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This document contains excerpts from an article entitled Prescriptions for change published October 2003 in The Ottawa Citizen. Reprinted with permission from CanWest Interactive. For the complete article, go to www.canada.com/ottawa/ottawacitizen/specials/suicide.
Health workers hope new strategy will finally tackle Canada’s long-ignored suicide epidemic
Andrew Duffy and Ian MacLeod
Frustrated by suicide’s ever-mounting toll, a dedicated group of mental health professionals is building a national prevention strategy for Canada.
The Canadian Association for Suicide Prevention hopes the blueprint, scheduled for completion next October, will spur action on a long-ignored epidemic.
Suicide claims about 3,700 lives a year and is now the second-leading cause of death among Canada’s young people, 15 to 24.
“Enough is enough. The fact is we’re not going to wait around anymore for the federal government to do something,” says David Masecar, president of the association, founded by psychiatrists, academics and social workers to lobby on behalf of the victims of suicide.
“This is a health issue of real importance, as important as AIDS or diabetes or cancer,” he says.
The federal government has no national suicide prevention strategy in development, despite the fact that countries with lower suicide rates—The United States, Sweden, New Zealand, Australia, Netherlands and the United Kingdom—already have national programs.
“It’s a challenge in Canada,” says Richard Ramsay, a professor of social work at the University of Calgary, and a world-renowned expert in suicide prevention training. “A lot of people, I think, want to believe that suicide is not preventable.”
Mr. Ramsay, who sits on the board of directors of the Canadian Association for Suicide Prevention, is the co-founder of a Calgary company, LivingWorks Education, that has created the most widely used suicide intervention program in the world, graduating 500,000 people in a dozen countries. The program equips front-line caregivers—doctors, policemen, teachers, ministers, counsellors—with the expertise to identify suicidal people, estimate their risk of self-harm and stop them from acting on the impulse.
“We’re trying to get people to be comfortable enough to feel that they can do a piece of first aid work at the point where somebody could be thinking of suicide. It’s something everyone can be taught to do,” says Mr. Ramsay, a former Ottawa social worker.
The program has been described as CPR for the suicidal. Its tenets have been adopted by the U.S. Surgeon General and the World Health Organization. The U.S. army and air force are major clients of LivingWorks.
U.S. Surgeon General David Satcher declared suicide a serious public health problem in 1999 and issued “a call to action.” Indeed, Dr. Satcher was so concerned by the human carnage—85 suicides and about 2,000 attempts per day in the U.S.—that he released his blueprint for suicide prevention in advance of developing a full national strategy.
That strategy was published in May, 2001, and outlined a public health approach to suicide prevention, including specific plans to:
The U.S. plan is interesting because, as in Canada, the federal government does not have primary responsibility for health care. It creates guidelines for state health officials while offering them financial and technical support, a model that could also work well in Canada.
More than half of all U.S. states now have comprehensive suicide prevention programs in place and more are in development.
In Canada, however, the approach to suicide prevention remains haphazard. British Columbia, Alberta, Quebec and New Brunswick have specific plans and funding in place for suicide prevention efforts; the other provinces do not.
Quebec, which suffers the highest provincial suicide rate in the country, now spends the most on prevention, more than $4 million a year.
Alberta, which was the earliest to respond, created an advisory committee in 1981 with an $800,000 annual budget. That committee developed a prevention strategy, now known as the “Alberta model,” that sought to raise suicide awareness, fund more research, create model prevention programs, and to train front-line workers in identifying and dealing with suicidal people.
Alberta now houses one of the world’s most extensive resource libraries on suicide and is home to a series of innovative suicide prevention projects, including Mr. Ramsay’s LivingWorks.
Suicide rates in Alberta, once the highest among Canadian provinces, have fallen from their peak levels of the late 1980s. Alberta is now second to Quebec.
“The rates of suicide in Alberta are at least headed in the right direction,” says Mr. Ramsay, who was one member of the advisory group that devised the Alberta model.
Although Ontario has little in place for suicide prevention, the province is home to the nation’s most high-profile piece of suicide prevention work. Earlier this year, the City of Toronto completed a $5.5-million suicide barrier along the Bloor Viaduct, a 40-metre high road bridge that spans the traffic-heavy Don Valley Parkway.
The Bloor Viaduct used to average one suicide every three weeks, but since the barrier has been installed, there have been no reported deaths.
To date, the federal government has taken part mostly in ad hoc suicide prevention measures, most notably through gun control laws. A study that examined suicide rates in the eight years before and after the 1978 legislation came into force—it required Canadians to obtain firearms acquisition certificates for all gun purchases—found a slight reduction in suicide deaths attributable to guns. There was also a slight decrease in the overall Canadian suicide rate.
Certain federal agencies have also taken important steps to arrest suicide. The Canadian military and the Correctional Service of Canada have both used Mr. Ramsay’s LivingWorks program to train their personnel to identify and assist suicidal people.
Still, most of Canada’s suicide prevention work relies on many small, privately funded programs and the goodwill of their volunteers.