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Feature - A path through the pain

Imagine a pain so intense that nothing can relieve it. It isn’t a physical pain, it is an emotional anguish which takes over your being. You lose sight of everything good in the world and in yourself.

Imagine a pain so intense that nothing can relieve it. It isn’t a physical pain, it is an emotional anguish which takes over your being. You lose sight of everything good in the world and in yourself. You can’t reach out to those you love because you are so lost in the pain. There doesn’t seem to be a way out. You just want the pain to stop. You will do anything – if only the pain will cease.

This is the kind of pain which leads a young person to consider suicide.

There are many different reasons why they might be feeling this sort of pain, but there is one thing all suicides have in common. A person who attempts suicide is trying to end the pain, and they see death as their only choice. It is important as a society that we help these young people see that they have other choices. There is a path through the pain.

But many young people aren’t finding the path. Currently in Canada, suicide is the number two cause of death among young people aged 15-24. And it is the leading cause of death among First Nations and gay or bisexual youth. Most youth (63 per cent) will seriously consider suicide before graduating from secondary school. One quarter will devise a suicide plan and one in seven will make a suicide attempt.

Kerry Dennehy of Whistler knows all about the pain of suicide. His son, Kelty, took his life last spring. Kelty was a bright, well-loved, successful boy, but he also suffered from depression. And it was this struggle with depression and the emotional anguish it caused which ultimately led Kelty to take his life.

Dennehy says everything happened very quickly. "We knew he was depressed, but he spiralled down in such a short time. He had only been diagnosed with depression two months before his death."

Since Kelty’s death, his parents have started a non-profit foundation to help educate people about the problem of youth suicide and, in particular, the impact of depression ( www.thekeltyfoundation.org ) and they are working closely with Whistler Secondary School to educate students about this issue.

"It’s as if there is a taboo around the subject of suicide," says Dennehy, "but we wanted to talk about it. And we want to warn people about the insidious nature of depression."

Dennehy also admits, with a great deal of sadness, that if he had known more about suicide and depression, things might have turned out differently.

Many people who commit suicide have a history of mental or emotional problems. It is estimated that 90 per cent of adolescent suicide victims are suffering from at least one diagnosable brain-based disorder, including depression and substance abuse. Dr. Steven Holliday, the director of Mental Health Services for the Sea to Sky Corridor, says he prefers the term "brain-based disorders" because there is such a stigma around the term "mental illness."

"The vast majority of people who attempt suicide are depressed," says Holliday. "There is a myth that suicide is the end result of a rational thought process, but most of the time suicidality is a symptom of a brain-based disorder. The ‘will to live’ is very strong, so the loss of this ‘will to live’ is a sign of some sort of neurochemical imbalances in the brain."

The Dennehys tried desperately to get help for their son. They took him twice to the Emergency department at the Whistler Medical Clinic and, with some difficulty, they managed to get him some counselling. But they found it very hard to find the resources they needed for their son. Dr. Holliday is keenly aware of the limited range of services available in the area.

"Essentially, the Sea to Sky Corridor is a rural area," says Holliday. "We don’t have dedicated psychiatric beds in Squamish. You have to travel to Lions Gate for that. And we don’t have 24-hour crisis teams. We just don’t have the staff or facilities for dealing with acute situations."

It doesn’t help that some parts of the corridor have high-risk populations. Native youth living on a reserve are six times more likely to die by suicide when compared to non-native youth. And Whistler, with its young and mobile population, has a large number of people in high-risk groups.

"Whistler has a lot of people in their late teens or early 20s," says Holliday. "And they are transient, so they don’t have the kind of social support that they tend to have in a stable community. They can’t go home. They can’t call their best friend. Their situation is exacerbated by the circumstances of their life in Whistler."

Holliday and his staff do their best with what they have. The Crisis Stabilization Team based in Squamish is part of Mental Health Services and they are available by phone seven days a week. This team of specially-trained psychiatric nurses can help in crisis situations and they try to ensure that people get access to the resources they need. For younger people, there are Child & Youth Mental Health workers in Squamish and Whistler and they provide counselling and other non-crisis intervention.

But Darien Thira, an educator who specializes in youth suicide program development and a former program director of the Vancouver Crisis Centre, says people have to look beyond the designated professionals.

"Everyone who has contact with a suicidal individual is a possible suicide prevention resource," says Thira.

Sometimes in media accounts, the family and friends of suicide victims will say they had no warning that a person was suicidal. Thira says there are almost always signs, you just have to know what to look for.

"I call them the "Signals of Suicide" (S.O.S.)," says Thira. "Eighty per cent of people will send out these signals before attempting suicide."

The "Signals of Suicide" include:

• Preparations for Death – saying goodbye, making a will, giving away prized possessions, talking about going away.

• Previous Attempts – 80 per cent of successful suicides will have made attempts in the past.

• Direct Warnings – comments like "life isn’t worth it" or "things would be better if I was gone," jokes, poems, drawings about suicide.

There are also a lot of myths around suicide. "People think that by talking to someone about suicide it might make them try it," says Thira. "In fact, talking about suicide actually reduces the risk of an attempt. People are relieved when they finally get a chance to talk about their pain. The talking can release some of the pain, making an attempt less likely."

