On behalf of the Canadian Association for Suicide Prevention, our board of directors, and our members across Canada, I want to thank this parliamentary committee for providing us with the opportunity to speak to you today about the intentional injury side of injury prevention.
Over the past two decades, close to 100,000 Canadians have died by suicide. Last year, almost 4,000 Canadians died by suicide, more than the total number of fatalities from all other unintentional injury-related deaths and homicides combined. Death by suicide is the leading cause of death over all other injury-related fatalities. Yet suicide, like injury prevention in general, has been largely ignored by the federal government.
Canada ranks in the top third of countries with the highest suicide rates. Suicide is not the result of a single cause; it is complex. Suicide prevention requires a multi-faceted approach.
Suicide is the result of an interaction of complex biological, psychosocial, and spiritual factors that can include social isolation, trauma, stress, family violence, poverty, poor mental health, and physical and mental illness.
In Canada, suicide prevention is fragmented, disconnected, and lacks a national vision. There is currently nothing under mental health or injury prevention that unifies suicide prevention in Canada.
If one examines the impact that suicide and suicide-related injuries have on our already overburdened health care system, the cost is alarming. It is estimated that in Canada there are in excess of 88,000 visits to emergency departments for suicide-related behaviour.
In 2004 over 7,000 Ontarians were admitted to hospital for suicide-related behaviours. Of this group, permanent partial disabilities were suffered by almost 1,500 people and 76 suffered permanent total disability.
Given the need for hospital and/or rehabilitation services and additional family support following a suicide attempt, the estimated cost of non-fatal suicide-related behaviours ranges anywhere from $33,000 to $308,000. There are many other economic costs associated with intentional injury deaths, but they fade in comparison to the price that is paid by the families of those who died by suicide.
Over three million Canadians, and no doubt some of us in this room today, have known the pain and anguish that comes when someone we love dies by suicide. What adds to this tragedy is knowing that many of these intentional injury deaths were preventable. Sadly, when someone dies by suicide, the pain is not gone. It is merely transferred to their family, their friends, and their community. Their injuries are largely invisible and mostly suffered in silence.
The Canadian Association for Suicide Prevention is made up of a group of dedicated volunteers. Since it began in the 1980s, CASP has conducted its work with no public funding or support from the Government of Canada. CASP and its board have volunteered thousands of hours to promote suicide prevention on a national level, often at great personal sacrifice.
For the past two decades, CASP has done the yeoman's share of the work without support, acknowledgement, or encouragement from federal sources. Up until now, we have only heard silence from Ottawa. The Government of Canada contributes to the stigma and the problem of suicide by its silence, rather than publicly and vigorously declaring its support for suicide prevention. Thank you for helping to break the silence.
While the United Nations, the World Health Organization, every other developed country, and every province and territory recognize suicide as a major public health issue and a priority, the Government of Canada has yet to do so, and has demonstrated little leadership on this intentional injury issue.
Your thoughtful and courageous decision to make the intentional injury of suicide part of this injury prevention discussion gives us hope.
As the UN recognized in 1993, suicide is not the responsibility of a single sector domain. It belongs to public health, mental health, social wellness, and injury prevention. No one can say this is not my problem or responsibility, and yet that has been largely the message we have heard from the Government of Canada.
To date, the federal government's response to our pleas has been that this is a provincial and territorial responsibility and not theirs. Suicide, as a serious intentional injury, is in fact everyone's responsibility. Everyone has a role to play, and that includes the Government of Canada.
Our national government has, in the past, demonstrated leadership and has worked collaboratively with the provinces and territories on numerous public health issues and pandemics, such as H1N1, SARS, and AIDS. It is now time for our national government to get involved, in a meaningful way, in addressing Canada's suicide pandemic. Our national government can no longer ignore the injury prevention issue and simply pass it off as a provincial and territorial issue and walk away.
While our federal government has made important investments in suicide prevention in first nations communities, it has failed to take action beyond this very limited and selective response. It has made no investments in suicide prevention outside of first nations communities.
The good news is that suicide-related injuries are preventable. We know what to do. We can do it, and we must do it together. For the past six years we have been offering the Government of Canada the gift of a national strategy for suicide prevention that was developed by CASP in 2004. I have a couple of copies that I brought with me today. It is a gift that keeps being returned. We invite you today to accept this as our intentional injury prevention gift in the spirit in which we are giving it. Please, let's work together to save lives and comfort those who grieve.
Over 15 years ago the United Nations and the World Health Organization recognized suicide as a major public health issue but didn't confine responsibility to a single domain. In 1992 the United Nations asked Canada to take a lead role in developing international guidelines for suicide prevention, which were later adopted by the UN, in 1996.
The UN guidelines and the subsequent World Health Organization guidelines asked that every country develop both a national suicide prevention strategy and a national coordinating body. Shortly afterwards, countries around the world began developing their strategies. To date, all developed countries have national strategies--all of them, with the exception of Canada. All of these countries overcame obstacles. Why can't Canada? In fact, not only has Canada failed to act on and recognize the UN and WHO guidelines, it has yet to even acknowledge suicide as a national public health issue.
Currently, suicide prevention is no more than a footnote on the Public Health Agency of Canada's website. Once an international leader in suicide prevention, Canada is now not even a follower. We are shamefully out of step with the rest of the world. It is now our turn to learn from other countries and follow their example.
So what can the Government of Canada do? The Government of Canada can do for suicide prevention what it did for mental health, which was to recognize mental health as a priority issue and establish the Mental Health Commission of Canada. When the Mental Health Commission of Canada was established, they were mandated to develop a national mental health strategy.
It is important that we not confuse the Mental Health Commission of Canada's strategy with a suicide prevention strategy. And note that in their excellent report, Towards Recovery and Well-Being, only one passing reference is made to suicide prevention.
We are asking that the Government of Canada do the following: formally recognize suicide as a serious public and community health and injury prevention issue and policy priority; appoint and adequately fund a national suicide prevention coordinating body that will serve as a knowledge broker; promote knowledge exchange, best practices, research, and communication; commit to working collaboratively with the national coordinating body, the provinces, and the territories on establishing a national suicide prevention strategy; and mandate and adequately fund the national coordinating body to develop and implement a national suicide awareness and education campaign.
In conclusion, too many lives are being cut short and are being deprived of a future that could be hopeful and fulfilling. Too many people and families are being deprived of loved ones who would have continued to enrich their lives and their communities.
There are hundreds of thousands of people in this nation whose lives have been forever altered by a tragic and needless suicide death. Some of them are your constituents. Some of them are maybe your neighbours, your friends, your families, and even your colleagues here in Parliament.
Suicides are preventable. When asked what you did to help prevent suicides in Canada, how will you answer?
There is hope, and with your support, we can and will save lives, and heal those who grieve.