SPECIAL REPORT

KILLING THE PAIN

Canada has an alarming rate of teenage suicide— and nobody, . including grieving parents, knows why

RAE CORELLI January 29 1996
SPECIAL REPORT

KILLING THE PAIN

Canada has an alarming rate of teenage suicide— and nobody, . including grieving parents, knows why

RAE CORELLI January 29 1996

KILLING THE PAIN

SPECIAL REPORT

RAE CORELLI

(UNICEF) reports . . . that Canada’s teenage suicide rate is alarmingly high compared with other industrialized countries. From 1979 to 1991, suicides by young people 15 to 19 doubled to 13.5 per 100,000, ranking Canada third behind New Zealand and Finland.

—The Canadian Press, Oct. 19,1995

STEWART—Mr. Douglas Georges Stewart of Calgary passed away at the Rockyview General Hospital on Oct. 23, 1995, at the age of 17years. He is survived by his parents, Bill and Judy; two brothers, Jason and Christopher; and his sister, Kendra-Lynn, all of Calgary; his grandmother....

—The Calgary Herald, Oct. 26,1995

Around four o’clock on the afternoon of last Oct. 23, Douglas Stewart came home from school and found his mother lying down to rest an ailing back. “How are you feeling?” he asked. “I’m doing OK,” she replied. He spent a moment comforting her and rubbing her back. Then, mindful of her dislike of hard rock, he put on a tape of what she remembers only as “easy-listening music.” After that, he went downstairs to his basement bedroom. While Judy Stewart lay there reflecting on her son’s unfailing thoughtfulness, Douglas hanged himself with a length of heavy two-inch-wide strap of the kind used by furniture movers.

On a Saturday afternoon in late November, a little more than a month after Douglas Stewart killed himself, the wind was chill beneath an overcast sky. Snow frosted the eaves and the driveway basketball hoops of the tidy pastel-colored bungalows in the southwest Calgary suburb of Woodbine, where the street names all begin with “Wood.” Simply dressed in a green cardigan and blue slacks, Judy Stewart, a 45-year-old trust company pension clerk, sits on a straight-back chair in the living-room of the three-bedroom frame bungalow in which she and her much-

Canada has an alarming rate of teenage suicide— and nobody, . including grieving parents, knows why

troubled family have lived for 14 years. She says if people talked more openly about the suicide of loved ones, that might diminish the stigma and make doctors and psychiatrists less inclined to dismiss parental concerns. And so for three hours, with a box of Kleenex on her lap, she talks and cries, sometimes almost uncontrollably, while she revisits the worst nightmare of her life.

She did not know it, but the nightmare had already begun while she lay there in bed with her sore back, listening to the music. After about 10 minutes, the doorbell rang. She assumed Douglas would see who it was, but then it rang again and she got up and went to the door. Two teenage boys stood there, asking to see her son.

“I hollered for Douglas, but he didn’t answer so I went downstairs. I opened the bedroom door. . . .” She bows her head, covers her face with a tissue and begins to sob. After a moment, she raises her head, face wet with tears, fingers fluttering distractedly over her mouth. She stares out the window, remembering, and takes a

deep breath. “I opened the bedroom door and he was hanging from the rafters. I started screaming and tried to get him down. I guess I kept thinking, well, he couldn’t possibly have done this right after he came in and that there was still time to save him.

“But I couldn’t get him down. He was a big boy and the furniture strap bound, you couldn’t loosen it. I kept trying to lift him up to take the pressure off, but then I couldn’t phone emergency, so I had to let him drop. Basically, they said try to get him down and I finally did. I tried to apply CPR but the air was not getting into his lungs. By the time the emergency crews came, I believe he was already probably well on his way. The two boys who had been standing at the door never did offer any help.”

Between June 15 and Oct. 23 last year, at least four teenage boys are known to have committed suicide in Calgary. A 13-year-old shot himself, and two 16-yearolds overdosed on drugs. Douglas Stewart was the fourth. Their deaths dramatize the frightening fact that Canada—described by the United Nations only last August as the best place on earth to live—has the industrialized world’s third-highest rate of teenage suicide.

