World Suicide Prevention Day

Suicide Prevention

by Dr. Zach

2018

Highlights/questions:

1. September 10, 2018 is world suicide prevention day
2. Suicide is final and devastating to all around
3. Quebec suicide statistics
4. Who is disproportionately affected
5. Risk factors for suicide
6. Warning signs of suicide
7. Protective Factors from suicide
8. What can be done — by individuals, people who work with the public, and by the government

September 10, 2018 is world suicide prevention day.  https://iasp.info/wspd2018/

The purpose of this day is to raise awareness around the globe that suicide can be prevented.

WHO: Close to 800 000 people die due to suicide every year, which is one person every 40 seconds. Many more attempt suicide. Suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 year olds globally (after unintentional trauma such as car accidents).

Quebec still has the highest suicide rate of any province in Canada, and men and Indigenous people are afflicted disproportionately.  Over 1,000 people die by suicide per year, at an average of just under 100 per month.

Men make up around 80 per cent of suicide victims in Quebec. French-Canadian men living in small towns and rural areas have particularly high-rates of suicide.  Risk factors include being unemployed or underemployed, and divorced.

Suicide rates very high in native communities.  Risk  factors including poverty, unemployment and hopelessness, and the long-term impact of assimilationist policy and the residential school system. Many Indigenous people were taught to be ashamed of their culture, and others were sexually or physically abused at residential schools. Such abuse is a strong predictor of suicide and alcohol use.

Quebec has the highest suicide rate of any province in Canada, about 15 per 100,000 (the territories have higher rates, esp Nunavut).

Women make suicide attempts more often than men, and are hospitalized more frequently for them, but men have a higher rate of committing suicide (often they use more violent methods).

The main risk factors for suicide are:

• A prior suicide attempt
• Mental health disorders
• Substance abuse disorder
• Family history of a mental health or substance abuse disorder
• Family history of suicide
• Family violence, including physical or sexual abuse
• Having guns or other firearms in the home
• Being in prison or jail
• Being exposed to others’ suicidal behavior, such as a family member, peer, or media figure
• Medical illness
• Being between the ages of 15 and 24 years or over age 60

Obviously most people with mental health disorders and substance abuse disorders, and most people 15-24 and over 60 do not commit suicide, but statistically they are at higher risk.

Making firearms inaccessible is one thing society can do to prevent suicide.

The behaviors listed below may be signs that someone is thinking about suicide:

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Planning or looking for a way to kill themselves, such as searching online, stockpiling pills, or newly acquiring potentially lethal items (e.g., firearms, ropes)
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain, both physical or emotional
• Talking about being a burden to others
• Using alcohol or drugs more often
• Acting anxious or agitated
• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking risks that could lead to death, such as reckless driving
• Talking or thinking about death often
• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

Protective factors:

• Strong connections to family and community support
• Skills in problem solving, conflict resolution, and non-violent handling of disputes
• Personal, social, cultural and religious beliefs that discourage suicide and support self preservation
• Restricted access to means of suicide — gun control
• Seeking help
• Easy access to quality care for mental and physical illness

What can we (individuals) do to help prevent suicide:

• Remove the stigma from mental illness so people talk about it
• Learn and recognize the signs of warning signs for suicidality
• Reach out and connect — engage the person, explore their situation
• Know resources available (there is a list of QC resources here — https://amiquebec.org/suicide/)

What people who interact with the public need to do:

• People who interact with the public need to know how to recognize risk factors and address them:  primary healthcare providers, mental healthcare providers, emergency healthcare providers, teachers and school staff, community leaders, police officers and other first responders, social workers, spiritual and religious leaders, traditional healers

What government can do:

• We need to restrict access to means of self-harm/suicide
• Government needs to support crisis centres and workers and community programs — mental disorders need to be identified and treated

Suicide rates in Quebec have declined by almost 50 per cent since the year 2000. This may be directly linked to the publication in 1998 of Help for Life: the Quebec Strategy for Preventing Suicide. This strategy was written by the Ministry of Health and Social Services.  But the rate is still the highest of any Canadian province.

References:

https://montrealgazette.com/opinion/opinion-more-can-be-done-to-reduce-suicide-rates-in-quebec

http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

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