Related national efforts and milestones: Suicide-Related Research in Canada: A Descriptive Overview

B. Related National Efforts and Key Milestones

Following is a brief summary of related national efforts and key milestones in the history of the suicide prevention movement in CanadaFootnote 3.

10th Congress of the International Association for Suicide Prevention, 1979

This Congress provided the catalyst for the formation of the Canadian Association for Suicide Prevention (CASP). At this meeting, a decision was made to establish a steering committee. This committee examined the viability of establishing a cooperative approach to promote and facilitate action in the area of suicide prevention. Tasks undertaken by the steering committee included a needs assessment that identified the following research priorities: evaluation of prevention programs, assessment of risk, psychology of suicide, and epidemiology. Respondents to the needs assessment also identified a mechanism for sharing research information as a key issue. (National Health and Welfare, 1987).

Canadian Task Force Reports on Suicide, 1987 and 1994

In 1979, Health and Welfare Canada established the National Task Force on Suicide in Canada. The Task Force met in 1980 and produced their first national report, Suicide in Canada: Report of the National Task Force on Suicide in Canada 1987. The comprehensive report provided an overview of the magnitude of the problem of suicide at the national level, reviewed the epidemiological and etiological knowledge base, presented findings on specific high-risk populations, and advanced a series of recommendations across the spectrum of prevention, intervention, and postvention activities. Nine recommendations focused on advancing the suicide research agenda, including: establishment of a broad national mortality data base, evaluation of current data collection procedures to standardize methods and increase efficiency, interdisciplinary investigation into the effectiveness of training efforts in suicide prevention, and multi-centre, multi-disciplinary research into youth suicide. While some of the recommendations listed in the original Task Force Report have sparked action (Tanney, 1995), for the most part, very little has been done in response to these recommendations over ten years later (Leenaars, et al., 1998). In 1994, an updated version of the Report was produced, and many of the original recommendations were restated and reinforced.

Canadian Association for Suicide Prevention

Efforts to establish a national association dedicated to the prevention of suicide and suicidal behaviour began in 1985 with the incorporation of the Canadian Association for Suicide Prevention (CASP). By 1988, the organization had elected its first president – Dr. Antoon Leenaars, and a Board of Directors, developed a formal set of by-laws and a five-year plan to guide the organization into the future. CASP's original vision was to "promote within Canada activities designed to reduce the incidence and/or effects of suicide."

Annual CASP conferences have been held in Canadian cities each year since 1990. Research and service recognition awards have been handed out since 1992. A series of specialized sub-committees have been in existence for several years including: research, youth/schools, survivors, crisis centres, and student committees. CASP's mandate has changed very little since its inception and the organization is still committed to advocating for and encouraging the development of suicide prevention, intervention and postvention activities on a national level, and to unite people across Canada's diverse cultures in an effort to understand suicide and reduce its impact.

L'Association québécoise de suicidologie

The first meeting of L'Association québécoise de suicidologie (AQS) took place in 1987 in Montréal. At this meeting, documents outlining the philosophy, objectives and general regulations were adopted and the first Board of Directors was elected. AQS was formed as one way to bring together and coordinate the efforts of several suicide prevention centres, each of which had previously been working in isolation. Over the years, the organization has steadily grown to become a vibrant provincial organization dedicated to advancing the suicide prevention mandate in Québec. In 1992 the AQS amended its general regulations to make them more consistent with those of several other provincial alliances. At the same time, the first subsidy from the Ministry of Health and Social Services permitted the AQS to establish an office whose main function was to coordinate and support the organization's activities.

Crisis Line Network

One of the first volunteer-based crisis lines to operate in Canada was in Sudbury, Ontario, to be followed shortly by Toronto's Distress Centre, which opened its telephone lines in 1967 (Leenaars et al., 1998). Today 24-hour, telephone based crisis response services exist in most major cities across the country, and are at varying stages of development. Several centres across Canada have been accredited by the American Association of Suicidology and a movement is currently investigating the viability of establishing a national crisis line network in Canada (Ian Ross, personal communication).

United Nations Conference in Calgary, 1993

In 1993, an international meeting was convened on suicide prevention where an interregional expert group sponsored by the United Nations was invited to develop guidelines for the creation and implementation of national strategies for the prevention of suicide. This week-long meeting took place in Alberta, with representatives from 12 countries. The draft guidelines from this meeting were submitted to the United Nations and were later published as Prevention of Suicide: Guidelines for the formulation and implementation of national strategies (UN, 1996). The core elements of a national strategy were articulated in this document and included the following features: government policy, conceptual framework, general aims and goals, measurable objectives, implementation through community organizations, and monitoring and evaluation (Ramsay and Harrington, 2000). This document has provided an important blueprint for many countries in the development of their national strategies for suicide prevention.

Combined Meeting of the International Association for Suicide Prevention, The Canadian Association for Suicide Prevention, the Québec Association of Suicidology and Suicide-Action Montréal, 1993

A meeting of over 700 participants, this was an important opportunity for increased contact between (a) Canadian francophone and anglophone suicide Researchers, and (b) with the international research community.

Choosing Life: Special Report on Suicide Among Aboriginal People, 1995

A Royal Commission was established to investigate the problem of suicide among Canada's Aboriginal peoples. Based on 172 days of public hearings that took place in 96 communities across the country, the Royal Commission produced a final report summarizing the findings from the hearings. The report discusses rates of suicide among Aboriginal peoples and acknowledges many of the individual, cultural, social and historical factors that have contributed to the high rates of suicide among many Aboriginal communities. The report highlights several promising approaches being undertaken by Aboriginal communities in Canada to combat the problem of suicide, while also pointing out some of the potential barriers to action. It concludes with a series of recommendations, with a strong focus on community ownership and community development principles.

