This Sunday, September 10th is World Suicide Prevention Day. On average at least 10 Canadians a day die by suicide. Worldwide it claims the life of 800,000 people each and every year, more than homicides and all natural disasters combined.
This project was originally conceived as an antidote to the popular Netflix drama “13 Reasons Why” about teen suicide. But in the real world, as I came to understand more deeply over the course of this project, the reasons are often unknowable.
“The challenge behind finding the reasons as to why or why not in relation to suicide is that the person who ultimately knows the answer is not able to share it with you,” says CAMH Senior Medical Advisor Dr. David Goldbloom.
Dr. Goldbloom is among the 12 CAMH employees and one client who agreed to share their stories about how suicide has marked their lives. Many of the people here say their personal experience with suicide or suicidal ideation was directly responsible for their career path at CAMH. Many of them felt their experiences gave them a deeper connection to the clients they serve. All of them felt a personal responsibility to reduce the stigma surrounding mental illness and addiction by putting their names and their faces to their stories.
“Ninety to ninety-five per cent of people who die by suicide have a mental illness,” says Dr. Goldbloom. “Better identification and better treatment of mental illness would have a significant impact in the area of suicide prevention.”
Dr. David Goldbloom, Senior Medical Advisor, CAMH
CAMH Senior Medical Advisor Dr. David Goldbloom is one of the most esteemed psychiatrists and mental health advocates in Canada. An Officer of the Order of Canada, he has been in practice for over 30 years. In his book “How Can I Help? A Week in My Life as a Psychiatrist” he wrote with rare candour about the grief he felt, and the tears he shed, over the death by suicide of long-time patient Daryl. I sat down with him at his College Street office recently to talk about why he felt it was important to share Daryl’s story.
“It was important for me to be honest about what the impact was on me as a person who bore some responsibility for his health. I remember my last moment with Daryl as if it was yesterday, his hand on my shoulder, saying it’s hard. Daryl was a friendly and affectionate guy so it wasn’t unusual for him to do that, but I couldn’t help but wonder in retrospect if that was a goodbye.
The thing about remembering a patient who has died by suicide is remembering more about that person than the suicide itself. I had the privilege of knowing Daryl for over a decade before he died, When I think about him, I remember not only the tragedy of his death, but also many of the rich aspects of his life and my interactions with him and his family over the years.
Around the question of doubt and second-guessing in the wake of the suicide of a patient, I think it’s inevitable I think we all do it. You can’t honestly prepare yourself for it. We can add up all the risk factors that leave someone vulnerable to suicide, but when it happens it always takes you by surprise. If you have a low tolerance for ambiguity and uncertainty, psychiatry may not be the discipline for you.
Suicide is something everybody with moderate to severe depression thinks about. I have yet to meet a patient who has said to me it never for a moment crossed their mind. One of the privileges of doing a job like mine for 35 years is the learning opportunities, including learning from patients and their families, their ability to surprise you with their strengths, their resiliency, the sharing of their struggles. One of the great lessons for me is having a much more nuanced view of human behaviour and human capacity.”
Renee Linklater, Director, Aboriginal Engagement and Outreach, CAMH
The suicide crisis in Indigenous communities across Canada shows no signs of abating, with a rate of suicide five to 20 times the national average. As Director of Aboriginal Engagement and Outreach for CAMH, Renee Linklater has seen that suffering up close in the lives of her clients, and in her own life too.
“I unfortunately have two family members who have died by suicide in the past decade. One was my aunt, the other was my 18 year old cousin. My son was 16 at the time of her death – they grew up together. I’ll never forget that when I told him that she had died, he already knew how without being told that she died by suicide. He just wanted to know why she went through with it, as he too struggled with suicidal ideation. I think sometimes we have severe stress in our families just from trying to keep each other alive.”
Kirk LeMessurier, Director, Corporate Planning and Strategy, CAMH
On June 11, 2014, Kirk was sitting outside CAMH CEO Dr. Catherine Zahn’s office waiting for a meeting when he received a phone call. His brother, a firefighter with two young children, had died by suicide.
“I was aware in that instant, that millisecond, that my family would be different forever. He had struggled with addiction issues. It started with opioids and painkillers, which makes the issues we deal with here at CAMH really personal. I am convinced that he had an underlying mental health issue that was never diagnosed. When people who struggle with addiction seek help, we need to treat the whole person, not just the addiction. In my planning work we always talk about engaging with people with lived experience, and I sometimes forget that I have what we consider lived experience.”
