As a researcher, Dr. Juveria Zaheer spent a large portion of her time at the Office of the Chief Coroner of Ontario transcribing notes by hand that were left by people who died by suicide in Toronto.
The notes, included in the files of people who died between 2003 and 2009, were a window into better understanding the experiences of those individuals, how much mental illness played a role and whether their deaths were ultimately preventable.
“The idea was that if we can read those notes and honour their stories, we can find ways of accessing people who are suffering right now and improving their treatment,” said Zaheer, a researcher with Toronto’s Centre for Addiction and Mental Health (CAMH), Canada’s largest mental health teaching hospital.
In the notes Zaheer examined, she found that many people described feeling like a burden to family, were too emotionally exhausted to engage in mental health treatment, felt like their problems were unsolvable and ultimately fought against those thoughts alone.
“It broke my heart that those were people we couldn’t help and that their stories were over.”
Now, Zaheer is part of a team heading the largest suicide prevention campaign in CAMH’s history. The campaign, titled “Not Suicide, Not Today,” launched on Thursday, and will consist of TV advertisements, social media posts and billboards that will be visible in the following months across the Greater Toronto Area.
The goal of the campaign is to normalize talking about suicide, Zaheer said, both in CAMH as a research institution, but also among families and friends, community members, religious institutions and the workplace so those who are struggling can access treatment sooner.
“If we change the way to have the conversation, it may make it easier for people to ask for help and for us to improve the treatments we do have,” Zaheer said.
For Zaheer and others at CAMH, the campaign signals a shift in openly and honestly talking about suicide — a topic that traditionally has been taboo in mainstream media, with beliefs that talking about suicide ideation, even in clinical settings, can worsen those thoughts
But through Zaheer’s studies and other leading literature on suicide, researchers say there is growing evidence that open and responsible conversations about suicide ideation can lead to a higher chance of being able to prevent deaths altogether.
“We are afraid to talk about it because we’re not sure how,” she said. “This can propagate this myth that suicide isn’t preventable, or that suicide is something to be ashamed of.”
It is estimated that 11 people die from suicide a day in Canada, and one in 20 Canadians suffer from suicidal ideation.
Indigenous communities have been disproportionately hit by these statistics over the years, where the suicide rate is three times higher than those who are non-Indigenous.
The COVID-19 pandemic has also posed a significant threat to people’s mental health, with growing concern that suicide rates will increase as people lose employment and experience a heightened sense of isolation and loneliness.
Zaheer said her research on suicide notes helped her understand the importance of tackling suicide ideation head on, and where better intervention methods could have saved lives.
Those methods include connecting those who are suffering with loved ones who can help them feel worthy, or better treatment options that can give them renewed hope even when they feel they’re at their lowest.
Though the campaign has been 18 months in the making, spokespeople at CAMH said they recognize the importance of launching it in September amid the pandemic to encourage timely conversations about suicide prevention and mental wellbeing.
The campaign was also created in consultation with other suicide experts, Aboriginal services at CAMH, clinicians and people who have suffered through suicide ideation and recovered.
A light for those suffering in darkness
One of those people is Angie Elliott, a 47-year-old mother from Bolton, Ont., who struggled with thoughts of suicide and a gruelling battle to access treatment for her severe panic attacks and anxiety.
Her life was seemingly ordinary with the usual stresses of life; maintaining a career, raising a family and grappling with her parents growing older. But Elliott began experiencing extreme panic attacks at age 44.
A funeral director, Elliott quickly stopped attending work. As the attacks became more frequent — reaching up to 15 to 20 times a day at one point — she stopped getting out of bed altogether.
“I was incredibly healthy but sicker than I had ever been in my life, and nobody could pin it down and tell me what was happening,” she said.
A doctor told Elliott she may have been suffering from anxiety and referred her to a mental health clinic. But she was told there was a wait time of about a year before she could access treatment.
She began to feel withdrawn and anxious, and couldn’t help but think about the challenges her condition had posed to her family and loved ones.
“My husband said he had noticed a darkness that had come across my eyes,” Elliott said. “After one of my episodes I just sort of shook my head and said, ‘I think you’re better off without me.’ ”
Elliott said she’s thankful that her husband took her suicidal ideation seriously, and he drove her straight to CAMH to get treatment.
“He said, ‘We can’t wait a year, please help her now,’ ” she recalled.
She was then officially diagnosed with Severe Panic Disorder and told she would be put on treatment that included medication and intensive counselling with a social worker.
Elliott said she collapsed in tears when she heard those words.
“Finally someone knew what was going on, and not only knew, but that it was treatable.”
Elliott now hopes her story can be used through CAMH’s campaign as a light to those who are severely struggling as she once was.
She said she hopes the campaign will give people suffering from suicidal ideation the chance to pause, reflect and reach out to loved ones or professionals who can help them.
“I’ve been through a war,” Elliott said. “But I’ve come out on the other side and I’m ready to help people fight their wars now.”
If you are thinking of suicide or know someone who is, there is help. Resources are available online at www.crisisservicescanada.ca. You can also connect to the national suicide prevention helpline at 1-833-456-4566, or the Kids Help Phone at 1-800-668-6868.