Research Profile – Bringing Research to the Policy Makers

A new report on suicide prevention will help form a national strategy.

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Thanks to a team of the country's top suicide researchers, Canada is getting closer to having a national suicide prevention strategy that is based on the latest health research findings.

The research was conducted in support of Bill C-300, the Federal Framework for Suicide Prevention Act, which was passed into Canadian law in February 2012. The bill was introduced in response to disturbing rates of suicide, especially among youth, and it requires that the federal government establish a national framework for addressing the issue.

"Death by suicide among 15- to 24-year-olds in Canada is estimated to be 10.5 deaths per 100,000, making it the second leading cause of death for this age group, and as many as 8% of youth may attempt suicide at some point," says Dr. Kathryn Bennett, professor of Clinical Epidemiology & Biostatistics at McMaster University. She is the lead author of the report Youth Suicide Prevention: Towards an Evidence Informed Action Plan for Canada. With the help of funding from CIHR, she and her colleagues assembled the report in direct response to Bill C-300.

For the report, researchers studied the evidence for the effectiveness of existing youth suicide prevention interventions. They focused on school-based programs for all youth (including those at high risk), and programs for youth who have attempted suicide at least once.

The researchers found a limited number of high-quality studies examining 32 unique school-based programs targeted at a range of age levels. From these studies, they identified program features that showed promise in terms of reducing suicide. These features include suicide screening programs, training leaders or staff to identify at-risk students and how to intervene, peer support and improving suicide awareness.

However, there are gaps in terms of knowing which interventions work best, and how their effectiveness varies between communities. Also, promising programs reduce risk factors for suicide, but researchers still need to determine whether addressing these risk factors actually translates into lower rates of suicide-related behaviours.

The second key area the researchers investigated was prevention in youth who had previously attempted suicide. "A previous suicide attempt is considered the most potent predictor of death by suicide," Dr. Bennett says.

Here again the number of high quality studies available was small. They found there are two main categories of youth who had attempted suicide: those who came into contact with the health care system, and those who did not. Most who came into contact with the health care system had been taken to an emergency clinic to treat their injuries, suggesting that this is an important point of contact for identifying at-risk individuals. However, this contact does not always lead to appropriate mental health care.

"About 90% of people who die by suicide have mental health issues that can be managed if they are identified, [yet] 80% are never treated at time of death," Dr. Bennett says.

The report also found gaps in knowledge relating to the differences between the sexes when it comes to suicidal behaviours and mental health issues. This is important because it may be that prevention interventions should be designed differently for male verses female youth who are at risk.

There are also gaps in terms of understanding the causes and triggers for suicide, and what sorts of interventions would work best in First Nations, Métis and Inuit youth in Canada. Yet some of these communities have the highest rates of youth suicide in Canada.

The report recommends the creation of a nation-wide network consisting of researchers, health care providers and decision makers who would work together to implement and evaluate promising suicide prevention strategies.

This network would ensure good-quality evidence about effective suicide prevention interventions is made widely available to those responsible for implementing programs and providing care to high-risk youth. It would also ensure that people who work in suicide prevention programs aren't working in isolation and have access to expertise, and can contribute what they've learned to the network too.

"This is our recommendation for how to move forward to improve our national capacity to prevent youth suicide and increase our knowledge about what works," Dr. Bennett says.

"This is our recommendation for how to move forward to improve our national capacity to prevent youth suicide and increase our knowledge about what works."
– Dr. Kathryn Bennett, McMaster University