Britain has launched a suicide surveillance tool meant to act as an early warning system about alarming changes in suicide rates and methods – with experts in Canada urging policy makers to adopt similar measures to better track and prevent self-harm in this country.
The announcement of the British surveillance system followed the May arrest of Kenneth Law of Mississauga. Canadian police accuse Mr. Law of using a series of websites to market and sell a legal but lethal substance to people at risk of self-harm. He allegedly sent at least 1,200 packages to people in more than 40 countries and faces 14 charges in Canada for counselling and aiding suicide.
As part of a larger probe into the allegations against Mr. Law, Britain’s National Crime Agency said it has identified 232 people in that country who bought products from the websites, 88 of whom have died.
The new British surveillance tool is meant to improve national tracking of suspected suicides; more rapidly identify emerging methods, and ultimately, prevent people from selling lethal materials to those at risk of self-harm. The British government will now be set to receive data on suspected suicide deaths, methods, ages and genders directly from police forces within months, rather than the years it used to take to release data.
The lack of accurate, timely information is a serious obstacle to suicide prevention, according to Ian Dawe, a psychiatrist at Trillium Health Partners in Mississauga, who began pushing for better data collection on suicides in Ontario nearly a decade ago.
“It’s a tremendous hiccup in the system and it risks people dying – the ultimate failure of the health care system,” said Dr. Dawe, an associate professor of psychiatry at the University of Toronto.
“It is something that demands we all work on together, to bend the curve on the deaths of our kids, neighbours, friends, family members. We haven’t effectively changed the number of suicides, year after year.”
Dr. Dawe and other experts have recommended that coroners and medical examiners across Canada standardize data collection on suicides and probable suicides and share their information with Statistics Canada and policy makers.
Today, the data collection process remains a “mishmash” in Canada, Dr. Dawe said. Coroners’ and medical examiners’ investigations of suicides are often lengthy, prompting reporting delays of many months to Statistics Canada.
“We don’t know accurately how many deaths in this country on any day are by suicide,” he said. “The information we get is often months behind and even under those circumstances, it likely is an under-reporting of what the actual numbers are.”
The stigma lingering around suicide contributes to undercounting: “The coroners and medical examiners … don’t tend to have a low bar for calling something ‘suicide’ because of the implication that would sometimes make to the survivors or the family members.”
The British suicide surveillance program started Thursday, the same day the Canadian government launched a national suicide crisis helpline (9-8-8). Toronto’s Centre for Addiction and Mental Health is leading implementation of the service, which is staffed by trained responders, available 24 hours a day, seven days a week.
Ya’ara Saks, Minister of Mental Health and Addictions, said the 9-8-8 hotline will collect anonymized data to help improve understanding on the numbers and patterns among those experiencing suicidal thoughts. She said the government has been collaborating with provinces and territories to improve data collection on many health measures, including mental health.
Ms. Saks added that the service will help connect people to support: “To have that nationwide for the first time is just a huge step in addressing suicide prevention in this country.”
Tyler Black, clinical assistant professor of psychiatry at the University of British Columbia, said the hotline is important but can only aid people who are willing and comfortable to seek help.
“It’s not going to solve the whole crisis of suicide for Canada,” Dr. Black said. “It’s obviously a smart, practical way to make it less challenging to know what number to call.”
Dr. Black said the British plan to revamp how suicide data are collected is something Canada should look at. While it can take months to conduct investigations when individuals die by suicide, Dr. Black said there is likely a way to share preliminary results to help with prevention efforts.
“If anything, the pandemic has taught us what real-time information can do,” he said. “We could have more data transparency and alert systems for suspected suicides.”
Ms. Saks said the substance involved in Mr. Law’s case is not currently being considered for additional regulation.
In the British suicide surveillance scheme, information will eventually be funnelled into a national alert system that will inform staff at schools, universities and charities about any emerging suicide methods, at-risk populations and possible safeguards.
Dr. Dawe thinks this could be useful, pointing to past alerts issued related to substance abuse, including contaminants in fentanyl: “There would be rapid alerts that flowed through hospitals and emergency departments about something being tracked and unusual activity taking place. It brought real-time awareness.”
Better data collection could also strengthen scientific research on suicide, according to Zachary Kaminsky, DIFD Mach-Gaensslen Chair of Suicide Prevention Research at the Institute of Mental Health Research at The Royal in Ottawa.
“We know there are suicidal thoughts, suicidal behaviours and death by suicide,” Dr. Kaminsky said. “Having more granularity to understand on a large scale – this sounds like it’s going to generate big data – may allow us to find patterns we didn’t know were there before.”
Zosia Bielski
Carly Weeks