Canada

YOUNG SUICIDES

Jane O’Hara July 30 1979
Canada

YOUNG SUICIDES

Jane O’Hara July 30 1979

YOUNG SUICIDES

Jane O’Hara

For years John had been told he was a sensitive, creative child—a kid with potential. Yet he called himself “an absolute failure." At the Alberta high school he attended, he was a consistent B student. The few friends who knew him remarked that he would “always manage to screw up" just when things seemed to be going well. Outsiders read it as a classic case of adolescent angst; it would work itself through. Last year, shortly before his final exams, John went to a friend 's garage, climbed into the front seat of his car, turned on the ignition and waited for the carbon monoxide to do its work.

It was not his first try at taking his own life—he had tried jumping from a bridge and slashing his wrists—but it was to be his last. In passing, John left his parents a series of notes. One was a cheque written for the sum of “endless amounts. ” Another stated simply, “I've finally completed something I've always wanted to do. I remove the guilt from every person . . . P.S. Happy Father's Day."

In shadowy decades landscape past, when peopled suicide by menowas a pausal men, the aged and the forgotten, John’s young death would have been a rarity. A personal tragedy borne by the family and hung like a skeleton

not far from the closeted 19th-century practice in Britain of staking suicides through the heart to lay the ghost to rest. Though the times are more enlightened, youthful suicides remain a mystery, a taboo subject generally ignored or denied by the public. Like child murder, it is a violation of what little innocence remains in our culture, a particularly abhorrent waste of potential in a world newly bent on conserving its natural resources.

Anonymous they may be in wider circles, but deaths such as John’s are becoming the focus of great concern in the esoteric communities of the social scientists. The reasons are clear. Since the 1950s, Canada’s rate of suicide among the young has almost quadrupled, making it second to automobile accidents as the leading cause of death of 15to 24year-olds. And, while some experts claim it is simply our awareness of an old problem that has skyrocketed, others maintain it is increasingly epidemic.

Not only is it a trend woefully paralleled in other industrialized countries (the U.S., Germany, Japan*), it is also a

*In the ILS. the suicide rate tripled between 19;55 and 1975 from four suicides per 100,000 to ll.S. In West Germany, IMS youngsters between the ages of 10 and 25 killed themselves in 197(1—almost twice the number in 19(1(1. In Japan, the number of suicides among children under 19 has increased 15 per cent since 1977.

sad reminder that the fragile shell of childhood may be cracking under the weight of shifting social mores. As the sins of society are visited on the young, it is perhaps only logical that suicide should be the final domino in a series which shows steady advance in such areas as teen-age pregnancy, depression, mental illness, alcoholism, venereal disease and criminality. In a perverse twist to George Bernard Shaw’s maxim, youth is no longer being wasted on the young—it is being wasted by them.

It is estimated, that in 1979, close to 1,000 Canadian youths will die by their own hands and it is generally conceded that the number, based on projections of reported cases, is light. The actual figure could be anywhere from 25 to 100 per cent higher—many cases never find their way into the books. Those involving drug overdoses, alcohol, or automobile accidents will often be classified as accidental deaths, sometimes in deference to the bereaved family. Said Gary Mavis, director of the Vancouver Crisis Centre. “There’s a tendency on the part of coroners, doctors and police to give survivors the benefit of the doubt.’’

Perhaps an even more troubling statistic is this: that close to 10,000 young Canadians, of all economic, social and ethnic stripes, will try to kill themselves this year. Most will do it by taking overdoses, using guns and hanging

themselves. Some will jump from high places or slash their wrists. Others will choose more bizarre methods such as swallowing fish hooks and table forks, or drinking volatile fluids. In the majority of cases attempts will occur between 3 p.m. and midnight during the spring and early summer. Girls will attempt to take their lives three times as often as boys, although boys will complete the act four times as frequently as girls. And, not surprisingly, most suicidal acts take place in the home, usually within earshot of parents, where there is a good chance of discovery and rescue. Studies bear out that more children will attempt a suicide in families where there is an alcoholic parent, a previous suicide in the family, or where divorce has fractured the home.

Some of these children, rare though they may be, will be under the age of 10. Last year, a nine-year-old boy was rushed to the emergency ward of a Halifax hospital after taking an overdose of his mother’s Valium. The offspring of a splintered home, the boy was revived, but his intention was real. In a handscrawled note he had left the following instructions: ‘T want to be buried with my Bible. Please give my teddy bear away.”

In another case, a five-year-old Ontario boy, who had recently lost his grandfather, was put under psychiatric care when he tried three times to kill himself—by swallowing dog vitamins, by drinking poster paint and by stab-

bing himself in the chest with scissors. It was a desperate attempt to regain a Loved One. In the boy’s infant mind, he knew that death would reunite them.

