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Suicide is Everyone’s Business

Steps in Prevention

Early Prevention
  • Early Prevention looks toward preventing the emergence or minimization of risk factors for suicide.  This includes providing socioeconomic and cultural conditions for life promotion, mental wellness and well-being in a population.
  • Issues of homelessness, equitable access to service, poverty, child maltreatment, intimate partner violence; access to potential means such as firearms, over the counter medication packaging; creating climates of safety in communities, workplaces, schools and homes where talking about bullying and suicide can be engaged in without judgement.

Who: policy makers, primary care physicians and other health professionals, community organizations, pharmacists, gatekeepers, teachers, regulatory bodies, unions, professional associations and health and wellness programs.

What: Education and awareness programs: targeting suicide awareness, mental health, bullying and maltreatment prevention.

Primary Prevention
  • Early detection and intervention for potential onset of a mental disorder; social-emotional support upon receiving diagnosis of a physical illness.
  • Support for losses including employment, housing, bereavement.
  • Developing programs for mental well-being including early childhood parenting courses, substance misuse, elder care, newcomers and marginalized communities including BIPOC, LGTBQ+, Indigenous youth and young adults.
  • Universal interventions educating the public that distress and upheaval are parts of daily life with dissemination of strategies for all to manage emotional challenges and distress.

Who: Primary care physicians/health care professionals, school counsellors/teachers, employers, spiritual care providers and community organizations and leaders.

How:  Government resources for funding education, initial/continuing education for professionals, training and services and universal accreditation for suicide prevention, intervention and post-vention in Canada.

Secondary Prevention
  • Early detection of suicide thoughts and non-suicidal self-injury.
  • Development of a Safety Plan including emergency contact with the understanding that this cannot be revoked in the midst of a crisis state.
  • Early intervention of psychological therapies for those experiencing suicide thoughts or engage in non-suicidal self-injury.
  • Early treatment for physical illness, substance misuse, and onset of mental illnesses including but not limited to depression, bipolar illness, schizophrenia, borderline personality disorder, post-traumatic stress disorder, eating disorders.
Tertiary Prevention
  • Follow up contact after discharge.
  • Safety planning and means restriction.
  • Active treatment: medication management; treatment for mental disorder, instrumental care for activities of daily living, e.g. bill payments, food insecurity, housing insecurity; suicide-specific intervention and treatment.

Who: Psychiatrists, mental health professionals, community support agencies, government policy makers.

Universal Responsibilities and Interventions
  • Responsible media reporting and depictions.
Adequate Government Funding for:
  • Accessibility to crisis lines/support and appropriate and timely health care.
  • Staff training in suicide prevention and crisis planning by local experts.
  • Reduction in access to means (e.g firearms restrictions; proper medication dispensing; over the counter medication packaging e.g. quantities).
  • Training and Access to bereavement and loss support for individuals and communities.
  • Training in community appropriate life promotion, suicide awareness and prevention by local community experts.
  • Respite centres for safety from interpersonal violence and suicide related crises beyond 72 hours, including services specific and geared to men and LGTBQ+.
Community/Healthcare Interventions and Responsibilities
  • Provide appropriate care in a modality that is most appropriate for the client (digitally, virtually, individual, group).
  • Provide ongoing training and regular support/clinical supervision for healthcare providers and mental health staff.
  • Provide, within 24 hours to one week, wellness/safety checks for the person discharged from hospital.
  • Ensure proper dispensing of medications.
  • Provide resources/treatment for suicidality, substance misuse, PTSD, mood disorders and other mental illness.
  • Provide client/family with crisis line numbers and support contacts.
  • Collaborative creation of a safety plan for every client at potential risk of self-harm or suicide.
  • Support for people who support people with suicide-related thoughts and behaviours.

Sources:

Gunnell, D., Appleby, L., Arensman, E….COVID-19 Suicide Prevention Research Collaboration, (2020). Suicide Risk and Prevention During the COVID-19 Pandemic. The Lancet.

Mann , J.J., Apter, A., Bertolote, J. …Hendin, H. (2005). Suicide Prevention Strategies. A Systematic Review. The Journal of the American Medical Association. 294(16), 2064-2074. Doi:10.1001/jama.294.16.2064

Pitman, A & Claine, E. (2012). The role of the high-risk approach in suicide prevention. The British Journal of Psychiatry. 201, 175-177. Doi: 10.1192/bjp.bp.111.107805