In the space of 20 years, some 550 children under the age of 18 have died by suicide in Quebec, leaving devastated families and loved ones to mourn. As found The dutywhile each story is unique, the coroners who have looked into these deaths have nonetheless brought to light recurring issues and missed opportunities to potentially change the tragic fate of these children.
“We had it under our noses, and we didn’t see anything. Five years after the death of her daughter, Caroline Tremblay is still trying to tame the guilt that inhabits her. Her daughter Cassandra, to whom she was nevertheless very close, never told her of her unhappiness or her suicidal intentions.
It is rather to her friends that the 14-year-old girl confided. “She wrote an apology to one of her friends and on the same day she wrote to another friend that she felt like she was falling, that she needed someone to grab her and that she felt alone. She also expressed her wish to end her life, ”wrote the coroner Nancy Bouchard in her report on the death of Cassandra, which occurred in 2017.
On the advice of her friends, the teenager went to the office of the school psychoeducator. “But this one was not available, and Cassandra did not make an appointment”, specifies the coroner. A few days later, Cassandra took her own life. “My world has collapsed,” her mother says with a sigh and in a voice that contains all the sadness in the world.
In the weeks following Cassandra’s death, Ms.me Tremblay found an essay written by his daughter at school, in which she expressed her distress. “She wrote that she was in so much pain that she was no longer able to cry and she had drawn a reaper. The teacher put a question mark, but I never saw this work until it was too late. »
On the phone, Mr.me Tremblay sighs again. “It’s very difficult to realize that all this was happening without being informed. If we had been contacted, we would have acted immediately, we would have taken her to the hospital, but we didn’t know anything. »
She is not angry with her daughter’s friends, but she believes that, in general, teenagers are still poorly equipped to know how to react when they receive such messages of distress. “Even the parents, we are misinformed, she laments. I didn’t even believe a 14 year old could take his own life. We should be better equipped to detect the signs. »
Red flags
Cassandra’s case is far from unique. In total, 546 minors have taken their own lives in Quebec since the year 2000. And 40% of them had verbalized their intentions, counted The dutywhich analyzed all of the coroners’ reports related to the suicide of minors.
Throughout the pages, there are many examples of trivialization of suicidal remarks by the entourage. Some believed the youngster was making jokes or tried to “make themselves interesting”. Others simply did not care anymore given the repetition of suicidal remarks.
In some cases, coroners indicate that teachers are not always well equipped to detect the suicidal risk of young people who express their pain in different ways. Conversely, others report school workers who offer help that parents refuse.
“Any verbalization must be taken seriously and validated, reminds the researcher of the McGill group of studies on suicide Marie-Claude Geoffroy. The idea that people who talk about their suicidal ideation will not act on it is false. »
Under the radar of professionals
A quarter (26%) of children who died by suicide since 2000 had consulted for mental health problems or suicidal thoughts. But in several cases, the professionals were not able to detect the extent of the distress or the imminence of the passage to the act.
This is the case of 15-year-old Thomas, who took his own life in December 2015. “He was a bright little guy, who played sports, who was funny and kind,” recalls his father, the businessman Alexandre Taillefer. But in the months before his death, the teenager’s behavior changed. He refused to go to school and withdrew into himself. He had also put on a lot of weight in a very short time and was “farting out” all the time.
“When I look at this today, I tell myself that we had almost all the symptoms required to be worried about a potential suicide,” laments Mr. Taillefer.
But no professional saw that Thomas was suicidal or raised the possibility. “It’s easy to say today, but there has never been a single alert, despite the various meetings and requests for help that we have made, deplores Mr. Taillefer. If someone had raised the slightest doubt about a potential suicide — the slightest doubt, he points out — we would probably have acted differently. »
However, Thomas had been followed in an assistance program at the CLSC for several months. One evening in June, following a crisis at home, her parents called the paramedics to take her to the emergency room. It was not until the next morning that he was seen by the psychiatrist.
“At the end of his examination, during which the young person denies any suicidal intentions, the doctor determines that his patient does not suffer from any major psychopathology, but that he suffers from severe insomnia in the context of an unstructured rhythm of life” , says coroner Gilles Sainton in his report.
He adds that the assessment of suicide risk “is a very difficult and potentially uncertain task”, because there are no “objective means such as X-rays” to make a diagnosis.
Access problem
But it is not because a young person or his family asks for help that he will necessarily receive it at the right time. In their reports, several coroners deplored the lack of access to professionals, a reality also observed by specialists in the field.
“When a teacher or a parent sees that a young person is starting to be depressed, that he is less motivated, it is difficult to find help easily and free of charge in the network”, deplores Karine Gauthier, president of the Coalition. psychologists from the Quebec public network. However, it is at this moment that it is necessary to act, before the child closes up and his suicidal ideas become invasive, observe the experts.
“When they raise the red flag, they cannot be made to wait several weeks and several months and think that they will contain their needs and their negative emotions while waiting for someone to mobilize to help them”, adds the Dr Martin Gignac, head of the child psychiatry department at the Montreal Children’s Hospital.
Over the years, he’s observed that the patients he sees in the emergency room are often stuck in what he calls “revolving doors.”
“Many young people who arrive in crisis at the emergency room are already waiting to be seen in CLSCs,” he explains. We make an emergency plan with them, we give them the means to manage their distress and we direct them to the resources in their community. But after a few weeks, if they are not taken care of, they will come back to consult [à l’urgence] for the same reason. »
It is for this reason that he and his team founded Le Spot, the very first outpatient clinic for young people in a suicidal crisis in Quebec. “We had to find new ways of doing things for this population that cannot be on a waiting list,” he specifies.
But he still sees the limits of his work, particularly in terms of suicide risk assessment: “Risk is like the weather; it varies depending on the day. »
With Sandrine Viera