Sense of belonging vital for youths contemplating suicide
Published Wednesday, October 5, 2011 11:36AM EDT
This is the first instalment in Speak Out On Suicide, a series running on Canada AM and on canadaam.ctv.ca. Click here for part 2, which looks at suicide in the military, or here for part 3, which looks at the link between suicide and sports
Earlier this month Mitchell Wilson, an 11-year-old Pickering, Ont. boy who suffered from muscular dystrophy, was found dead in his bedroom.
But it wasn't Mitchell's debilitating disease that had claimed his life. Mitchell had committed suicide, out of fear, his father believes, of returning to school and having to face the bullies who had robbed and beaten the youngster a year earlier.
They had smashed Mitchell's face and teeth into the pavement and stolen the iPhone he had borrowed from his dad to take on the walks he would go on to combat the effects of his illness.
Craig Wilson said his son was never the same after his attack, and the fear of returning to school, as well as being subpoenaed to testify in court against his attackers, was too much.
"Subsequent to the beating that he took, he just lost that spark you see in a kid's eye," said Wilson, who is now speaking out about his son's death in order to raise awareness about youth suicide.
Mitchell is not alone in feeling that the only way to escape his pain was to end his life. According to Statistics Canada, 218 youths between the ages of 10 and 19 committed suicide in 2007, the most recent year for which data is available.
The year before that it was 183 and in 2006 the number spiked to 256.
Roughly one-fifth of the total each year were suicides among youths between the ages of 11 and 14.
Victimization, isolation major risks
Dr. Abel Ickowicz, psychiatrist-in-chief at Sick Kids Hospital in Toronto, said feelings of victimization or acute embarrassment can often lead to depression or suicidal feelings.
It's one of the risk factors that Sick Kids looks at when treating patients who have made an unsuccessful suicide attempt, or appear to be edging towards one.
"The experience of victimization, such as sexual abuse, physical abuse, being consistently being bullied at school and other aspects of being a victim are contributing factors for suicide," he told CTVNews.ca.
Sick Kids is all too familiar with suicide among youth. As a Toronto hospital that specializes in children and teenagers, they see numerous cases where a patient has attempted suicide either as a cry for help, or a legitimate attempt to end it all.
Dr. Ickowicz said the first thing they do when a patient comes through the door is conduct a risk assessment.
Staff look at everything from the patient's use of illicit drugs, to their previous history of suicidal behaviour and their family's history with suicide.
"To put it in simple terms, suicide runs in some families," Dr. Ickowicz said.
"Whether it is transmitted through actual genetics or modelling... it is the same thing. If there is a history of someone in the family, someone close to the person who has committed suicide, the risk factor for that individual increases significantly."
Even the patient's "personal style" is factored into the assessment. If it includes aggressive behaviour or impulsiveness, their risk increases dramatically.
And when a number of risk factors are present in one patient at the same time, there is a multiplying effect, Dr. Ickowicz said.
"If one is sad but has a tendency to be aggressive, those are additive factors, because one might be sad and choose to take out one's aggression on oneself," he said.
"Or if one is impulsive, something that could be a transient thought for another person, in a person who is impulsive it can jump from being a thought to being an action very quickly."
Access to means, media, major factors
Sick Kids psychiatrists also look at environmental factors when assessing a patient's risk level.
Perhaps not surprisingly, suicide is more prevalent in societies where it is common for families to have firearms at home, Dr. Ickowicz said.
The other major factor, he said, is the amount of exposure the patient has to media reports about suicide.
"Whenever there is a TV show in North America where there is some glorification of suicide, the next week we get busier," he said.
Dr. Ickowicz, a dedicated user of public transit, said he is convinced the Toronto Transit Commission understands the effect that reports of suicide can have -- which is likely why officials are always discreet about reporting subway suicides.
"It is always managed with discretion and that is a good thing. At any given point there may be more than one person thinking about it, but knowing that it happens encourages it," Dr. Ickowicz said.
And finally, he said, it is important to look at where patients spend their time online. Those who frequently visit sites that promote or encourage suicide, or offer tips about how to do it successfully, are simply more likely to make an attempt.
Dr. Ickowicz said parents of at-risk youth should track the risk factors that may be affecting their children. But beyond medication, cognitive therapy and counselling, Dr. Ickowicz said the most powerful weapon for combating suicide, is communication.
Family support vital in suicide prevention
In families where the lines of communication are open and kids feel they belong, and can come to their parents about anything they are struggling with, there is a lower risk.
"It's not just active family support, it's being available to listen to the kids when the kids are in distress and being able to recognize the presence of distress and encourage a conversation about it," he said.
Likewise, youths who feel they are part of a community and that they belong -– be it an arts group, a chess club, a sports team or religious group -- are also much less likely to initiate self-harm.
When it comes to suicide prevention, Dr. Ickowicz said, the family has a responsibility that truly begins at birth in fostering an environment of love and belonging, and open communication.
Jason Carey, counselling manager for Kids Help Phone, understands how important it is for young people to feel they are being listened to.
His career is built on providing that listening ear that so many young people feel they lack in those who are supposed to be closest to them.
"Often times it's really tough for a teenager to talk to an adult because it's so common for an adult to say ‘how do you know what love is?' Carey told CTVNews.ca.
"It's really not taking the time to validate what the child is going through, what they're experiencing, and often the child gets to the point where they are feeling desperate."
Breaking through the isolation
About 3 per cent of the 225,622 calls Kids Help Phone received last year were directly related to suicide.
Often the callers were dealing with the loss of a valued relationship, or were in an abusive one. But in many cases they were simply scared to go to school, knowing they would face bullying and had no one to turn to for support or help.
"Often suicide is heightened by a state of isolation and part of our role as an agency is to break that isolation," Carey said.
Counsellors do this by listening, first and foremost, but also striving to share the caller's burden.
"They see Kids Help Phone as a safe place to go. They know we are not judging them, that we don't tell them what to do, we don't put them down in any way shape or form. We basically sit with them and in a sense are witness to what they are experiencing at that time and we join them in a place they are at," he said.
This requires a lot of trust, Carey said, because the callers are empowered to make their own decisions. Because of the anonymous nature of the service, help can only be sent if the caller asks for it and willingly provides the necessary information.
In many cases, this is what the callers are seeking -- a listening ear from someone who will stand by them if and when they decide they are ready to accept help.
Going into the trenches
This hit home a few weeks ago, Carey said, when a counsellor received a call from two teens who were concerned that their friend might be about to commit suicide.
The friend lived in another province, and as the counsellor spoke to the callers, the learned that in fact the suicide was in-progress, and the youth had already taken something with the intent of ending their life.
The counsellor was able to coach the friends, who were communicating via text message with their friend, on how to provide the support, encouragement and friendship that was needed to convince their friend he had something to live for.
Through their third-party conversation, the youth eventually decided he didn't want to end his life, and Kids Help Phone was able to activate emergency services and send help -- thereby saving his life.
"It was very powerful and the counsellor did such an amazing job that after emergency services was there she spent time with the callers assessing, them and walking them through the process, so it was really a two-fold counselling call in the wee hours of the morning," Carey said.
It's calls like that, Carey said, that remind him and his colleagues why they have chosen their line of work, and the direct, life-saving results that can be achieved through coming along side of a child and being a friend.
"We join them in the mud, we get in the trenches with them and we muck it out and together we come up with some solutions," Carey said.