Quinn Kirby, CAMH Foundation, Manager Gifts of Light
The death of Quinn Kirby’s brother Matt at the age of 23 illustrates why the term “committed suicide” is no longer socially acceptable. “There is no doubt in my mind that it was the illness and not him making that decision,” she says about his death by suicide six weeks after his first episode of psychosis. In the aftermath of Matt’s death, Quinn left a career in advertising and now works fulltime for the CAMH Foundation as manager of the Gifts of Light program. “This is where Matt wants me to be,” she says. “I see him in some of the clients here.” She keeps his memory alive in a private memoir. On one beautiful August afternoon on a bench outside the CAMH daycare, she shared some of her reflections.
“He saw value in everything and everyone. He had this way about him, he could connect with anyone. He wanted to see those who were struggling succeed and would do anything in his power to boost someone’s confidence who truly needed it.
He was a prankster – cue his cheeky grin. He would do anything to make you laugh. It was his medicine. His family (including his two canine companions) always came first – but a very close second were his friendships. He could make you feel like you had no worries in the world.
But his own worries – his dark thoughts and pain, were so deep that none of us knew how powerful they were. It angers me that he will never be older than 23…He was supposed to celebrate his 30th, 50th, 90th birthday. He had plans to show off his tattoos to his grandkids and great-grandkids.
Everything we thought we knew about our lives, our home and one another has been flipped upside down. Grief has the power to restrict your ability to breathe, think and speak. I guess that’s why I’ve turned to writing. Matt’s sudden passing has forced my family to feel the overwhelming brutality of loss, every day since.
The irony is that the most painful and tragic part of my life has also allowed me to find myself, disheveled and exhausted, yet at the doorstep of a fulfilling and life-changing career. It has allowed me to feel even more grateful for each family moment, caring friend, outburst of laughter and those “easy” days.
Matt has given me the gift of compassion. The understanding that it’s the hard days and the losses in your life that will ultimately determine who you are and how you will live moving forward. Something I am required to remind myself of nearly every day, and wish so badly that every hurting soul could know, is that when tragedy or grief strikes, you have the ability to get through it. You as a resilient, loved and valued human being have the ability to get through anything.”
Joel Rosenbloom, Dentist, CAMH
In his third year of dental school at the University of Western Ontario, Joel was already going through one of the most stressful periods of his young life. Then a sudden life shock made a bad situation worse.
“The dental course is a very demanding one – many exams, clinical requirements and a myriad of skills to acquire. At UWO, it was made even more demanding because of the intimidating and disrespectful attitudes of many professors towards the students. There was not a day when I did not worry about being penalized, failing or being spoken to in a punitive tone. For four full years, I was never addressed by my first name, just “Rosenbloom”. I never really believed that I would graduate until the day I walked across that stage.
Being prone to anxiety, this situation was extraordinarily difficult for me to deal with. I had many dark days and barely a week went by when I did not contemplate dropping out. I did not consider suicide.
In third year, tragedy struck. Our class president, a close friend of mine, died by suicide. The class was devastated. This event left me hopeless, rudderless and struggling to cope with the demands of school. It also provided me with a better understanding of the nature of suicidal despair, and why some people might see it as their only option when everything appears to conspire against them. This has remained with me since that time.
Many years later, when working as a dentist in a position that was defined largely by a difficult supervisor, I once again spiraled into a very dark place. The difference between this time and the previous one was that I was much older, I was in a relationship and I had a young child. I had reached a low point of despair where I had no impetus to go on. I remember cycling for short periods of time with my eyes closed. I sought counselling and had support from friends and family.
The responsibility of having a relationship and a young child was paramount in keeping me going.
I eventually came to the conclusion that this situation was untenable and I quit my job for the sake of my health. I am truly fortunate that I am a dentist and have more employment opportunities than most people do.
At present, I am thankful that all is stable – two jobs that I love and a peaceful and happy family life, but these dark periods are never far from my mind. They emerge every so often as poignant reminders of the frailty of the human mind.”
Noreen Jamal, Pharmacist, CAMH
Noreen went through a period of suicidal ideation in her 20’s following the death of her sister from cancer. During her grieving process, she came to realize that she had been dealing with anxiety and depression for much of her life. She also found inspiration in the most unlikely of places.
