Understanding suicide
Joint Suicide Prevention Strategy
Canadian Armed Forces and Veterans Affairs Canada
Suicide is complex. There is no “typical” case, and there is not a single solution to the problem of suicide and self-harm. This does not mean, however, that we are powerless. Medical research and experience allow us to understand the factors that contribute to a person starting down the suicide pathway and put in place measures to mitigate those risks.
In the vast majority of cases, suicide doesn't just happen. Of those who become suicidal, research indicates 90 percent suffer from a mental illness (particularly depression), and have a life crisis (such as a relationship conflict or loss, financial stress, legal problem, or serious health concern). Given such a situation, a series of additional negative events can coincide to reinforce suicidal intent, and increase the risk of suicide.
Experts identify important opportunities for intervention in this model for suicide prevention:
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Descriptive text of infographic: The Suicide Pathway
- Mood or other Phychiatric Disorder
- Stressful Life Event
- Suicidal Ideation
- Personal Factors
- Such as feelings of burdensomeness, loss, chronic pain
- Imitation
- Where suicide by one person can influence another
- Access to Well-being Supports
- Lack of access to spiritual,physical, financial and other supports
The most important lesson to be drawn from this model is that there are multiple factors contributing to suicide, rather than a single cause, and this means that there are multiple points of intervention and treatment that can help vulnerable individuals. It is also critical to note that these factors rarely (if ever) “cause” suicide independently; it is the interplay of these many factors, which differs among individuals, and their combined effect that can lead to a suicide attempt.
Some of the factors that have been associated with an increased risk of suicide are identified below. These risk factors are not specific to military members or Veterans. However, some of these risks can be exacerbated by the military lifestyle or post-service challenges. These risks include:
- A prior suicide attempt
- Suicidal thinking or self-harming behaviour
- Suicide by a family member or friend
- Mental illness
- Substance abuse
- Impulsivity, impaired problem-solving
- Relationship conflict, discord or loss
- Few supportive relationships (sense of isolation)
- Feelings of hopelessness
- Feelings of being a burden to others
- Other significant loss (employment, financial)
- Physical illness or chronic pain
- Adverse events in personal history (trauma, abuse, including in childhood)
- Access to lethal means (such as firearms or
medication) - Harassment, discrimination and/or bullying
- Stigma associated with help-seeking behaviour
- Imitation, meaning the “contagion effect” where suicide by one person can influence vulnerable people who identify with the person who died
- The Federal Framework also notes the importance of protective factors, stating: “the risk of suicide can be mitigated by strengthening protective factors…Strengthening protective factors should be an ongoing process in order to counter suicide risk and build resilience for individuals, families and communities.” Some protective factors that can mitigate or counter suicide risks include:
- Psychological, physical and spiritual resilience
- Positive social, community and family connections
- Good mental and physical health
- Better management of stress, including coping and problem-solving skills
- Restriction of access to lethal means
- Education/awareness about mental health and suicide (including reducing the stigma associated with seeking care and/or support)
- Access to appropriate health care and social services (including reducing barriers to care)
- Assessment/management/treatment of:
- suicidal behaviour
- mental health disorders
- substance use disorders
- physical illness
- Responsible media reporting
- Examples of important interventions include:
- Assuring access to effective health and mental health care (including treatment for substance use disorders)
- Breaking down barriers to care (including stigma)
- Education/awareness about mental health and suicide
- Good social support
- Building resilience, including psychological and spiritual
- Enabling financial stability
- Providing meaningful work or other activity
- Restricting access to lethal means (such as firearms control, monitoring medication prescriptions)
- Working to promote responsible media reporting.
“When I retired after more than 40 years in uniform, I wanted to give back to the community that had been my life but I didn’t know where to start. I was encouraged to reach out to like-minded Veterans and very quickly, I became involved in a network of like-minded Veterans and civilians who saw the need to reach out to Veterans and to connect Veterans with resources and help and reassure them that they are not alone.
We aren’t mental health professionals and would never profess to be.
“However, just being there for fellow Veterans is often a huge help in providing reassurance and compassion. And I can testify that it is the first step towards professional help. One of the greatest contributions that we can make to Veteran mental well-being is to be there for them, to be open and listen, and to encourage them to get professional help. We can overcome the isolation and loneliness if we educate ourselves and reach out to fellow Veterans.The VAC-sponsored Mental Health First Aid course provided me with the basic tools that I needed to be comfortable reaching out and offering assistance.”
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