Suicide prevention: Advocates call for relaxed confidentiality rules, more family involvement

Content warning: This article discusses mental illness, suicide and homicide.

A bereaved father wants loved ones to be more involved in the care of those struggling with mental illness, and for confidentiality rules to be eased among professionals.

Jean-François Ryan made the recommendations Friday morning as part of the coroner's public inquiry on suicide in Quebec.

His son, Mikhaël Ryan, died by suicide in a Quebec City hotel after killing his mother, Joceline Lamothe, in May 2017.

According to Ryan, the information that could have been used to help his son was "scattered."

"None of the interveners had this amount of information," he said, arguing that the tragedy might have been avoided if details had been better circulated.

He recommended a "triangle of care" approach that centres family and friends within treatment, as they can often sense details that go under the radar.

"It has been shown by the evidence presented that this would greatly improve the information available to professionals," Ryan told coroner Julie-Kim Godin via video conference.

To establish this triangle, he said the rules of confidentiality must be relaxed "between professionals."

Dr. Benoît Croteau, psychiatrist and founder of a Quebec mental health clinic (CTAH), said Friday that this link with loved ones is more easily applied in a community clinic than in a hospital setting. He said the latter can involve a lot of staff changes and pressure.

Ryan's recommendations are in line with those made the previous day by police, who called for a relaxation of professional secrecy and easier access to information.

The hope is that this would facilitate the sharing of information and improve interventions with people in distress.

Ryan also suggested developing universal standards for suicidal risk assessment, reducing treatment delays between stays, and revising the authority of therapy agencies.

Mikhaël Ryan and Joceline Lamothe are among six deaths covered by the coroner's inquest, which began in 2019. The others are Suzie Aubé, Jean-François Lussier, Marc Boudreau and Dave Murray.

A CONCRETE PLAN

The sister of Jean-François Lussier called for better support from hospitals after patients are discharged, recommending they leave with a concrete plan of care and a follow-up with a professional.

Patients shouldn't "go home with pamphlets," said Annie Lussier.

Her brother had undergone a psychiatric evaluation because of suicidal thoughts. After a "review of the situation" with a psychiatrist, his brother was sent home with three brochures for help, Lussier said.

He was considered in no danger to himself or others and well cared for by his family. Less than two weeks later, he was found lifeless in his Laval home in May 2018.

In Lussier's eyes, having family around should not be an excuse to send a patient home. According to her, the family is not equipped to "respond appropriately" to a loved one who is in mental distress.

Hearings will resume on Monday and continue until June 10.

This report was first published in French by The Canadian Press on June 3, 2022.