International Francophone Suicide Prevention Congress, 2000 and 2002

The First International Francophone Suicide Prevention Congress was held in Québec City in 2000, and had over 800 persons attending. The Congress was organized by the Québec Association for Suicidology and the Centre for Research and Intervention on Suicide and Euthanasia (CRISE) of the University of Québec at Montréal. A second international Francophone meeting was held in Liège, Belgium in 2002, with significant French Canadian participation. A third Francophone meeting is scheduled for France in 2004.

First International Conference on Innovative Practices in Suicide Prevention, 2004

CRISE is organizing, in collaboration with Suicide-Action Montréal and the International Association for Suicide Prevention, a First International Conference on Innovative Practices in Suicide Prevention (Pratiques novatrices pour la prévention du suicide) May 4-7, 2004 in Montréal.

France-Québec Collaboration

There has been ongoing collaboration between France and Québec in suicide prevention, which includes research components as part of the France-Québec Cooperation Project. This has included exchanges in areas such as Suicide in the Metro (Montréal and Paris), gun control and evaluation of training programs. The collaboration is expanding to include Belgium.

In the area of Public Health, there have been a number of activities as part of the French International Network on Injury Prevention (REFIF) which holds annual seminars, including research seminars and international conferences on suicide as part of the injury prevention content. The last meeting was in Montréal in 2002 and the next meeting will be held in Lebanon. The 6th World Conference on Injury Control and Prevention "Injuries, Suicide and Violence" was held in Montréal in May 2002, with over 1,600 participants from around the world. This conference included many sessions on suicide research with simultaneous translation.

Survivors/Bereavement Groups

Survivors of suicide offer an invaluable perspective in advancing the knowledge base and improving the everyday practice of suicide prevention. CASP has had a Survivors' Committee in place for several years, which has enabled survivors of suicide to bring their particular interest and knowledge to the attention of the broader suicide prevention community. Annual CASP conferences have provided an important vehicle for survivors, mental health professionals, and researchers to communicate with one another. It is also probably fair to say that survivors' interests have often been quite narrowly understood, i.e., their needs have typically been constructed in terms of their use of bereavement services, and yet survivors of suicide also have a valuable role to play in advocating for suicide prevention programs and educating others about needed changes to the overall mental health system (Bonny Ball, personal communication).

Research Units

Several specialized research units devoted specifically to the study of suicide have been created in Canada in the last few years, including: the Centre for Research and Intervention on Suicide and Euthanasia (CRISE) at the University of Québec in Montréal, the Arthur Sommer Rotenberg Chair in Suicide Studies at St. Michael's Hospital in Toronto, the Laboratoire d'étude sur le suicide et le deuil at the Centre de recherche Fernand-Seguin at Louis-H. Lafontaine Hospital in Montréal, and the McGill Group for Suicide Studies at McGill University in Montreal. Each of these centres will be described very briefly below Footnote 4.

The Center for Research and Intervention on Suicide and Euthanasia

The Center for Research and Intervention on Suicide and Euthanasia (CRISE) is a research unit affiliated with the Université du Québec à Montréal (Montréal, Québec, Canada) which includes researchers, practitioners and students from throughout the province. The centre is unique in that all projects involve collaborative efforts between suicide researchers and community organizations. The members of CRISE share a view of the suicidal phenomenon using the social ecological model developed by Uri Bronfenbrenner. According to this approach, the complex phenomenon of suicidal behaviour may be understood in terms of reciprocal exchanges among individuals and various social-environmental influences.

Arthur Sommer Rotenberg Chair, University of Toronto

The Arthur Sommer Rotenberg Chair in Suicide Studies is an academic program affiliated with the Department of Psychiatry at the University of Toronto. The Chair is housed at St. Michael's Hospital, an urban health care facility located in the inner-city of Toronto. The Arthur Sommer Rotenberg Chair in Suicide Studies has the mission of conducting research leading to a greater understanding of the various biological, psychological and sociological determinants of suicidal behaviour, and implementing societal and clinical healthcare advances to reduce the losses and suffering resulting from suicide and suicidal behaviour. The multi-professional team at the Arthur Sommer Rotenberg Chair in Suicide Studies is headed by Dr. Paul S. Links, Professor of Psychiatry at the University of Toronto, and includes research and healthcare professionals representing the fields of Epidemiology, Psychiatry, Psychology, Social Work, and Sociology.

McGill Group for Suicide Studies

Affiliated with both McGill University and the World Health Organization, the McGill Group for Suicide Studies (MGSS) in Montréal is the only research unit of its kind in Canada, housing one of the world's largest collections of DNA from those who have died by suicide. Led by Dr. Gustavo Turecki, MGSS is composed of 5 independent investigators and more than 20 research associates from a wide variety of disciplines including histopathology, clinical psychology, psychiatric nursing, and laboratory technology. The role of MGSS is to study biological, behavioural, and clinical risk factors for suicide.

Fernand-Seguin Research Centre, Montréal

The Laboratory for the Study of Suicide and Bereavement is financed by the Québec Health Research Fund. It has been part of the Fernand-Seguin Research Centre since 1994. A key mission of the Centre is to carry out various research projects addressing suicide, violent death and bereavement. Suicide and accidents are major causes of death among adult males. It is thus essential to better define the risk factors associated with these deaths in order to be able to prevent them in the future. It is in this spirit that a group of researchers has undertaken a program of research to evaluate the neurobiological, psychosocial and genetic dimensions of this type of mortality.

Other relevant Canadian research centres include the Suicidology Research Group at the University of Windsor, the Centre for Addiction and Mental Health at the Clarke Institute in Toronto, the Culture and Mental Health Research Unit at McGill University in Montréal, and the Mental Health Evaluation and Community Consultation Unit (MHECCU) at UBC in Vancouver.

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