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Elizabeth Payne: Talking about suicide counters contagion

The idea that suicide can be contagious is an old one. It partly explains the long-observed taboo around reporting on and talking about suicide, as if even acknowledging it could somehow spread the contagion.

The idea that suicide can be contagious is an old one. It partly explains the long-observed taboo around reporting on and talking about suicide, as if even acknowledging it could somehow spread the contagion.

That taboo has done little but add shame, secrecy and isolation to the burden loved ones bear after a suicide.

But things are changing, thanks, in part, to the determination of those touched by suicide, such as Amanda Todd’s mother Carol, that talking about it is the best way to prevent it. They are right, and the results of a recent study that shows the contagion effect of suicide is real should not convince people otherwise.

In fact, the study’s findings should strengthen the resolve to get issues of mental illness and suicide out in the open.

The study, published this week in the Canadian Medical Association Journal, got a great deal of attention, in part, because the question of contagion and suicide has long been a controversial one. But anyone who has witnessed the suicide clusters seen, especially, in small First Nations communities — including the Cowichan Tribes community, which has declared a state of emergency regarding suicides — should not be surprised that teens who know of a schoolmate who died of suicide are more likely to think suicidal thoughts than those with no exposure, as the study based on the responses of more than 22,000 teenagers found.

Dr. Ian Colman, Canada Research Chair in Mental Health Epidemiology at the University of Ottawa, who wrote the paper with Sonja Swanson of the Harvard School of Public Health, calls the study “solid evidence” that supports the theory that suicide contagion is real.

The study asked teens whether anyone in their school had died by suicide and whether they personally knew anyone who died as a result of suicide.

Researchers were surprised at how many respondents reported knowing of a suicide. They found that, in one group, more than 15 per cent of those exposed to suicide had suicidal thoughts, more than four times the number not exposed.

But what do you do with that information?

Don’t confuse discussion of suicide with exposure, for one. Not talking about suicide does not protect teenagers from it, nor does talking about it give them ideas they don’t already have.

Talk is what helps them, their friends and families better understand how to recognize the danger signs and seek help.

That is precisely what the health system has been trying to do — in some cases with more talk than action. The new evidence of how many teens can be affected by the suicide of a classmate means more must be done. That means programs to support students after a suicide should probably include entire classes and larger groups and that more and better ways to get help for those at risk are needed.

Dr. Zul Merali, CEO and president of the Institute of Mental Health Research and director of research at the Royal Ottawa Health Group, says the response to the recent study should be more talk about the causes and risk factors for suicide. “The biggest risk factor in completed suicides is when you don’t talk about it.”

And Merali said the study underscores that “we need to be more mindful about the impact of suicides in the community.”

At a time when there are long waiting lists for psychiatric services for children and youth, the ability to act on that mindfulness is a real concern. Knowing young people have been “exposed” to suicide and are at risk is one thing, trying to assess and treat them is another.

Merali suggests responses to suicides might move into the schools to be more effective. The Royal Ottawa Health Group is already working with schools to combat mental illness and is hoping to look at best practices across the country to come up with new national guidelines for doing so.

If suicide is contagious, the schools are the obvious place to go to open discussions and work to prevent its spread.