I had the privilege of being in Montreal with Cliff's daughter Ileah June 10-13 for a world congress on suicide research. For three and a half days, researchers, academics, medical professionals, and government representatives presented their work -- everything from micro-RNA studies to national suicide prevention strategies.
Some of the information I've learned:
- In Canada, a person is three times more likely to take their own life than to be killed by someone else. (The ratio in the U.S. is 2:1.)
- Although men and women engage in similar amounts of suicidal behaviour, men are at four times greater risk of dying by suicide.
- Of everyone who attempts suicide, older men are those most likely to die.
- Despite all the statistics and assessment tools, we are very weak at being able to predict who is most at risk of dying by suicide.
- Suicide is preventable: The physiological and psychosocial factors that put people at risk of dying can be changed.
- Effective treatments are available that reduce psychological suffering, increase capacity for problem solving, and prevent deaths.
The conference was an enormous learning experience and an excellent opportunity to meet others with deep interests in this tragic topic. It was sometimes inspiring, sometimes emotionally taxing.
In the midst of seminars on statistics, cutting-edge research, and evidence-based practices, Government of Canada representatives made an emotional presentation on a Manitoba First Nations youth program they're funding, without providing any evidence the program has reduced deaths by suicide or even improved participants' mental health.
On the other end of the spectrum, Dr. Matt Miller from the Harvard Centre for Injury Prevention showed that restricting means can reduce suicide deaths dramatically. For example:
Suicide rates in Great Britain dropped sharply after residential gas service was changed from coal gas to natural gas. Rates dipped again much more recently when the number of paracetamol pills in each package was reduced to a sub-lethal dose.
Having a gun in the house increases the risk of dying by suicide for all members of the household. Storing guns unloaded and locked separately from the ammunition reduces that risk, but not as much as for a household with no guns.
After the import and sale of World Health Organization class 1 toxicity pesticides were restricted in Sri Lanka, suicide rates declined by 50%. Thousands of people's lives have been saved every year. These same pesticides are still responsible for about 1/3 of suicide deaths world wide each year -- deaths that could be prevented if other developing countries had the same bans and restrictions as North America and Europe.
Why is means restriction so effective? Because a suicidal crisis -- the time period in which a person is most at risk of attempting suicide -- is usually short-lived, and the person at risk is usually acting on impulse. The method chosen is therefore usually one that is readily available. If that method is highly lethal, there is less chance of intervention or survival. Of those who do survive a suicide attempt, fewer than 10% eventually die by suicide -- over 90% do not.
After the conference, Ileah and I spent the weekend in Toronto visiting Cliff's family there as well as a childhood friend. Friday, June 21 marked 18 months since his death. The pain I feel on these anniversaries and the pain I see in Cliff's children, family and friends strengthens my resolve to change this for others.