An even more detailed—and alarming—picture is provided by the 1994 report of the federal health department’s national task force on suicide. While the overall national suicide rate increased by 78 per cent between 1952 and 1992, the rate for 15to 19-year-olds rose from two per 100,000 to 12.9—more than 600 per cent. “The prevalence of suicidal behavior among teenagers,” said the report, “is of serious concern.” Worst off: Quebec, where the rate of teenage suicides multiplied 14 times in 40 years, and Alberta, up 15 times. More shocking still was the suicide rate among teenage males: 42.4 per 100,000 in Saskatchewan, 28.6 in Alberta, 27.1 in Quebec.

‘This is a disaster, this is a shame,” says Dr. Diane Sacks, an assistant professor of pediatrics at the University of Toronto. Menno Boldt, a sociologist at the University of Lethbridge in Alberta and an authority on suicide, suggests that the right-to-die movement on behalf of terminally ill patients may be sending the wrong message to teens. “This whole notion,” says Boldt, “is communicating something to young people that I don’t think they’re ready to hear.”

■ There are five others in the living-room: Judy Stewart’s husband, Bill, 49, a casual laborer; her sister Lucie, 38; Kendra-Lynn, her 15-year-old daughter; and two of Kendra’s friends, Vic Jenson and Kenney Allen, g both 16. Her two surviving sons, Jason, 23, and o Christopher, 21, both unemployed, are absent. There is 9 also a big old orange cat called Morris who prowls restlessly. Somebody brews coffee and puts it on the table. “I can’t remember who was here first, the paramedics or the fire truck,” Judy says. She presses a fist against her lips, eyes brimming over. “There was a police car, maybe, that came to the house as well. At the hospital, somebody from the emergency came and told us they were trying to bring him around but it didn’t look very good.”

Douglas Stewart may have rehearsed his final flight from the demons because it was his second trip to the hospital in two months. On the August civic holiday weekend, someone summoned paramedics to a Calgary house where they found Douglas unconscious and hanging by a dog choke chain from a stairway banister. There were cigarette burns and slash marks on his body and evidence of a drinking party. He was in a coma for 30 hours and when he regained consciousness, he said he could not remember what had happened or even being at the party. When he had apparently recovered, he agreed to increase the frequency of his visits to

the psychiatrist, who had been treating him for one year for attention deficit disorder (ADD)—a condition characterized by an extreme inability to concentrate—and prescribing an antidepressant. Douglas resumed classes at Dr. E. P. Scarlett High School in September.

And then on Oct. 23, Judy Stewart found herself back in a hospital waiting room. “I remember thinking that I wasn’t going to be lucky a second time and hoping that I was wrong. I think I knew in my mind’s eye that he wasn’t going to make it, and about how useless it was, you know, to take such an action. Then a doctor came in and told us that they had lost him.” The medical examiner reported later that Douglas had a modest blood-alcohol level of .04. “The only reason people get involved with drugs and alcohol,” says Kenney Allen, “is because they’re trying to get away from whatever the pain is.”

There are three significant factors in teenage suicide, says pediatrician Sacks.

“The first is depression.

Why don’t we treat kids who are depressed? Because we are ashamed of mental illness.” The second thing is firearms—“it’s not a question of keeping them under lock and key but of keeping them out of the house.” The third factor: alcohol. “Many suicides,” says Sacks, “are done after kids have been drinking.” In fact, says Sacks, “a significant number” of teenage deaths in car accidents are really suicides where alcohol was a factor.

“Canada has an abysmal record of providing mental health care for teenagers and it has gotten worse during the last 15 to 20 years,” says Sacks. Psychiatrists, she says, either have 18-month waiting lists or, worse, are accepting no new patients. ‘Try telling a kid who is so depressed that he can’t get to school that he has to wait 18 months to see somebody.”

There is no shortage, however, of public and private agencies across the country offering immediate but short-term help to teens in fullblown crisis. Alberta, which has the secondhighest teenage suicide rate in the nation (behind Saskatchewan), also has the highest overall rate—and among the most aggressive countermeasures. Calgary’s highly regarded Suicide Information and Education Centre has trained more than 50,000 people across Canada—teachers, guidance counsellors, nurses and doctors— to recognize and deal with warning signals among students and patients. “People just don’t realize how big a problem it is,” says director Gerry Harrington. At the same time, Calgary’s Suicide Services, run by the Canadian Mental Health Association, offers crisis and bereavement counselling.