Children often see death as a mystical, almost magical place; its permanence is rarely realized. For this reason, a suicidal gesture among the very young is particularly dangerous. By adolescence, however, the perception of suicide is an adult perception. It is seen as a final, irreversible solution to one’s problems—more anti-life than prodeath. Although many experts believe that a suicidal attempt is mainly a cry for help or a way of seeking attention with little intent to die, Dr. Barry Garfinkel, one of Canada’s foremost authorities on youth suicide, disagrees. Having recently completed a study of 505 “attempters” at Toronto’s Hospital for Sick Children, Garfinkel maintains: “For the most part, these kids wanted to die.”

At 19, Paul was still living with his parents, but had dropped out of school to get a job. And although he was having trouble finding work, his parents said it didn’t seem to be bothering him. He still managed to support himself on money he had earned in the summer. On returning from work one day, Paul’s father heard thumping coming from his son’s bedroom. He figured Paul was listening to music with his earphones on and was just keeping time to the beat. But when he went upstairs to check it out, he found Paul writhing on the floor with a gunshot wound to his abdomen. He was rushed to the hospital, but was dead on arrival. Neither of Paul’s parents said he seemed depressed when

“Suicide has become an acceptable alternative to living for many kids,” says Menno Boldt, a suicidologist and sociologist at the University of Lethbridge. “For many of them life has become intolerable. The question is why?”

There are as many theories as there are theorists, but in spite of a growing body of scientific data youth suicide is still like an uncharted psychic planet, ringed with secrecy and only partially illuminated by case history and anecdote. While the scientific shamans of biochemistry have recently offered evidence that it might be due to a chemical deficiency, others (more or less dismissed) have claimed that it could have meteorological bases—caused by

phases of the moon or the influence of electromagnetic waves. Dr. Sol Hirsch, a professor of psychiatry at the University of Dalhousie, is one of many in the field not overly presumptive of his profession’s ability to stem the increase. “There’s a danger in thinking we are preventing suicide,” he says. “There’s still a tremendous X factor we know nothing about.”

One recent development, which appears to be gaining ground in the medical community, is the idea that youth suicides are closely related to childhood depression. Although it would appear to be a fundamental assumption, prior to the 1960s psychoanalytic theory didn’t embrace the notion that children could suffer from depression. They were thought incapable of it. In recent years, however, both the World Health Organization and the American Psychiatric Association have added definitions of childhood depression to the medical vernacular. It is sometimes called “masked” or “smiling” depression, because it is usually hidden behind a facade of apparently inappropriate behavior.

Already, one European study, conducted by Swiss psychiatrist Walter Poldinger, has shown that suicide rates among the young can be lowered by 12 to 15 per cent with the use of antidepressant drugs. “Unlike adults, kids don’t tell you that they are depressed,” says Dr. Barry Garfinkel. “They express their depression behaviorally in ways such as truancy, vandalism or problems with schoolwork. The suicide rate is rising in this age group because pediatricians and family doctors don’t recognize depression in children and are not treating it with anti-depressant drugs.”

The idea of fitting a child with a chemical straitjacket early in life, has its own inherent problems and, predictably, doctors are lining up on both sides of the controversy. Some, like Toronto physician Dr. Jim Paupst who has done a special study of the problem, are cau-

tious about prescribing anti-depressants. “First, there is the real threat of an overdose,” he says. “And secondly, telling a kid he is depressed is stigmatizing him and teen-agers are very sensitive about that. They don’t like to be different.”

On the other hand, Dr. Amarendra Singh, program director of the Hamilton Psychiatric Hospital, says: “Nobody cries foul when you prescribe an antibiotic for a child who has pneumonia and yet they scream when you use drugs to treat a psychiatric problem. When there is growing evidence that depression is due to a biochemical disorder, it is foolish not to use drugs to combat the harmful effects.” Depression can either be a cause or a symptom of suicidal behavior, but it alone is not responsible for the recent increase. And although there is seldom a single, pure motive for suicide, experts agree that certain factors can be comfortably linked.

In her clinical work as director of the Crisis Intervention Unit at Toronto’s East General Hospital, Dr. Diane Syer has isolated what she believes are the common denominators in virtually every suicide attempt. “First, there is a feeling in these kids of severe isolation, that they are alone and that nobody gives a damn. That’s followed by a sense of helplessness and hopelessness, that their world isn’t going to get any better and so what’s the use of going on. Finally, many kids feel they are worthless, that, in fact, they are a burden.”

There’s little doubt that the special anxiety of adolescence, with its emotional arpeggios of self-doubt and selfconsciousness has something to do with it. Often a fight with a girl-friend or a wrangle with parents will be enough to set an adolescent off on an irredeemable course. And, increasingly, many adolescents are suffering from the competition syndrome—the race to get high grades or a good job—a problem which largely accounts for the high rates of youth suicide in Germany and Japan.

But adolescence, the rambling ride from childhood to adulthood, has always been a bumpy trip. Why is it more so now than at other times? Experts blame it on the wider social picture, on a planet which seems, temporarily at least, to have gone on the fritz. Given the breakdown of families, the general moral flabbiness, on-again off-again sexual roles and the decreasing importance of religion, “Kids today often feel adrift in a sea of permissiveness,” says Dr. James Brown, a psychiatrist at the University of Manitoba. “They are caught in the middle of a massive change in human behavior and they don’t know how to cope with it.”

