World Suicide Prevention Day (WSPD) happens every year on September 10th. It is a day that I have acknowledged since I starting working for the Hatching Ideas team as a reminder that the work that we do is important and valued. This year, however, WSPD has taken on a much more personal meaning to me. This year, my family suffered a great loss. My cousin died tragically at the age of 41. He had struggled with anxiety and depression for quite some time and, for the last three years, was dealing with chronic pain. On April 28, 2017, my cousin died by suicide.
While, on the one hand, the work that I do for Hatching Ideas has armed me with the tools to understand and deal with the loss, and all the difficult emotions that come along with it; on the other hand, it was that much more frustrating, because I knew the circumstances of my cousin’s suicide were in no way unique. It is a story we hear over and over again, an almost middle-aged man, struggling with anxiety, depression and pain, who simply slipped through the cracks of the mental health system.
Self-harm and Suicide is extremely common
Presentations to the Emergency Department are extremely difficult to estimate, due to chronic under-recording of episodes. In 2015, our research team collected data from all Emergency Departments in the Champlain Local Health Integration Network (LHIN), which revealed that no two hospitals are capturing self-harm presentations in the same way (1).
With this caveat in mind, the Canadian Institute of Health Information (CIHI), estimates that approximately 16,000 people present to the Emergency Department each year for self-harm (2). Unsurprisingly, self-harm has a very strong association with suicide: approximately 1.6% of people who present to the Emergency Department with self-harm will die by suicide within one year (compared to 0.001% of the population) (3).
Self-harm and suicide is more common among men
Men represent approximately 40% of presentations to the Emergency Department for self-harm (4); however, they represent approximately 75% of suicides in Ontario. Studies show that providing one-size fits all treatments for self-harm do not work (5). Men and women rarely respond to psychological treatments in the same way (5).
One potential explanation for this is gender role strain. That is, dominant forms of masculinity place social pressures on men to meet certain gendered expectations (i.e. emotional control, self-reliance, and dominance). When individual men are unable to meet these expectations, they experience strain which may impact their behaviour in a number of problematic ways, including a resistance to seeking psychological help.
What are we doing about it?
We at Hatching Ideas are working very hard to address the high rates of suicide and self-harm among men. In 2015, our team was awarded an Ontario SPOR Support Unit (OSSU) IMPACT award to develop a smartphone-assisted problem-solving therapy for men who present to the Emergency Department with self-harm. This study will pair an innovative smartphone application developed specifically for men, with problem-solving therapy, an intervention that has been shown to be effective in treating self-harm. The purpose of this smartphone application is to extend the reach of traditional face-to-face therapy by allowing instant and time-delayed communication between the patient and the therapist. More information about this study can be found here: https://www.hatchingideashub.com/beacon-study
So today, on this day of remembrance, I sit here taking stock of what is important. On the hardest days, I try to remember that my cousin is now free and I can only hope that I will see him again one day. I carry my memories of him with me and they remind me why we do what we do here at Hatching Idea and how much more there still is to be done.
If you or someone you know is struggling with depression and thoughts of suicide, know that you are not alone. Please reach out for support however you feel comfortable, whether this is to friends, family, colleagues or mental health professionals.
The world needs you.
For more information about mental health resources, please visit our Resources Page: https://www.hatchingideashub.com/resources/
1. Hatcher, S. (2015) - unpublished.
2. Canadian Institute for Health Information (2014) Health System Performance 2014. https://yourhealthsystem.cihi.ca/epub/SearchServlet. Accessed February 20 2017.
3. Carroll R, Metcalfe C, Gunnell D (2014) Hospital Presenting Self-Harm and Risk of Fatal and Non-Fatal Repetition: Systematic Review and Meta-Analysis. PlosOne. doi: http://dx.doi.org/10.1371/journal.pone.0089944
4. Hawton K, Harriss L, Zahl D (2006) Deaths from all causes in a long-term follow-up study of 11,583 deliberate self-harm patients.[see comment]. Psychological Medicine 36 (3):397-405.
5. Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Hazell P, Townsend E, van Heeringen K (2016) Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews (5). doi:10.1002/14651858.CD012189.