Calls for help are commonplace in every major city. An average of 500 distressed people call the Vancouver crisis line every week, about 50 of them “having a suicide component,” says executive director Arthur Dick. One call in 20 is from a teenager. “It’s pretty

devastating for a parent of a child who commits suicide,” says Dick, “because the first thing that goes through their mind is what the hell did I do wrong?” Geoff Jopson, the Vancouver school board’s former counsellor co-ordinator, says students frequently tell counsellors they are thinking about suicide—or have already attempted it. ‘We weren’t talking about this a decade ago like we are today,” says Jopson.

It is only late afternoon, but the wintry sky outside is beginning to darken and the coffee is running low.

“I had a phone call from the school the morning after Douglas

died,” Judy says. “They had heard rumors and wanted to confirm it and have a school assembly and have the counsellors available for crisis work. We went to the funeral home to make arrangements, but I didn’t know what to do about the service—particularly because of Douglas’s demeanor towards the church. He fancies himself to be an atheist although I don’t believe he is.” Present tense.

“The next day, Kenney here and two or three of her friends came, and she said we’ve got this tree and we want to plant it in the forest for Douglas. We said OK and we got our coats and stepped outside and there were 37 kids on the street and they had this 7 'A-year-old tree, a Douglas fir, in a bucket and we went over to a field nearby and planted this little tree. One of the kids sang a song and one read a poem.

“The service was at the funeral home on Saturday. We did a lot of focusing on the kids, keeping in mind that the loss was not ours alone. Douglas was a big fan of Leonard Cohen and that was the music they played for the prelude. The interlude was Bette Midler’s Wind Beneath My Wings, and the postlude was the final theme from Star Wars where Darth Vader and Luke Skywalker fight it out.”

Kendra is in the kitchen talking on the phone to a friend. “Questions like ‘what have I done wrong?’ are very much there,” says Judy. “I guess I have to consider myself fortunate. I had taken some counselling about four years ago for stress because it seems that as the kids were going through their teenage years, each tried to one-up the other with stunts. So I took some time off work to deal with a counsellor. It was an agonizing nine months, coming to grips with the fact that I could not live my children’s lives or my husband’s, and that they had decisions to make and if they made the wrong ones, they ultimately were going to be held responsible for not getting the help they needed. I think if I hadn’t done that I wouldn’t be in one piece today.” Kendra reappears and flops down on the sofa.

"What was Douglas like?” says Judy. “He was well thought of by some of his teachers, but by others”—she half smiles, remembering—“he was considered just plain strange. He was, I guess you

‘We have an abysmal record of providing mental health care for teenagers’

could say, the epitome of the nonconformist. He wore his baseball cap backwards with a lightbulb on it and two corn skewers stuck up in it. Sometimes he wore his boxer shorts on the outside of his jeans. His favorite shopping spot was a kind of thrift store. He was very proud of a car coat he bought for $3. He was basically the champion of the underdog at school, although unfortunately he was often distracted. We used to spend a great deal of time talking.”

Vic Jenson grins. “He used to cover the ground out front with pillows and jump off the roof. I did that with him once. If you didn’t do it right, he’d make you do it again.”

For the tortured, self-doubting families of suicide victims, as well as for the doctors and the counsellors, the inescapable question is

why. What are the monstrous forces that so overwhelm teenagers that they can see no solution other than to kill themselves?

“The act of suicide tells one that the victims feel desperate, feel angry, feel betrayed, by life, by society,” says Dr. Isaac Sakinofsky, head of the suicide studies program at Toronto’s Clarke Institute of Psychiatry. “Sometimes they are suffering from a clinical depression. Sometimes they are suffering from another psychiatric disorder. Sometimes they are just suffering from a series of blows that life has dealt them.”

At the Children’s Hospital of Eastern Ontario in Ottawa, a national study in 1993 showed that one-third of adolescents would prefer to handle mental health problems on their own. Most would turn to their peers. “So they’ve lost their faith in turning to adults,” says Dr. Simon Davidson, the hospital’s chief of psychiatry. “Is it not possible that adolescents have lost their sense of belonging to their society and their community and, if so, that might account for the increased rates of suicide?” At the same time, Davidson says,

“our services are really stretched now and we’re not even seeing the tip of the iceberg.”