Another myth is that if someone talks about suicide, they aren’t really serious.

"Almost all suicidal people warn those close to them," says Thira. "Unfortunately, these warnings are often missed or ignored."

It might be a reference to being dead, a poem, a drawing or a joke. But Thira says only a person who is thinking about suicide will talk about it. They are telling us their thoughts and asking for help.

Thira also says that a failed suicide attempt is more than "just looking for attention," it is a cry for help. "Most people do not die in their first suicide attempt because they are not really trying to die, they are just trying to stop the pain." But a non-lethal attempt is a very serious sign. Eighty per cent of lethal suicides follow an earlier attempt.

And suicide attempts or warnings should be taken seriously at all ages. In recent research, it was discovered that by the time they are eight years old, most children can accurately define suicide. And by Grade 5, the majority of children were able to name three lethal ways to kill themselves.

"A person’s youth does not protect them from suicide," says Thira. "The pain experienced by a young person is just as great as that experienced by an adult. In fact, youth are less able to cope with pain than adults because they have less skills to manage and see beyond it."

Another myth is that suicide results from a single tragic event in a person’s life. The reality is that most people who commit suicide have a history of distress in their life. Often media accounts convey the idea that a final precipitating crisis event was the only cause of a suicide. Thira says there is a three-stage process which can lead to suicide.

"First of all, there is a loss," says Thira. "This loss is a change, or the fear of a change that seems to be ‘for the worse’. Then there is a crisis – usually the result of a significant decrease in self-esteem. When a person is in crisis, they feel overwhelmed by the pain of their loss . And finally, there is a trigger event. To a person in crisis, one more loss, no matter how insignificant it may appear to someone else, can make the pain of living unbearable."

So if you think someone is suicidal, what should you do?

"Ask them directly if they’ve been thinking about suicide," says Thira. "And listen to them. Listening is suicide prevention’s most powerful tool. Then help them find the resources they need. They may not be able to find them on their own."

In the long term, the ultimate weapon against suicide is the development and maintenance of a strong sense of self-esteem. A person with self-esteem recognizes that they are a valuable human being and that they have means other than suicide to solve their problems.

According to Thira, there are two sources of self-esteem: having a sense of social support and having a sense of personal mastery. The social support comes from family, friends and community, while a sense of personal mastery comes from the feeling of being capable or good at something.

"Young people need to be given a role in society and ways to fulfil that role," says Thira. Also, to have a sense of support, the source of that support must be important to the young person. For instance, a youth who has a loving family will not necessarily feel a strong sense of support if they are not accepted by their peers, and vice versa.

In the same way, a sense of personal mastery must come from accomplishments or qualities that are important to the person in question. A youth might be an excellent student, but if they believe that being a successful athlete is more important than academics, they will not feel a sense of mastery.

Ultimately, suicide is not about death. It is about stopping the pain. A suicidal person is overwhelmed by unbearable pain, and they just want it to stop. Death is a tragic side effect. Thira says that in almost every case, a person considering suicide would choose to live if they could find a different way out of their intense emotional pain.

This is why the vast majority of suicidal people send out a signal of suicide to those near them. They are desperate to find a way out of the pain. This fact is the key to suicide prevention – if you can reduce a person’s pain, you can reduce their suicide risk. We need to help them find a path through the pain.

 

Finding a path through pain: Resources for suicide prevention

SIGNALS

If someone is exhibiting the following Signals of Suicide (S.O.S.), do not leave them alone:

Preparations for Death

– saying goodbye, making a will, giving away prized possessions, talking about going away.

Previous Attempts

– self-harm in recent past or just disclosed.

Warnings

– saying "life isn’t worth it" or "things would be better if I’m gone," jokes, poems, drawings about suicide.

WHAT CAN I DO

?

Reach out

– let them know you care.

Ask directly

– "Are you considering suicide?"

Be a supportive listener

– accept their feelings.

Offer help

– find out who they can talk to, a counsellor, teacher, parent, relative, doctor, nurse or crisis centre.

Never promise to keep a suicide plan secret.

PHONE NUMBERS

CRISIS CENTRE DISTRESS LINE: 1-866-661-3311 (Toll Free from Squamish, Whistler, Pemberton)

– The Crisis Centre Distress Line is staffed by highly-trained volunteers 24 hours a day, seven days a week. The service is free and confidential.

CHILD & YOUTH MENTAL HEALTH SERVICES, SQUAMISH

: 1-604-892-1418 – There is a Child & Youth Mental Health Worker available for young people under 18 who live in the Sea to Sky corridor.

SEA-TO-SKY CRISIS STABILISATION TEAM

: 1-604-892-6365 – The Crisis Stabilisation Team is available to help adults in crisis in the Sea to Sky corridor.

WEB SITES

www.thekeltyfoundation.org – A Web site developed by a Whistler family to promote youth suicide prevention and encourage an understanding of depression.

www.crisiscentre.bc.ca – The Web site for the Crisis Centre based in Vancouver.

www.suicideinfo.ca



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