich's Hellesdon Hospital, part of the Norfolk and Waveney NHS Mental Health Foundation.
But a psychiatrist decided Rose was not a serious enough case for a hospital stay. Instead, she was referred to an outpatient clinic where appointments with community psychiatrists were sporadic. Her mother often went with her to appointments.
'But whenever she tried to explain to the doctors that she felt Rose was suicidal, they treated her as if she was exaggerating,' says Humphrey.
Becoming increasingly manic, Rose was switched to clonazepam, a sedative used to treat anxiety orders, which put her in a slump.
'It seemed to me the doctors were just playing with drugs,' says Susan. 'We assumed they knew what they were doing, but I have my doubts.
'I asked if we could be put on the list for the NHS mental health crisis team, who are supposed to be on call for emergencies, because I felt she was suicidal. But I was told the service wasn't for people like us. They seemed to assume we could pay for private help.'
Rose was seen by three GPs and a handful of psychiatrists while living in Dereham. Growing desperate for better care, Susan phoned local private psychiatrists, only to find there were no appointments for months.
Eventually she found a psychiatrist through a Christian charity. After a few sessions with Rose, the new therapist offered another diagnosis - saying she may have been bipolar, which would explain her manic response to antidepressants.
But a week later, Rose left a message on the psychiatrist's answerphone complaining about her drugs, loaded a gun from a cabinet in the house and shot herself in the head, dying instantly.
'Oliver called and said Mum had found her body and I cried uncontrollably,' says Humphrey. 'I couldn't believe she had been so let down.'
Dr Peter Byrne, consultant psychiatrist at Newham Hospital in London, and spokesman for the Royal College of Psychiatrists, says people who experience depression should be offered more than antidepressants.
'GPs are the front line of care,' he says, 'but NICE guidelines are clear: offering counselling is better than writing a prescription.
'As soon as someone shows a risk of suicide, I suggest attending A&E at the nearest hospital where the resident psychiatrist can take them under their care.'
Humphrey, who is single and lives in Chelsea, feels the family found it impossible to access the care that Rose needed, no matter how hard they tried. 'Anyone feeling depressed must make sure they have access to therapeutic counselling,' he says.
'Relying purely on prescription drugs can be dangerous and I don't want Rose to have died in vain.'
A spokesperson for Norfolk- Waveney Mental Health NHS Foundation Trust said: 'We review the case of anyone who dies while in our care. In this instance, the review found that Trust policies were followed correctly, and no recommendations were made as a result.'