Suicide Prevention – Time to Get On With What We Know Works

Another World Suicide Prevention Day (September 10, 2009) has passed and in many locations a variety of activities were underway across Canada, for example, community suicide awareness walks such as the one that has been initiated in New Minas/Kentville Nova Scotia and one that will be occurring in Halifax on the weekend following. The Canadian Broadcasting Corporation has presented a number of stories on the topic and the London Free Press newspaper has announced that it will publish obituaries in which suicide can be identified as a cause of death. The president of the Canadian Association for the Prevention of Suicide is quoted as saying that a national suicide prevention strategy is needed. All in all, there is increasing awareness of the importance of this issue nationwide.

Unfortunately, in all the media reports I have seen or heard on this issue there has been not one mention of what I consider to be the most important item that needs to be addressed. That is, based on solid scientific evidence we already know what to do to decrease suicide rates, so why are we not doing those things? Marches are good for raising awareness but do we need to march to put effective programs into place?

So what do we know helps bring down suicide rates? First of all is the identification and effective treatment of people who are living with a mental illness – especially depression, bipolar disorder and schizophrenia. Second is the reduction of access to lethal means – be that through control of handguns or barriers on bridges. Third is the creation of “gatekeeper” programs in organizations such as schools or similar institutions. In this way those individuals at highest risk can be identified and interventions provided to them. None of these are difficult to do. None of these are costly to develop and implement. So why are they not universally in place?

Health care systems are notoriously inert – change comes very slowly and often inefficiently. Stigma against the mentally ill pervades the health care system and providers are not immune from its insidious effects. Could this be a reason why those relatively simple and proven effective approaches are not already in place everywhere? Where are our legislators - provincial/territorial and federal? Why are they not demanding that these approaches are in place and properly supported? Perhaps it is because they feel no pressure to do so. Perhaps the scientific evidence and moral imperatives are not enough.Perhaps they need a push from the people.

So, what do I have to say about this? Walk on. Speak out. Demand change. Demand that what we already know works be implemented. Demand that we learn more. Crush the stigma and let the science lead us to do what works best!

Dr. Stan Kutcher

Sun Life Chair in Adolescent Mental Health

IWK and Dalhousie University