Perhaps it’s not illogical that more kids are crumbling in a world that threatens to seize up because of oil

shortages, in a world that fears itself on the brink of a nuclear holocaust. But ME surely Oliver Twist, David Copperfield and the child-slaves of the Industrial Revolution had less to keep them afloat than today’s children. Or is this the generation that goes slouching off to 1984 with moral fibres worn thin by too many washings?

It is not coincidental that the current exemplars of the youth culture are punk rockers, groups that call themselves The Voidoids and The Dead Boys, thumb their noses at society and play their anarchy allegretto. Nor is it surprising that cult heroes such as Jimi Hendrix, Janis Joplin and Freddie Prinze made more of a statement with their self-orchestrated deaths than they ever did with their performances.

When rock star Alice Cooper used to hang himself on stage in a symbolic suicide, the message was clear to the teenagers who made him a millionaire: okay kids. It’s time to get off. Or, as the words of the popular theme song from M*A *S*H state: “Suicide is painless.”

Living isn’t.

When Raymond was two, his father ran off, leaving his mother with three kids and a house. He was often left alone when his mother went out to work and when he finally started at school, he said he had trouble making friends. Raymond admits that for 15 years, he grew up thinking that nobody cared for him, a situation that was aggravated last year when his mother started living with another man. It forced him to

move away from home, and two months later he tried to kill himself with an overdose of drugs.

“I did it ’cause everyone’s against me,” he said. “I’d come in late, I’d get yelled at. I’d want to talk and nobody would listen. I figured what’s the use?” Raymond is now in daily therapy sessions at a Toronto hospital. Will he attempt suicide again? “Maybe. Sometimes you gotta solve your problems your own way.”

Perhaps more than anything, Raymond’s story points a steely finger at one of the root causes of suicide—the upset in the modern family. At present, one in every four Canadian marriages ends in divorce, and kids, either neglected in the fight or sucked into the whirlpool of antagonisms, are suffering for it. As more women make the long march into the working world and as extended families become extinct, the security of the child is under siege. “We have to remember that a child’s whole world is his family,” says Dr. Andrew McTaggart, clinical supervisor of child

psychiatric services at Vancouver General Hospital. “In many cases the family milieu is so catastrophic, the child just can’t deal with it. Kids sometimes wish they could kill their parents and when they realize they can’t they turn their hostility back on themselves.”

In many cases, adolescents attempt suicide to settle the score with parents, to mete out retribution in equal amounts of pain and grief. According to therapists, kids will go so far as to plan their funerals, right down to the music they want played. It is a seductive fantasy, one in which the child is still a part of the action, like an omniscient overseer taking a body count.

In a recent Alberta study, which questioned 90 survivors (relatives and friends) of suicides, the majority of parents said they felt responsible, that in some way they had either caused the suicide or in some way could have prevented it. And since suicide remains a subject which is often discussed in whispers, but rarely confronted openly, survivors are forced to lock themselves

up with their secret. Exorcism of the grief and guilt is a long and painful process. “I have a hollow there now,” said the mother of one Alberta boy who committed suicide. “I want him back, but I can’t have him back. I know that. Friends have been helpful, but only time will really help.”

How can youth suicides be stopped? Experts emphasize that there are certain warning signs which should not be ignored. They are: suicidal threats; change in behavior; loss of sleep and fatigue; a decline in schoolwork; an increase in smoking; giving away possessions. According to Alberta’s provincial suicidologist, Dr. Mark Solomon, “It’s extremely important to take all threats and attempts seriously. This will sometimes mean just being a friend, sitting down and letting the kid talk it out.” Solomon adds, however, that if the behavior persists the child should be taken for professional counselling (see box).

Although there are 95 officially recognized crisis intervention centres in Canada, manned 24 hours a day by volunteers, studies have shown that they are rarely used by suicidal children. Other ways must be found of reaching out to these kids whose only playground is despair. Public education is one means. “We need to put a lot more work into raising the awareness of the gatekeepers of society,” said Dr. James Brown. “This means parents, teachers, pediatricians, and teen-agers themselves.”

There is much concern that provincial and federal governments are not doing their part to fund adequately suicide programs and research. At present, Alberta has made the greatest commitment of any province, earmarking more than $200,000 over two years toward suicide programs and hiring the only provincial suicidologist in Canada. But that’s a pittance, according to Dr. Menno Boldt, one author of Alberta’s Task Force Report on Suicides. “Alberta is giving millions to heart and cancer research. Suicide is a bigger problem in terms of productive lives lost than either heart disease or cancer. It’s a matter of government priorities. Suicide has no pressure group.”

In 1972, when the Canadian law changed, it was no longer considered a crime to try to take one’s own life. And, although the conservative religions such as Judaism and Roman Catholicism still anxiously decry it, suicide victims can now be buried in sanctified grounds. The act itself no longer shoulders the everlasting theological penalties it once did.

The evil remains, however, in a world which, by denying hope and embracing despair, has brought about this chilled state in childhood.