The rate of people committing suicide or going to hospital after deliberately harming themselves is higher than the rate of patients hospitalized for stroke in Canada, a new study indicates.
Learning more about the patterns and demographics of self-injury and suicide can help in targeting certain geographic regions and age groups with community programs for prevention and identification of mental illness, experts say.
“Absolutely community supports make a difference, but it’s not only at a time of crisis,” said Karen Letofsky, executive director of Distress Centres that log 120,000 telephone calls a year for assistance in Toronto.
“It’s also at a time of emerging issues like substance abuse, early onset of mental health problems, and how soon they get diagnosed and how soon they can be addressed.”
The Canadian Institute for Health Information compiled the statistics on suicide and self-injury for 2009-2010 to establish baseline data.
About 140 Canadians per 100,000 population were cared for in an emergency department, admitted to hospital or died from self-inflicted injuries — compared to 124 per 100,000 population hospitalized for stroke.
The statistics, released Wednesday, show there were 17,482 hospitalizations for people age 15 and over for self-inflicted injuries.
After looking at earlier data from other sources, the CIHI study said there are indications that rates of hospitalization for self-injury have decreased in the past decade by 16 per cent, while the suicide rate fell by 10 per cent between 2000 and 2007.
“You could certainly attribute it to more focus on mental health issues in Canada and across the world,” said Kira Leeb, director of the institute’s Health System Performance.
Young women from 15 to 19 were most likely to self-injure, but men were three times more likely than women to actually die from self-inflicted injuries, Leeb said in an interview.
Letofsky said 10 to 12 per cent of calls to the distress lines are considered “suicide calls.”
Males tend to be more averse to seeking help, she indicated.
“Men may not even show up, may be under-reported in the statistics because depending on the nature of their self-injury, they may self-manage — or it may mean when they go to hospital will not acknowledge it possibly as an attempt, but as some other kind of injury,” she explained.
“The other possibility is that a suicide attempt for a female may be a cry for help. It may be a way of rallying her social supports, whereas for a male, the suicide may be seen more as a solution for a problem that they have, and combined with more lethal means, they may just unfortunately be more successful.”
Often the calls to the distress lines concern relationships — familial or involving a love interest, she said.
The late teens and early 20s are the time of the onset of some chronic mental health disorders, so callers may be trying to manage uncomfortable symptoms, she said.
Among men, there can sometimes be sexual orientation issues or issues related to failure.
The bad economy has also been a factor in recent years.
“Two, three years ago we saw a huge spike, and it correlated with a spike in the number of calls we received from people who were suicidal, who had lost jobs, were worried about economic hardship, could not find jobs,” Letofsky said.
“We’re still hearing it as a theme, but it’s kind of reduced back to its former levels.”
The study found that poisoning was involved in 85 per cent of the self-injuries that led to hospitalization, and nine out of 10 of these were attributed to prescription or non-prescription medications.
Carol Adair of the University of Calgary said services for people who harm themselves or have mental illness can run the gamut from family and peer support, to housing and residential programs that include 24-7 observation.
The report also looked at readmissions for mental health patients, and found that about one in nine hospitalizations for a mental illness was followed by a readmission within 30 days.
Individuals who are hospitalized are in “pretty severe need” because patients have to be very ill to even be admitted to hospital these days, said Adair, an adjunct associate professor in the departments of psychiatry and community health sciences.
The report shows which regions in Canada have high and low rates of hospitalization for self-injury, and these can indicate whether community services and alternatives to hospital admission are sufficient.
“In most cases, the story they’re telling us is that we still don’t have our community services — the types and adequacy in terms of volume — to support individuals, and to try to prevent and reduce hospitalizations.”
Letofsky said that the discussion around suicide should not be oversimplified.
“There’s never a single cause for suicide. It’s always multi-causal, and generally there are some internal vulnerabilities and external stresses that come together in a time and place for a person.”
The report’s release coincided with a rash of federal funding announcements Wednesday for mental health initiatives in various parts of the country, many of them targeted at aboriginal groups and young people.