Canada needs to adopt a national suicide prevention strategy, and physicians can play a key role in the strategy, states an analysis in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/site/embargo/cmaj111008.pdf.
Many countries in Europe as well as the United States, New Zealand and Sri Lanka have adopted national suicide prevention strategies. Canada, a country in which at least 10 people die by suicide daily (2007 figure), however, lacks a strategy.
There is evidence that shows targeted interventions can reduce suicide. For example, education of primary care physicians was estimated to result in a 22% to 73% decline in annual suicide rates and restricting access led to a 1.5% to 33% decline, according to one study.
"Many Canadian physicians, policy-makers and politicians have not been adequately updated by experts in the field that suicide is preventable," states Dr. Paul Links, Department of Psychiatry, University of Toronto. "As a result, physicians in particular may not be aware of their important role in suicide prevention."
Common elements in suicide prevention strategies include public education, responsible media reporting, detection and treatment of depression and mental health issues, addressing alcohol and drug abuse, crisis intervention and follow up, training and education of health care professionals, reduced access to methods of suicide and more.
As front-line health care professionals, physicians need to be aware of risk factors, such as recent discharge of a patient from a psychiatric institution, and provide appropriate support or referrals. Early follow up after discharge has been shown to reduce the rate of suicide reattempts. Pharmaceutical therapy and psychotherapy are other treatments shown to be effective in reducing the risk of suicide in high-risk people.
"Given the number of Canadians who die by suicide each year, the burden in terms of the suffering and pain of those left to cope with the loss of a loved one and the growing evidence of effective strategies for prevention, physicians have a responsibility to encourage governments to move toward policies and programs that will prevent suicides," concludes Dr. Links. "In Canada, this includes encouraging the federal government to form a national strategy for suicide prevention similar to those in place in so many other developed nations."
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