Nobody knows why Canada, as compared with other countries, has such a high teen suicide rate. It is well-known that the country’s natives have a high overall rate of suicide—twice the national average, according to the federal government—but the actual numbers are too few to inflate the national rate significantly. What are some other possibilities? “The theory is that suicide generally can be attributed to two major things,” says Sakinofsky, “the state of the economy and the attitude in the country towards committing suicide, but nobody really knows.” Sacks says neither climate nor the time of year appear to be factors, except for holidays and exams, “which are normal stress times.” Dutch-born psychologist Antoon Leenaars of Windsor, Ont., former president of the Canadian Association for Suicide Prevention, sees Canada in social disarray: “I think that what’s happening among aboriginal youth,” he says, “is a magnification of what is happening generally among our youth.”

A hundred years ago, French sociologist Emile Durkheim concluded that some suicides are caused by a breakdown of social standards, which he called “anomie.”

Durkheim said when that occurs, many people are overtaken by a sense of futility, lack of purpose, emotional emptiness and despair. Canada and her teenagers, says Sakinofsky, may be suffering from anomie.

But among families that more or less stay together, says psychology professor Brian Mishara of the Université du Québec à Montréal, vigilance may help. “Suicide is not an impulsive act; it very rarely comes out of the blue,” says Mishara. “Nine out of 10 people who attempt suicide talk about it beforehand. It’s not a desire to die or a desire just not to live but a desire to end whatever is going on. That’s why suicide prevention services

are so effective because the person doesn’t necessarily want to die, he just wants to stop living like this, to stop suffering.”

“Douglas lost his girlfriend during the summer,” Judy says. “When she was around, he took his medication regularly. He seemed in tune with his moods and she was very good with him. She would refuse to catch up with him at night if he didn’t take his medication. He had to show up at school. It was a very positive relationship. But her parents had come from an upper-class family and I suppose it was only natural that they would want their daughter to get someplace in life. They may have undertaken to separate them because she was sent to Hawaii for the summer.” She falls silent. Next door, there is the sound of a snow shovel on concrete; Hawaii is a long way away.

Kendra places an album on the coffee table. It is filled with Douglas’s writings, mostly poetry.

What a pitiful state it is to simply exist,

All hope fora better I have dismissed.

All that I want is to leave this behind,

Let go of the chains that you have on my mind,

Judy says the mood of his poetry alarmed her. “But the thing was that Douglas always qualified it by saying I wasn’t reading it right. However, I did see it as a warning— that’s why we had him going to a psychiatrist.” The psychiatrist said something about not getting terribly excited over the poetry. “And the family doctor was aware,” says Judy. “In retrospect, you wonder whether he should have been institutionalized for a while in the summer. But people have rights and if they are not deemed to be a risk to themselves by those who are the professionals, then basically what that makes you is a hysterical parent.”

At some point during that blurred week in October, Judy met with a crisis counsellor at Rockyview General Hospital. The counsellor told her that the chances of a person taking his life in the heat of the moment are very slim, that Douglas likely planned his last day on earth. “She said that Douglas probably went to school, saw all of his friends and had a good day. He came home and I was here and he spoke to me, he put on his music that he liked and went downstairs and took his life, just like that.”

I find myself deep in a hole of sorrow,

Too far to bother,

Too far to try,

Too far to get out.

So I think I just wait here and die.

TEEN SUICIDE STOP 20 Ages 15-19; deaths per 100,000 1991 1970 New Zealand 15.7 5.8 Finland 15 10.6 Canada 13.5 7 Norway 13.4 1.3 United States 11.1 5.9 Austria 10.2 Hungary 8.4 Czechoslovakia (former) 7.7 Ireland 7.5 Bulgaria 7.2 Poland 7.1 Switzerland 6.7 Sweden 6.2 France 5.3 Denmark 4.4 United Kingdom 4.3 Japan 3.8 Portugal 3.7 Netherlands 3.1 SOURCE: WORLD HEALTH ORGANIZATION