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Monique Muise

The Montreal Gazette
Date Published: Tuesday, April 3, 2012
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Rhonda deals with troubled teens almost every day.

As a counsellor at health and social services provider Head and Hands, she  faces the difficult task of helping young people work through issues ranging  from drug abuse to depression. But for Rhonda, there is nothing more terrifying  than when someone with their entire life ahead of them tells her that they would  rather not live it.

“When you think that someone might feel that depth of despair … nothing is  worse than that,” said Rhonda, who asked that her last name not be used. “When  you think your client could leave your office and go jump off a bridge … well,  then they can’t leave your office.”

Until recently, suicide among children and teenagers was rarely publicized or  talked about. The fear that widespread publicity could prompt “copycat” suicides  is both real and, many experts believe, justified.

But suicide remains the second leading cause of death among adolescents in  Canada after car crashes (a statistic that holds true in Quebec as well) and a  string of high-profile cases over the past year have meant that the days when  media outlets, schools and governments could avoid discussing the issue are  over.

In Quebec, the suicide of 15-year-old Marjorie Raymond was a major turning  point. Raymond died at her own hand in November, leaving a note for her family  in which she said that she could no longer handle the incessant bullying she  suffered at the hands of her peers.

In a move perhaps inspired by the actions of other grieving parents who went  public in Ontario, Raymond’s mother released the note to the media, calling on  the provincial government to do more to prevent future tragedies.

In February, Premier Jean Charest responded, announcing several initiatives  including an anti-bullying law and funding for research and awareness  campaigns.

Still, teenage suicide persists. On Monday, the body of 16-year-old Maxime  Richard was discovered near Granby. Richard had vanished on Feb. 28, leaving  word before his disappearance that he intended to end his life. The official  cause of death has not been confirmed, but investigators say suicide is the  primary hypothesis.

By the numbers

Statistics pertaining to suicide among young Quebecers are sparse, but they  do exist. We know, for instance, that between 1999 and 2006, an average of 8.38  children under the age of 14 took their own lives in the province each year.

Among teens 15 to 19, suicide rates in Quebec climbed steadily in the years  between 1976 and 2000, then began to drop, down to 8.9 deaths per 100,000 people  in that age group in 2007.

Dr. Patricia Garel, chief of the psychiatry department at Ste. Justine  Hospital, said the media and the public should resist the urge to look at the  statistics and declare an epidemic.

“It remains a rare event, even if it’s too frequent in terms of the tragedy,” Garel cautioned. “If you took an entire arena filled with 100,000 teens aged 14  to 24 … you’ll have 30,000 who have had suicidal thoughts. You’ll have 7,000 who  have demonstrated some form of suicidal behaviour, and you’ll have about 15 who  will actually kill themselves. Among those under age 14, it’s even less.”

While deaths may be rare, the fact that so many young people are considering  ending their own lives can be seen as alarming in itself.

Sylvie Nadeau, who runs the province’s Suicide Prevention Centre in Quebec  City, said that out of 20,000 calls over the past year, about 3,000 involved a  person under the age of 14. That works out to about 15 per cent of calls, and  doesn’t include those in their later teens – when depression, substance abuse,  stress related to sexual orientation and bullying become more prevalent.

Close to home

At the local level, Raymond’s death and those of other teens may have  produced something of a ripple effect over the past several months in Montreal.

A source within the emergency department at the Montreal Children’s Hospital  told The Gazette that staff have seen a spike in the number of young patients  with serious self-inflicted injuries.

That doesn’t necessarily point to an increase in suicide attempts, cautioned  Dr. Lila Amirali, who works in the psychiatry department at the Children’s,  because self-harming and suicidal behaviour are different things.

“Recently we had quite a few patients in the emergency room, but this is the  way it happens,” she explained. “They come in waves, not necessarily always  linked to suicides but in terms of all psychiatric emergencies.

“If we look at the total number of presentations (linked specifically to  suicidal threats or behaviour), this year we have seen a small increase but it’s  still around three per cent of cases.”

That number is in keeping with the overall trend over the past few years,  Amirali said.

Like Garel, she stressed that panicking would be counter-productive and  irresponsible, but added that parents, teachers and other guardians should  always take suicidal threats or actions seriously.

“Parents should also be talking to their children, and should not give up  their responsibility to communicate with their children when they reach  adolescence,” she said.

“They need to notice things like changes in behaviour, isolation,  irritability, low mood, avoiding friends or not showing interest in activities  that (the child) used to enjoy … because these may be signals that an evaluation  is needed.”

A family history of mental illness is also something parents should be aware  of, she said, and they should be on the lookout for early signs of these  illnesses in their kids.

Garel agreed, saying that “among young people who successfully kill  themselves, the biggest risk factor in 80 to 90 per cent of cases is a  psychiatric illness.”

Rhonda said both St. Justine and the Children’s hospitals are doing “amazing” work when it comes to confronting child and teenage suicide, but caregivers must  understand there are other resources like Head and Hands and local support  groups.

“Parents need to reach out and find the resources,” she said. “Often, the  youth don’t know where to begin.”

mmuise@montrealgazette.com