Sunday, October 9, 2011 | Categories: Episodes
On Cross Country Checkup: managing suicide
There's a move in Parliament to create a national strategy for suicide prevention.
So often concealed, it's a subject that needs to be coaxed from the shadows.
What do you think? Can Canada do more to prevent suicide?
With host Rex Murphy.
As someone diagnosed with Bipolar II disorder, who has spent the best part of thirty years in the mental health field, I have a great deal of experience in the area. I have dealt with thousands of individuals and families in crisis, and have had to help with the aftermath of hundreds of suicides (Stopped counting in 1997 after 100). I could not even begin to count the number of people I have helped after suicide attempts.
Suicide is often discussed in isolation - away from mental illness. This is done for a host of reasons: to make surviving family members feel better, to lessen the perceived stigma of the act, to 'protect' the reputation of the victim, and to lessen the 'shame' of the act.
However, the facts are that suicide, and suicidal behaviour, is invariably linked with a mood disorder, in better than 90% of cases. But, rather than treating the whole issue, most of the general public, and the pontificators who want to pass laws, only want to talk about the actual event of suicide itself. Often, they want to downplay the possibility of mental illness, and instead of making the problem better, this actually makes things even worse.
By ignoring the root cause of the behaviours, and the very treatable illnesses that cause such behaviours, and only focusing on the event of suicide itself, you actually increase the stigma against suicide and mental illness of all kinds. You also make it much, much harder to encourage people to get the kind of long term help that is needed.
But whatever, make sure that suicide, and any policies to deal with suicide, are not dealt with in isolation. That would be disastrous - and would harm, rather than help the situation.
I lost my 15-year-old son to suicide 12 years ago and have been active in prevention ever since, giving presentations in schools to students, counsellors, etc. Some schools are resistant to talking about this much stigmatized topic but more families are speaking out and stigma is lessening.
Through education we can lift this taboo (just like we did with cancer and AIDS). A national strategy would help with education ,treatment and training people to recognize the signs of depression and potential suicide.
Families should be included in treatment especially with youth and we need more availability of psychiatrists and psychologists.
Vancouver, British Columbia
Thank you for dealing with this topic. Kudos to Bob Rae for mentioning that teachers should be part of the process. Teachers spend time daily with children over a number of years. They are an incredibly valuable resource in identifying at-risk teenagers. In over 25 years in education, I have worked in schools where a student died by suicide, have taught a student who witnessed someone commit suicide and have identified students I have felt were at risk for committing suicide.
As it stands, teaches are kept out of the information loop. School administrators wrongly believe that teachers should not be informed when a suicide attempt is made or if a student is at risk. Although teachers are expected to share information with administrators, counsellors and social workers, we are not considered trustworthy enough to be given crucial information about our students. The irony is that it is not the counsellor or principal who deals with such students on a daily basis.
Last year, a student caught my eye as I walked down the hall. Although I was rushing to a class, I felt compelled to go back and talk to her. Within two minutes, this youngster who I had never talked to before, indicated that she had attempted suicide over the weekend. She was back in school on Monday with no one the wiser.
Please encourage everyone involved to help make teachers part of the solution to this devastating problem.
I am writing from Nunavik, Northern Quebec, where suicide is at one of the highest levels in Canada. I just want to suggest that despite how difficult and baffling suicide is and has been for our region, I have recently taken a workshop dedicated to suicide prevention called ASSIST. It was developed in western Canada and is as basic and straight forward as any First Aid course with the same kind of mandate : that anyone and everyone could take this workshop (2-3 days) and be then prepared to recognize suicidal behaviour and signs and have a step by step procedure to follow that could bring the suicidal person back from the brink until more professional help can be brought in. Tbis is obviously the next level that needs to be addressed, but prevention is so essential first.
I was astounded by the concept that such a workshop has not become as commonplace and required as basic first aid in the workplace and schools, especially given the statistics you have just presented. I would like to suggest that all governments look into this kind of basic tool amongst the entire population and mandate the use of such training in all public and private sectors. It takes a caring animator that can deal with the depth of the emotion evoked during such workshops as the course will trigger memories for anyone that has experienced suicide at any level. Then, any other caring individuals can go on to become workshop leaders themselves, again just like first aid training leads to. There is no longer any excuse that such a prevention program for suicide is not as widespread as first aid courses are in Canada.
