What we can learn from the tragedy of suicide

Carol Marquis has written a touching and highly personal story about her brother Donnie and his tragic suicide at age 27 years. While Carol’s personal journey led her to feel life more deeply, my professional journey is more focused on what we can do to prevent others, who like Donnie are living with a mental disorder (in his case bipolar illness), from death by suicide.

We know that unfortunately suicide is a mode of death for people who suffer from and live with mental illnesses; much like a heart attack is a mode of death for those who suffer from and live with heart disease. Thus, it is no surprise that in Canada, the highest rates of suicide are found in people who live with a major mental illness – in particular: major depression; bipolar disorder; schizophrenia. Study after study has demonstrated that these mental disorders are the greatest risk factors for suicide. Study after study has demonstrated that there are effective interventions for individuals living with mental illness that can decrease this risk for suicide.

Some of these interventions are: the continued application of effective treatments (medications and psychological interventions); easy access to emergency/crisis mental health care; unique programs that address a variety of factors that can lead to or trigger a suicide act. We know that the majority of individuals who die by suicide visit a health provider prior to the event.

The difficult questions we need to ask are as follows. Why is it that with so much knowledge about what can be helpful that so many people living with mental illness still die by suicide? Why is it that with so much knowledge about what we can do we still invest in programs and activities for which there is little or no evidence of effectiveness? Why is it that we do not widely distribute and ensure that evidence based standards of care for suicide prevention are available in every location where health care is provided? Why is it that we spend little or no time in educating the large legion of health providers to identify and intervene when their patients are or could be suicidal?

Are there many other areas in medicine where we know what to do to make things better and we still persist in doing things that we either know do not work or do not know if they work? If not, what is it about the field of mental health that encourages us to act this way?

~ Dr. Stan Kutcher