Robin Williams's death this week came as a shock. The actor's diagnosis of bipolar disorder, his history of depression and substance abuse offer some context to his suicide, but no comfort to his family or his legions of fans. His death is a singular loss, but it is not a celebrity story. Rather, it should serve to remind us that nobody is immune from the risk of depression and its consequences. We need to strive toward a better understanding of mental illness, and recognize suicide as a public health issue requiring a national discussion – in the hope that those suffering feel less isolated.
In North America, suicide has emerged as a leading cause of death. In the U.S., suicide has become the leading cause of death by injury, surpassing car accidents. About 38,000 Americans die by suicide annually, a number that has risen by 15 per cent over the past decade. In Canada, the suicide rate is lower, with 3,500 people dying every year, slightly below the number of deaths from colon cancer and breast cancer. Cancer is treated as a public health crisis, with public awareness and fundraising campaigns. Suicide? Though it takes nearly as many Canadian lives, it is largely unacknowledged.
Canada's suicide rate is not accelerating, as it is in the United States, but it's not declining either. In fact, since the 1920s, this country's suicide rate hasn't really budged in any kind of statistically significant way. Suicide in Canada is the seventh-most common cause of death among Canadian males, and the 10th-highest among both sexes combined. What can be done about it?
In 2004, a survey of 21 OECD countries concluded Canada was among ten that lacked "countrywide integrated activities carried out by government bodies" to address suicide. In the past, several ideas have been floated. In 2010, a private member's bill proposed the creation of a national strategy, including a national medical surveillance program for suicide prevention and risk identification. The bill also proposed setting standards for best practices and training in suicide prevention.
In some countries – most notably, Finland – national suicide prevention strategies have worked. After adopting a strategy in 1986, Finland reported a 9-per-cent decrease over 10 years. For Canada, a good starting point would be to acknowledge that it is a national public health issue – something Ottawa has yet to do. Mr. Williams's death is a terrible reminder that suicide can affect anyone. It is also preventable.