the Capilano Courier

Many professionals, organizations, and individuals who are involved in the mental health field are aware of stigmas attached to suicide. According to some, this stigma is a product of history, policy, and cultures. The Canadian Mental Health Association explains, “Suicide is the second leading cause of death among young people after motor vehicle accidents, yet people are often reluctant to discuss it. This is partly due to the stigma, guilt, or shame that surrounds suicide.”

Here to Help, a Vancouver organization that specializes in mental health and substance abuse, elaborates on this stigma as it exists within Canada. Suicide is often considered a taboo subject, although it is has a constant presence in our society; a presence that is likely closer to you than you might be aware of. According to Here to Help's stats, 3,500 people in Canada take their own lives annually. “That’s more lives lost than from traffic accidents and murders combined,” as per their website. The high amount of suicide in Canada is not mentioned in the public because it is what Here to Help calls a “hidden epidemic”.

Bonny Ball, who was living in North Vancouver when her 21-year-old son committed suicide, explains the impact of the suicide stigma: “Unlike other deaths, survivors quickly discover that talking about a suicide brings dinner conversations to a screeching halt. But the true impact of stigma is that it keeps survivors from connecting with each other, robbing us of both 'like me' support and the opportunity to band together with professionals to 'make a difference.' ”

Ball explains, “The worst impact of stigma was not when our son died, but after his first suicide attempt. Stigma meant that we told no one. Stigma thus isolated us from the very support and information that might have made a difference then.”

Pips929 is an online organization that offers suicide information, prevention, and emergency help information. Their website claims that the stigma of suicide has its roots in history, concluding that religious philosophers and politicians, such as Socrates, St. Augustine, John McManners, John Wesley, and Thomas Aquinas “fortified the Church's official position against suicide,” and “vilified suicide as an act against God, and denounced suicide as a sin for which one could not repent.” According to this website, “As a result of religious, civil, and criminal sanctions against suicide, the social stigma of suicide reached menacing heights during the Middle Ages.”

However, in the last 400 years, philosophers such as Montesquieu, Voltaire, John Donne, Emile Durkheim, and Sigmund Freud have begun to challenge and reshape the views society has on suicide. Pips929 explains, "Donne used the laws of Nature, Reason and God, as well as biblical text, to defend Christians' rights to choose death. Suicide was once again a topic of philosophical debate. The French philosophers, Montesquieu and Voltaire, both argued in defence of an individual's right to choose suicide. … The notion that mental or emotional distress could be caused by natural, physical factors helped pave the way for changes in civil, criminal and religious laws concerning suicide.”

Pips929 also says that another such break in the rethinking of suicide came when “in 1983, the Roman Catholic Church reversed the canon law that prohibited proper funeral rites and burial in church cemeteries for those who had died by their own hand.” It concludes, “One of the reasons suicide is less stigmatized today is the understanding that outside pressures, or societal stressors, can contribute to suicidal behaviour.”

NO MAGIC CURE

With the recent suicide death of Rick Rypien, former player for the Vancouver Canucks, the topic of suicide prevention has once again been raised in the media. “We relied on experts and we relied on both the NHLPA [National Hockey League Players Association] and the NHL doctors,” says Mike Gillis, General Manager of the Vancouver Canucks, in a public address in regards to the level of help Rypien received from the organization prior to his death. “We relied on different facilities. We relied on lots of people. There is no blueprint. I think it ebbs and flows depending on circumstances that are beyond your control, often.” Gillis didn’t elaborate on the specific treatments used. “I don’t want to talk about that,” he said. “As anybody knows who’s dealt with these issues in the past, there’s no answer, there’s no defined course of action. If there was, we’d all be better off.”

Like Gillis and the NHL, many organizations that offer mental health support offer a multifaceted treatment and approach to mental health issues. However, warns Erica Weir, author of Suicide: The Hidden Epidemic, “despite gains in insight and methodology, since the 1970s there has been an almost universal upward trend in suicide rates, particularly among young men.”

eir believes that high suicide rates are the failure of governments to “identify suicide as a critical public health priority.” Weir’s research shows that “in the 1970s, Canadian suicide rates overtook US rates, and they have remained consistently higher.” Despite the fact that, says Weir, “in 1996, the World Health Organization and the United Nations urged member nations to address the growing problem of suicide and provided guidelines for the formulation and implementation of national prevention strategies,” but by 2006 “only five countries (Australia, Finland, New Zealand, Norway and Sweden) had comprehensive national strategies. … Canada falls alongside Austria, Denmark, Germany and Japan as countries that were not taking action nationally.” Weir explains that these strategies generally contain “promoting awareness of suicide as an important, preventable public health problem and developing strategies to reduce the stigma associated with seeking psychiatric help or substance- abuse and suicide-prevention services.”

JUMPING TO A BETTER PLACE

Vancouver, like a few other notable cities including San Francisco, New York, and Oakland, are looking for solutions to the problem of people jumping from high, public places. Scholars and officials have been researching the impacts of placing suicide barriers on public structures that are known areas of suicide, such as the bridges in and around Vancouver.

John M. Grohol, Doctor of Psychology, and founder and editor-in-chief of PsycCentral, a mental health organization based out of San Francisco, talks about a different approach to suicide prevention: “Instead of only looking to help treat people most at risk for suicide (people who suffer from depression, for instance), public health officials are also looking at the common means in which suicide is committed.” The “band aid” approach, says Grohol, “is relatively new in the public health sector and one that we support. While we can’t remove all methods of suicide and people will always commit suicide, we can take a common-sense approach and work to reduce some of the more popular and easy-to-fix methods.”