I'm concerned that tight resources will be stretched further with a National Suicide Prevention Program. For example, some of the groups mentioned -- returning veterans, Aboriginal Canadians, people with mental health issues -- have issues not being addresses which, in my opinion, contribute to suicide. Veterans face struggles with poverty and poor housing, First Nations are living without access to clean running water, and millions of Canadians do not have an assigned general physician. Put more money into already existing programs that help prevent issues that lead to suicide, don't starve them further in order to fund another program that cannot address a complex issue on its own.
Vancouver, British Columbia
I work in a community of 30.000 people in BC. In the last week, our youth mental health office attended at the hospital 4 times for attempted suicides, and had 5 youth between 15 and 17 come into our office (three as emergencies) who were thinking of suicide.
As an intake worker, there were two common themes I saw that ran through all the contacts we had with these children. The first was that the youth had been bullied at some point in their young lives. The second was that the clients all reported that their parents were "always at work", "too busy", or that "my parents are never home". I'm sure we cannot generalize these two things as root issues. However, it bears consideration. In many situations, childhood anxiety (whatever its cause) leads to depression if untreated, which is a contributing factor to suicide.
On another note, studies have shown that talking about suicide with our children does not increase the likelihood that they will commit suicide. Sometimes I've spoken with parents who were worried about this, but that it is the opposite -- more information, more education = less suicide.
We can do a lot to prevent suicide among young people. Dr. Hazel McBride and I conducted a study of adolescent suicides in Ontario. We found that all of these youth had learning disabilities such as dyslexia and/or mathematics disabilities that had not been properly identified and treated. Of course, there are many reasons for suicide but this problem of undetected learning disabilities is one that we do something about.
If we are really serious about preventing suicide, we should be identifying these learning disabilities early and offering intervention before the problems become more serious. The identification of these learning disabilities has been made expensive and complex but that is not really necessary. The solution is to screen children for potential learning problems early and provide the help that they need. Carefully monitoring the reading, writing, and mathematics skills of all students and offering help to the ones that need it without excessive bureaucratic regulations.
Dr. Linda Siegel
Vancouver, British Columbia
I would like to share an example of stigma against treatment of mental health. When I was in the middle of a difficult divorce, I took my 15 year old daughter to a psychiatrist to have an outsider to talk to: someone not involved with either parent or taking sides etc. This was suicide prevention: I felt that this was such a difficult time for her that there could be problems. I was highly criticised for this by my ex-husband's family: they said that it would be something that would come up and prevent her from getting life insurance or other insurance and would cost her money in the future. I did not have money for a few years while the legal battes ensued for a psychologist, but the health care system does pay for psychiatrists. The reaction of the ex in-laws was based on fact, however. I took the side of better to have mental health than cheaper insurance. What can be done about the problem of disclosure of mental health problems when applying for such things as insurance and jobs?
It's been my personal experience that mental health issues are not taken seriously by any level of our governments. There are scarce resources available for many of us who are struggling with depression, bi-polar and schizophrenia. It is almost impossible to find a psychiatrist who is accepting new patients in Vancouver. General practitioners are not equipped, or, in my opinion knowledgeable enough to evaluate or diagnose mood disorders. Finding help through the medical system is arduous and an almost impossible feat when you are in the throes of battling a mental health crisis. I've almost given up many times, and am resigned to the very real possibility I may one day take my own life.
Vancouver, British Columbia
I have a 14-year-old daughter who was finally diagnosed with depression one year ago. Thinking back when she showed first sign, it was in grade 5 (age 10). At that time, the diagnosis came down to chronic pain and hormones. A young doctor at our medical centre agreed with me that there might be juvenile depression and referred us to a psychiatrist. I consider us fortunate to have been able to see the psychiatrist within a month. He confirmed the depression and diagnosed an anxiety disorder (panic attacks). He also referred us to the London Health Science centre for therapy.
