This is part four in The Globe and Mail's special series confronting the agonizing enigma of teen suicide. Read part one here, part two here, and part three here.
The causes of suicide are complex – an interplay of psychological, biological, social and environmental factors, often sparked by a personal crisis like a failed romance. But about 95 per cent of cases spring from a mental illness such as depression or schizophrenia.
With teenagers, who are undergoing a lot of changes, hormonal and otherwise, spotting the warning signs and hearing the cries for help can be particularly challenging, and there is no simple solution. Everyone, from individuals to community groups to governments, has a role to play.
But much can be done. The Globe and Mail’s public-health reporter, André Picard, spoke to experts and reviewed suicide-prevention strategies adopted by provinces and other countries to draft this concise, four-part action plan.
ACCESSIBILITY
The number one challenge is getting timely help.
Local demand for treatment has increased dramatically since the death last November of the 14-year-old daughter of Ottawa Senators assistant coach Luke Richardson. This pleases her parents, whose Do It For Daron campaign urges troubled teens to seek assistance, but it also “causes us anxiety,” admits Daron’s mother, Stephanie, because the system is so overburdened, fragmented and starved of cash.
“The frustration I hear expressed over and over again is: ‘I can’t get help,’ ” says Jude Platzer of Vancouver, who founded the Josh Platzer Society in honour of her teenage son who died 12 years ago.
The wait to see a psychologist or a psychiatrist can stretch for months, even years in most provinces and territories. “When a young person is suicidal, it’s an emergency. I don’t want to hear about wait lists.”
There is also tremendous inequity because those with means can easily access treatment not generally covered by provincial health plans.
Darcie Atkinson-McKee of Ottawa says she thought of suicide every day as a teenager. Luckily, her mother’s private health insurance paid for regular sessions with a psychologist, but she finds it “terrifying” to think what might have happened otherwise. “I’m very lucky.”
Few family doctors are readily accessible or equipped to provide immediate help to a teenager in distress and young people are not prone to turn to doctors for help. That means those who reveal their despair to friends or family will likely end up in emergency rooms, which are unwelcoming places, although some hospitals – like the Royal Jubilee in Victoria – now have special mental-health ERs.
Ottawa patients wait as long as a year for treatment, but Luke and Stephanie Richardson decided against taking it slow. “The guidance we got … is, if you wait for the system to be ready, it is never going to change,” Mrs. Richardson explains. “It is going to have to adjust to the demands of youth.”
And there is much adjusting to do, argues Simon Davidson, head of child psychiatry at the University of Ottawa and the Royal Ottawa Mental Health Centre.
In a recent report, he accuses political leaders of turning “a blind eye” to the level of care, noting that “if only one in six adults requiring a hip or knee replacement received one … governments would fall. It should be no different for our children and youth suffering with mental illness. In fact, their services should be a greater priority.”
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PREVENTION
To prevent suicide, you need to identify those at risk. But that is not easy. Many people, especially the young, keep their torment secret and don’t know where to turn.
In fact, about half of the young people who take their own lives are in regular contact with the health and social-services systems, with the other half hidden in plain sight (the warning signs often apparent only in retrospect). Dr. Stan Kutcher, the Sun Life Financial chair in adolescent mental health at Dalhousie University in Halifax, says there are good diagnostic methods and treatments but “people are reluctant to come forward when they are sick, and their friends and family members often don’t know how to help them. There is still tremendous stigma about mental illness.”