Opponents to the idea of suicide barriers on Vancouver bridges is Kevin Falcon, British Columbia’s Minister of Transportation and Liberal MLA of Surrey-Cloverdale. Falcon had a firsthand experience with the difficulties and inconveniences associated with potential jumpers when he was trapped in traffic during a Canada Day jumper episode in 2008. After the incident, he demanded both on television and in print interviews alternatives to full-on closures, while also dismissing the idea of suicide-preventionbarriers on the bridges.

"We need to be sensitive to people in distress,” he said, “[but] we also need to think about the ramifications of paralyzing the system and jeopardizing the lives of others.” In regards to the barriers, “the budgetary cost isn’t even an issue, but they’re considered a visual eyesore.” Falcon concludes, “Suicidal people tend to be ingenious about their methods.” In a report done by CTV: British Columbia's Carrie Stefanson the day after the Canada Day bridge closure of 2008, Vancouver Police Const. Tim Fanning spoke on behalf of the Vancouver Police Department in response from Falcon and the media, saying, “The measures we took yesterday were absolutely necessary in guaranteeing the safety of the woman on the bridge.” Moreover, the Police who were at the scene said, “The woman's life was saved because of their decision to close the bridge indefinitely while a negotiator tried to talk the woman down from the ledge.”

Nick Rathwell, who has worked in suicide prevention organizations throughout the Fraser Valley, disagrees with Falcon. Rathwell explains, “It isn’t true to say that the bridge barriers don’t work … [but] they won’t work for everyone. The barriers are successful because they save some people, not everyone.”

"[Suicide prevention] is a very complicated field. The best we have are barriers. Each person’s problems are different, which makes prevention very difficult, and sadly, impossible in all cases. But the bridges are a very convenient place to commit suicide, so we have to be there and do everything we can.” However, says Rathwell, “I think it should be obvious that most prevention is done by family, friends, and doctors, who are able to look for, and address warning signs appropriately. Bridge barriers are a small safeguard for a small percentage of suicides.” Ultimately, “love, an active community, and an understanding of the issues are what save people,” he concludes.

Grohol, like Rathwell, believes that "bridges should be proofed against suicide and that a human life is worth more than a slightly-obstructed view.” Grohol attacks the argument that suicidal people “will just find another way to commit suicide.” He relies on the work done by Richard Seiden, a retired professor and psychologist at the University of California, who “published a study showing that the vast majority of people who are thwarted from jumping from a bridge don’t go on to commit suicide.” Grohol explains, “This misperception that we cannot stop people from hurting themselves is false – research data shows that we can. Because suicide is often an irrational, in-the-moment act, simple barriers are extremely effective in helping a person make the choice to live another day until the crisis has past. … While we can’t prevent all suicides, we can certainly make certain types of suicide a thing of the past.”

SUICIDE IN MINORITY GROUPS

Canada.com, a Canadian-based online news source, says in their Facts on Suicide section, “Certain groups have disproportionately high suicide rates compared to the general population.” These groups include “young men between the ages of 20 and 24; senior men over the age of 80; prison inmates, for whom suicide is the leading cause of death; people of First Nations and Inuit descent, who have suicide rates three to six times greater than the national average; this is even higher for adolescents 15 to 19 years old, with suicide occurring up to eight times more frequently than for other Canadian youths; and people with prior histories of attempted suicide.”

According to Canada.com, “More women attempt suicide, [but] about four times as many men as women die from their suicide attempt.” The reason for this appears to be that “men generally use more lethal means such as firearms, hanging, or asphyxiation (suffocation). Women often use drug overdoses or asphyxiation, or they cut themselves."

Information from Here to Help adds that “Canadian seniors make up 12 per cent of all suicides. In BC, the suicide rate for all men averages out to 17.5 deaths per 100,000 people; men over 85 have double that rate. A shrinking circle of friends, the death of a spouse, or a major illness can all lead to depression and in turn lead to suicide.”

Still, the upward trend in suicide continues, Here to Help explains: “In the last 45 years suicide rates have increased by 60 per cent worldwide. Suicide is now among the three leading causes of death among those aged 15-44 years [both sexes].”

AN APPLE A DAY

According to Vancouver-based Counselling, a private mental health service directory, there “are more than 400 psychologists, counsellors, therapists, and other professionals” in the Fraser Valley. This is because, according to Counselling, “anxiety, depression, sleeplessness, excessive anger, and addictions” are some of the most common causes potentially leading to suicide.

Counselling is one of many ways people overcome their suicidal thoughts, though there are many other groups available that deal with issues that indirectly help people overcome suicide. Hospice organizations, drug and alcohol rehab groups, and community centers are a few of the many specialized ways in which the community attempts to help.

For those who have experienced suicide as the loss of a loved one, this experience does have the potential to be channelled into an empowering one; the aforementioned Bonny Ball has turned her grief into a powerful tool to change the public perception of suicide. She is now Acting Vice- President and Chair of the Survivors Division, Canadian Association for Suicide Prevention. She is also Project Manager of Vancouver Suicide Survivors Coalition, a project of the Consumer Initiative Fund of Vancouver Community Mental Health Services.

//Illustrations by JJ Brewis