My daughter is on medication and is in therapy and is working hard on getting better. It is a long process and I am confident she will get there. However, I wish all children and youth, who battle with mental health, would have the same opportunity. I think we were lucky. Health should not depend on luck. We got the right diagnose, referrals and have the opportunity to access these services.
The three suicides that I have been most closely associated with were impulsive acts committed with guns. The accessibility of guns in Canadian homes has to be a part of any discussion about suicide prevention.
Lake Country, British Columbia
Suicide is the most difficult type of 911 call that I personally deal with on almost a daily basis. Several times over the past 20+ years I have been the last one the suicidal person has spoken to. Those are the calls that haunt me. Many times we are able to successfully intervene and obtain medical assistance but the medical system often fails. I remember one case where officers took a young man to the hospital 3 times in one day. He was released within a couple of hours each time. He finally killed himself and his mother later that same night.
Our police service now has a couple of Mental Health police officers who are each partnered with an RN (mental health nurse). They attend on attempted suicide calls or any call of a mental health nature. They provide assistance on the scene and do follow up visits afterward. This is a valuable service and it does help in many situations, but should mental health issues be dealt with by the police?
You just mentioned that surely the average person would see that environmental and social factors may play a role in suicidal intentions. I guess that this point should apply well to the high rate of suicidal attempts in First Nations. What if First Nations people got the message that they are valued as highly as other Canadians, perhaps that might make a difference, or if the First Nations found that their life chances were just as good as non First Nations people, that might make a difference to suicide rates.
Kingston, Nova Scotia
I work for the Crisis Line in Vernon, B.C. and have listened to the pain of both those who are considering suicide and from those who have lost someone to suicide. The loneliness of the stigma of mental illness and suicide perpetuates the suffering. In turn the suffering in silence further perpetuates the isolation. We need to talk about both mental illness and suicide, and we need to accept these as real and serious health concerns in order to make a difference to this problem. On a day to give thanks, I am grateful for the motion for a National Suicide Prevention Strategy and for Cross Country Check-up for allowing us to talk openly about suicide.
Sharon Durant, Suicide Prevention Committee Chair
Vernon, British Columbia
As I listen to your show, the word that keeps coming up for me is "stigma". I have many family members with mental illness, a sister who has attempted suicide on many occasions and friends who have committed suicide. For one family member in particular, I feel that she is so ashamed of her diagnosis that she does not seek help and does not stay on her medication. From my experience, most people still don't talk about mental illness and are uncomfortable in the face of it. As a society, we need to open our hearts and minds and truly include people with mental health issues for them to feel that they that they are not marginal citizens. We need to do this for people to feel that their lives matter.
Sault Ste. Marie, Ontario
Our federal and provincial governments need to do more than just create a national strategy for suicide prevention. My point is specifically regarding the transgendered community, in which an estimated 50% of youth attempt suicide. Conservative representatives have been opposed to legislation, such as Bill C-389 to amend the Canadian Human Rights Act and the Criminal Code to included protection for gender identity and gender expression, and also against improving education around this topic in schools. For a youth demographic that is at an extremely high risk of suicide, our governments need to support legislation and education that will improve social conditions for these young people. It is useless to talk about suicide prevention while permitting and perpetuating discrimination against those at risk.
Our family has lost a dear son to suicidal depression. We were unable to save him because we could find no effective means of getting him into treatment. Not only did British Columbia's Mental Health Act utterly fail us; it frustrated our attempts to get help.
Kudos to Bob Rae and all of the lawmakers who are advocating a national strategy to deal with the scourge of suicide. Only a national strategy in which federal and provincial agencies participate would be capable of dealing with suicide.
Although health care is a provincial responsibility, no province can receive the full benefit of federal funding without complying with federal standards. The same should apply to any suicide prevention strategy.
Canada has had little success in developing national strategies. Even our health care strategy, good as it is, is not universally effective. Nor has any federal government ever articulated a national economic strategy. Developing a national strategy on suicide might be a valuable exercise in both thinking and acting as a whole nation while applying policies in ways that suit local conditions.
Penticton, British Columbia