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True Suicide Prevention Comes in the Form of Treatment, Bob

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Former interim leader of the Liberal Party of Canada, Bob Rae (who is also a former NDP Premier of Ontario), wrote an op-ed in the Globe and Mail calling for a national strategy on suicide to remember Chris Peloso who recently ended his own life. While Rae is undoubtedly moved by sadness at this tragic loss of life, he has failed to do his homework.

His suggestion assumes that suicide prevention does not already exist and that no one is working on it. The fact is that Canada passed the Federal Framework for Suicide Prevention Act on December 14, 2012. Rae was still a Member of Parliament when this legislation was passed but, as one cynic said, maybe he was on a Rae Day when it was passed. For those too young to remember his tenure as the NDP Premier of Ontario, Rae Days refers to his 1993 Social Contract which imposed a wage freeze and mandatory unpaid days of leave for civil servants.

And of course Rae also does not seem to be familiar with the Mental Health Commission of Canada who are also working on suicide prevention and have developed a mental health strategy for Canada.

And, on Sept 10, 2013 Louise Bradley, the CEO of the Mental Health Commission addressed people on Parliament Hill in Ottawa for World Suicide Prevention Day. She talked about people requiring access to treatment services as a method to help prevent suicides.

The question then, Rae is not "why aren't we doing anything about suicide prevention?" but "is suicide prevention effective?". As an experienced psychiatrist commented to me, suicide prevention focuses on the outcome rather than the cause. We can make a difference through intervention, treatment, continued treatment and monitoring of those illnesses that can lead to suicide. And those illnesses are schizophrenia, depression, bipolar disorder, severe anxiety disorder and other psychotic illnesses like post-partum depression and those induced by drugs.

A study published in 2011 that looked at all prevention strategies attempted found that what worked is this:

  • training general practitioners (GPs) to recognize and treat depression and suicidality,
  • improving accessibility of care for at-risk people, and
  • restricting access to means of suicide.

This study confirmed the results of an earlier study published in the Journal of the American Medical Association in 2005. That also concluded that the best preventative is "physician education in depression recognition and treatment and restricting access to lethal methods."

What we do not need is another committee wasting scarce resources to study what is already known. We do need better access for people so that they can get the treatment that they need. The Canadian Alliance on Mental Illness and Mental Health states that mental illness is the most common reason for suicides. And they said that "the downsizing of institutional care was not matched with a complementary upsizing of community-based services, resulting in significant gaps of service for those with severe illness and for people with moderate degrees of impairment.

We do not have enough services for those who need it and that is what Rae should be demanding.

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