Suicide prevention is not a choice

When the tragic death of Amélie Champagne was announced, my spouse and I were shot through with anger, revolt, tears and other emotions that eroded our pride in being Quebecers.

Diane Aubin
Psychologist

Deep indignation and dismay at these tragedies which continue to shatter lives, those of young people drowned by their distress, those of their parents, of those who love them and who have to live with fear in their stomachs, desolation, guilt and other unbearable feelings. Our emotions resonate with those of parents, loved ones and caregivers confronted with the stubborn and unjustifiable inconsistencies of our Quebec healthcare system, knowing that it is nevertheless possible to do otherwise.^⁠ in 2022¹.

As a psychologist still active in the profession, I worked for over 20 years in a community organization and a few years in school and institutional settings. I can testify to the frequency of situations of acute distress and suicidal crises, both among young people and among suffering adults. My years of practice in a community organization taught me, myself and the workers with whom I collaborated on a daily basis, that to prevent suicide, it is essential to work as a team, in order to weave a solid safety net and to give back long-term hope.

Preventing suicide, coming to the aid of a person in danger is an individual and collective responsibility^⁠2.3. Working with the urgency to act in mental health requires, paradoxically, taking the necessary time: to welcome, acknowledge receipt of the distress message, secure, reassure, create a bond of trust, listen to better understand, identify outstanding needs and potential allies, and collaborate in the implementation of solutions adapted to the needs of the person.

In order to develop an action plan, a first quality interview will certainly take place over a period of more than 20 minutes, and it will certainly take a few more.

Not taking the necessary time means risking not seeing what lies under the tip of the iceberg. It will also be necessary to make sure to check that this person has been able to eat and sleep enough, in a safe and soothing place, it should be specified. It will be necessary to involve significant people in the lives of those who suffer. Yes, it takes time, like when dealing with a complex health problem that requires multiple delicate interventions.

With my colleagues, I had to put a lot of energy into finding allies in the current care system, which has become extremely hierarchical. We have often been confronted with administrative rigidity which establishes deadlines incompatible with the urgency of acting in the face of suicidal distress, the inhospitality of the premises (absence of safe spaces for people in distress), the lack of will to cooperate between teams, or the expression of disbelief in the face of our expertise, even when mentioning our professional title. The few alliances created through determination remain at risk of vanishing if their sustainability is to rest solely on the shoulders of a small group convinced of the need to work together.

Precariousness also threatens community organizations, often champions in terms of the quality of hospitality and reception of people in distress. Underfunded, they do not benefit from conditions that ensure the hiring of the necessary number of workers or the retention of their qualified and passionate staff. However, their expertise and relevance are undeniable.

In order to prevent suicide, we have a duty to team up and cooperate, with the young people themselves, with their relatives, friends, roommates, parents, workers, teachers or any other significant person. We have an obligation to attack without complacency the factors that undermine our social safety net and our healthcare system, which perpetuates the inequities between the public network and the community, which complicates access to services instead of favoring transdisciplinarity, when it does not jeopardize alliances built on the ground to face the winds and tides raised by suicidal distress. There is an urgent need to rethink frontline services^⁠ by restoring an ethic based on shared responsibility. Urgent to recognize the undeniable role of psychologists^⁠4 in the treatment of psychological distress and the prevention of suicide, as well as that of families and loved ones, precious partners too often left aside. There is an urgent need to depressurize the burden imposed on the medical profession, which seems trapped in a logic of productivity stimulated elsewhere by fee-for-service remuneration, which can insidiously contribute to disengagement from the teamwork that suicide prevention requires.

As a psychologist, I know my role is important in preventing suicide and alleviating suicidal distress. I know the effectiveness of a local practice that allows you to rely on a team, to go to the person in pain, to move around, in a day center, a school or the corridor of the emergency of a hospital. It is no longer acceptable in 2022 that this way of doing things is not the norm in our healthcare system and that administrative issues affect access to mental health services, the effectiveness of our interventions and to suicide prevention. I often had to insist that I be allowed to speak for a few minutes with members of the emergency department when I accompanied young people there. When I was able to do this, it made a considerable difference in alleviating the distress and finding meaningful and concrete solutions for the person suffering.