Reprinted from "Suicide" issue of Visions Journal, 2005, 2 (7), p. 6-7
Until I became depressed and suicidal myself in the fall of 1996, I never understood what it was like on the ‘inside’—how dark and all consuming, how someone who had everything going for them could want to go to sleep and not wake up. Waking up each morning was a daily exercise in disappointment. I’m only glad ideation (i.e., thinking about suicide) was as far as I got—glad I never actually acted on temptation to turn the wheel into oncoming trafﬁc as I commuted home from university each day.
I also didn’t realize how common suicidal thinking like mine was, particularly in almost-19-year-olds. In the most recent Statistics Canada national mental health survey, around 4%, or one in 25 Canadians, say they’ve had suicidal thoughts in the past year. That number nearly doubles if you just look at young women ages 15 to 24.1
What follows is meant to be a quick reference guide to some key statistics and trends with regard to suicide. I’ve adapted some materials provided by our wise guest editors and have excerpted information from the BC Partners for Mental Health and Addictions Information fact sheet on suicide. This will provide a prologue of sorts to the complex and rich points of view you’ll ﬁnd in the coming pages of this issue of Visions.
Although BC’s suicide rates have remained fairly stable over time, at roughly 500 per year, suicide rates in Canada have been rising sharply for nearly ﬁve decades. Suicide deaths in Canada numbered 3,648 in 2002. By contrast, there were fewer than 500 murders and around 3,000 trafﬁc-accident deaths.2 A closer look at the ﬁgures reveals that suicide strikes hardest at the elderly, the young and other vulnerable members of society.
Canadian seniors have among the highest suicide rates in the country, with men over the age of 85 having the highest rate of completed suicides of any age group.3 In BC, in the year 2000, the suicide rate for all men averaged out to 17.5 deaths per 100,000 people; men over 85 had double that rate.4 Major illness, the death of a spouse, a shrinking circle of friends—all contribute to stress and depression, which can lead to suicidal behaviour or suicide. One exception to this trend is the low suicide rate among Aboriginal Elders. In many cases, these Elders may be less likely to take their own lives because, traditionally, their cultures have valued and respected them for their wisdom.
Canada’s youth are another group at high risk for suicide. Suicide continues to be the second-leading cause of death among young people in Canada, in BC and worldwide. In the half-century between 1952 and 2002, the Canadian suicide rate for 15- to 19-year-olds rose from two deaths per 100,000 people to just over 10—a ﬁve-fold increase.4,6,7 In 2000, 70 young people ages 15 to 24 took their own lives in BC.4 Like the elderly, the majority of adolescents who commit suicide have related mental health issues, including depression, substance use problems and eating disorders. The increase in suicidal behaviour among Canada’s youth indicates that many adolescents feel they should be able to handle their mental and emotional issues on their own. Suicidal youths may be reluctant to turn to others for help, having learned from their role models not to rely on others.
Adolescent and adult suicide rates are even higher in Aboriginal communities. Deteriorating quality of life in some Aboriginal communities may play a role, particularly among people with clinical depression, sexual abuse histories, problem alcohol and drug use and limited family support. The suicide rate among Aboriginal people averages triple the rate of the general Canadian population.
Not all Aboriginal communities, however, are affected by suicide to the same extent. While some communities have suicide rates 800 times greater than the national average, suicide is virtually unknown in other communities. Cultural rehabilitation factors such as land claims, self government, and education services are implicated in reduced suicide rates.
Immigrants and refugees
Ethnocultural communities other than Aboriginal also experience variations in suicide rates compared to the general population. On the whole, suicide rates for immigrant communities are about half those for the Canadian-born. In fact, the pattern of suicide among immigrants more closely reﬂects patterns in their countries of origin than that of the Canadian-born population.11 In BC, among immigrants born outside Canada, those from India are the visible minority presenting the highest suicide rates.12 This concern also extends to refugees from the Indian subcontinent. BC immigrant- and refugee-serving organizations indicated in a 2002 survey that 90% of their refugee clients of South Asian origin (e.g., India, Pakistan, Sri Lanka) had unmet mental health needs, more than any other cultural group. These agencies ranked depression and suicidal behaviour as the most prevalent mental health concern.
Males die by suicide more than three times as often as females, a statistic that follows international trends. This may in part be due to males using, on average, more lethal methods such as hanging and ﬁrearms.
