Talking about suicide without proper supports can be dangerous, experts say

As people scramble to cope with a spate of suicides and suicide attempts in Woodstock,Ont., experts warn that simply opening up discussionis not an effective way to prevent other suicides and can even be dangerous without the right supports in place.

"When something like this happens, everyone wants to do something right away and they kind of come out of the woodwork," said Ian Manion, a psychologist specializing in youth suicide told CBC News."You have a lot of well-intentioned people and sometimes [good] intentions don't always lead to good actions.

"Sometimes it could be enhancing risk." he said.

• Youth reaching for mental health care find a 'big gap' in delivery

Five young people have died by suicide in four months in Woodstock,asouthwestern Ontariocity with a population ofabout 35,000. It's not the onlycommunity in Canada dealing with multiple suicides or suicide attempts.In April, Attawapiskat First Nation declared astate of emergencywhen 11 people tried to take their own livesin one night.

Experts say suicide is an urgentnational problem, as thesecond-leading cause of death, after accidents,among Canadiansaged 15 to 24.

Manion, who is the director ofYouth Mental Health Research at the Royal Ottawa Mental Health Centre, has been in contact withtheWoodstock, Ont., school board. On Tuesday, hundreds of high school students walked out of class to rally against teen suicide andraise awareness about the need for mental health services.

The danger facing communities in the aftermath of suicide,experts say, is "contagion,"when people already at high risk start thinking of suicide after others havekilled themselves.

Dr. StanKutcher, aprofessor of psychiatry at Dalhousie University who, like Manion,specializes in youth mental health and suicide,said he worries that "let's talk about suicide in the community" responses haven't been scientifically tested enoughto prove theyactually prevent other suicides.

"What we have done in Canada is we have very enthusiastically taken up a community-based approach, without knowing whether or not it works and without knowing whether or not it's safe," Kutcher said."Could we, with all the best intentions, be doing more harm than good? And I don't know the answer to that question but we have to ask."

But Manion said there isno question thatpeople need to talk about suicide in the community.The issue, he said, is how peopletalk about it.

"Just having a conversation is insufficient," Manionsaid."If you go to a high school and you have a suicide expert stand up in front of 1500 students and talk about suicidal warning signs and then leaves and that's all you do, there is evidence to suggest that that is dangerous."

Without support services in place, a gathering like that cantrigger suicidal thoughts in vulnerable people, he said, who then have "nowhere to deal with them, nothing to do about them."

• Need help?Here's where you can find a suicide crisis centre

In conjunction with public awareness conversations about suicide,it's critical to make sure that people know where they can turn for help, how to access those services and how to "bridge" a friend to anappropriate service,Manion said.

Kutcher advocates for a more targeted approach, specifically aimed atpeople proven to be at higher risk for suicide. The most important risk factors, he said, are previous suicide attempts; mental illness, including depression, schizophrenia and bipolar disorder; and alcoholism.

"You don't have to be a rocket scientist to figure out that if you're going to intervene effectively you need to intervene where the problem is at its greatest," he said.

• What needs to happen next to deal withWoodstock, Ont., suicide crisis?

Both Manion and Kutcheragree that suicide prevention studies in Europe have shown some promising results that could help Canadians.

The Europeaninterventions, which reduced suicide rates, linkedpeople at higher risk with treatment.

But Manion said theyalso showed the importance of a"whole community approach," bytraining community facilitators to identify those at risk and by building public awarenessabout mental illness and suicide.

'What should we be doing?'

Another vital stepcommunities need to take in suicide prevention, Manion said, is "meaningful engagement" of young people, including listening to their thoughts on what supports they need and what needs to change.

That kind of knowledge aboutsome of the "right" ways to deal with suicide already exists, he said, but the fact thatcommunities across Canada don't have that information in hand before crisis strikes is a major problem.

A solution to that problem, he said, is a national suicide prevention strategy and action plan for communities.

"You have community after community that are facing such really tragic circumstances and the communities are saying, 'what should we be doing?'" hesaid.

"Rather than a community kind of trying to figure that all that out in the middle of a crisis, can you imagine if it was proactive and all the material was available to every community so they could actually do it in advance and not be reactive?"

Where to get help

If you, or someone you know is at risk of suicide, here's how to get help:

Canada Suicide Prevention Service

Toll-free 1-833-456-4566

Text: 45645

Chat:crisisservicescanada.ca

In French:Association qubcoise de prvention du suicide:1-866-APPELLE (1-866-277-3553)

Kids Help Phone:1-800-668-6868 (Phone), Live Chat counselling atwww.kidshelpphone.ca

Canadian Association for Suicide Prevention:Find a 24-hour crisis centre

U.S.-based National Suicide Prevention Lifeline:1-800-273-TALK (8255)

f you're worried someone you know may be at risk of suicide, you should talk to them,says theCanadian Association of Suicide Prevention.Here aresomewarning signs:

• Suicidal thoughts.
• Substance abuse.
• Purposelessness.
• Anxiety.
• Feeling trapped.
• Hopelessness and helplessness.
• Withdrawal.
• Anger.
• Recklessness.
• Mood changes.