Females tend to use drugs, poison, and gases more often than males in their suicide attempts, meaning there is more time to intervene and therefore a better chance to prevent death—although there is an increasing trend of females using more lethal means. Women are also more likely than males to ask for help surrounding a suicide attempt.
A common thread
Mental health problems are the common thread in all groups with a high risk for suicide. Research indicates that as many as 90% of people who commit suicide are experiencing depression, an addiction or some other diagnosable disorder when they take their own lives.16 People with major mental disorders who attempt or commit suicide do so not out of a desire to die, but out of a desperate need to put an end to their suffering. In most cases involving suicide, the act itself is not an impulsive decision. Most people who die by suicide give some indication of their intentions prior to killing themselves. In fact, most people who attempt suicide talk about it beforehand without any immediate plans to carry it out. In one study, more than 60% of participants who had made near-lethal suicide attempts had sought help for health or emotional problems from a clinician in the month before their attempt; nearly half of them had discussed suicide.
In the year 2000, 815,000 people lost their lives to suicide worldwide—more than double the number of people who die as a direct result of armed conﬂict every year.
Fortunately, immediate intervention and ongoing support can help a person recover from despair and reconnect with their own self-worth. If other people notice the warning signs and act on them, they may have an opportunity to save a life. For more information on how to recognize and help someone thinking about suicide, see Ian Ross’ Crisis Centre prevention guidelines on page.
About the Author
Sarah is Director of Public Education and Communications for the Canadian Mental Health Association’s BC Division and Visions’ Editorial Coordinator
Statistics Canada. (2002). Suicidal thoughts, by age group and sex. Canadian community health survey, mental health and wellbeing.Retrieved August 15, 2005, from www.statcan. ca/english/freepub/82-617XIE/htm/5110065.htm.
Statistics Canada. (2000). External causes of morbidity and mortality. Causes of death. Retrieved August 15, 2005, from CANSIM database [V01-Y89, Vital Statistics – Death Database – 3233] at www.statcan.ca/english/freepub/84-208-XIE/2000/tables.htm.
Centre for Suicide Prevention. (1998). SIEC Alert #28: Suicide among the aged. Calgary, AB: Author.
Suicide Prevention Initiative, Mental Health Evaluation and Community Consultation Unit (Mheccu), University of British Columbia, and BC Coroner’s Ofﬁce. (2001). BC suicide deaths by age and gender – 1994 2000: Frequencies and rates per year. Vancouver, BC: Author.
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Centre for Suicide Prevention. (2003). SIEC Alert #52: Suicide among Canada’s Aboriginal peoples. Calgary, AB: Author.
Chandler, J.J. & Lalonde, C. (1998). Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural. Psychiatry, 35(2), 191-219.
Malenfant, E.C. (2004). Suicide in Canada’s immigrant population. Health Reports, 15(2).
Singh, K. (2002). Suicide among immigrants to Canada from the Indian subcontinent (letter). Canadian Journal of Psychiatry, 47(5), 487.
Refugee Mental Health Project. (2002). Refugee mental health – moving ahead: Survey and symposium report. Vancouver, BC: Authors.
Centre for Suicide Prevention. (2003). Facing the facts: Suicide in Canada. Calgary, AB: Author.
Centre for Suicide Prevention. (1998). SIEC Alert #30: Trends in Canadian Suicide. Calgary, AB: Author.
Cavanagh, J., Carson, A., Sharpe, M. et al. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395-405.
Barnes, L.S., Ikeda, R.M. & Kresnow, M.J. (2001). Help-seeking behavior prior to nearly lethal suicide attempts. Suicide and Life-Threatening Behavior, 32(1 Suppl), 68-75.
World Health Organization. (2002). World report on violence and health.Geneva, Switzerland: Author.
White, J. & Jodoin, N. (1998). Before the fact interventions: A manual of best practices in youth suicide prevention. Vancouver, BC: Suicide Prevention Information and Resource Centre, Mental Health Evaluation and Community Consultation Unit, University of British Columbia.
Ashworth, J. (2001). Practice principles: A guide for mental health clinicians working with suicidal children and youth. Retrieved August 15, 2005, from www.mcf.gov.bc.ca/publications/youth/suicid_%20prev_manual.pdf