“With her passing I lost many things – my ability to guide my own life, my love of life. The permanency of life had been taken away. Why am I here? What does it matter?
I lived with depression and anxiety my whole life as a teenager but I could never put a name to it. I thought it was normal to take homework to a family gathering so I wouldn’t have to talk to anyone. I remembered this inspirational fridge magnet I bought my sister when she was diagnosed…’This too shall pass’. Clichéd and cheesy, but I started thinking I won’t always feel this way – just be patient and get through the numbness.
Slowly, life sorted itself out. I have a dream career in health care now. I accept that depression is a part of my life. I can cope with suicidal thoughts as an extension of that depression, knowing that they will pass.”
Jaymie-Lyn Labelle, Occupational Therapist, CAMH
Jaymie-Lyn’s uncle died by suicide when she was 14-years-old. As with many of the people here, she cites her personal experience with suicide in her family as the reason she decided to work at CAMH.
“I was so confused. How does a 14-year-old process that? He was the fun-loving cool uncle – how could someone so easy-going be so sad that he would take his own life?
I’ve thought a lot about all the things he missed out on because he wasn’t able to get the help he needed and deserved. I’ve thought about how lonely he must have been, going through that pain and not being able to open up to anyone.
I am at peace with knowing that I will never have an answer. I choose to focus on what I do know. He was loved and he is deeply missed and even though I only had him in my life for 14 years, he left a mark on me and made a positive impact on so many others.
It’s because of him that I chose to pursue a career in mental health and addiction.”
Katie Stemeroff, Social Worker, CAMH
After struggling with substance abuse, Katie’s sister Sara, who aspired to be a teacher, died of an overdose eight years ago. In the aftermath of her sister’s death, what began as grief for Katie became a lingering mental health crisis.
“My sister died when she was 29 years old… My parents say it was an accidental overdose.
I remember the day my mom told me. The shock, sadness and anger I felt. Everything changed after she died…. Eight years later my husband still tells me I have never been the same.
I struggled with depression and anxiety for as long as I can remember. After my sister died, the depressive episodes were more severe and frequent. During these episodes if I was not working, I spent most of my time in bed, isolating myself. When I’m in the depths of it, it’s like it’s not me. I literally change into a different person.
As my depression worsened, the suffering increased despite anything I tried. I began to have suicidal thoughts. I am not sure what stopped me; maybe it was fear or thinking about my sister or knowing the pain it would cause my family.
Two years ago I was diagnosed with bipolar disorder. Even though I work in the field as a social worker, I still feel as though I have this vulnerability to hide.
There is no happy ending, my struggle is ongoing, but it has allowed me to connect with my clients from a truly authentic place.
I miss Sara’s laugh. She had an innate talent for kids, they loved her. If she had more support, her true self would have come out, because when that was there, she was electric.”
Sean O’Malley, Senior Media Relations Specialist, CAMH
I’ve been chased by the black dogs of depression in one way or another much of my adult life. Luck of the Irish I guess. On one particular night a few years before I came to CAMH, they caught up to me.
It was a confluence of events – the loss of my career of almost 20 years, the collapse of my marriage of over 20 years.
After a terrible fight, I said I would prove to my ex that I was in crisis and asked her to drop me off at Emergency. She did. I immediately realized I had been bluffing. I didn’t want to check myself in.
In the moment, I felt I had to do something. I didn’t want to live. I didn’t want to die. So I walked….All night long…20 miles, maybe longer. I remember thinking, maybe I’ll die of a heart attack and spare my daughter from feeling I meant to leave her behind.
I thought of my brother-in-law who had died by suicide a decade earlier – he wasn’t feeling any pain this night.
It was a beautiful, cloudless summer night. My mind began to wander. I thought of a show I had just watched, where a character said that people in a bad way don’t keep going because they think it’s going to get better, they just want to see how the story ends. I thought of a loved one who said in all seriousness once while in the grips of depression that she couldn’t kill herself – there were too many good shows on.
I decided there was no bad reason to keep going. I decided I wanted to see how my story ends.
Dr. Katy Kamkar, Clinical Psychologist, CAMH
Dr. Katy Kamkar is a clinical psychologist in the Work, Stress and Health Service at CAMH and Director of Badge of Life Canada, which provides mental health supports and suicide prevention awareness to police officers. Stepping outside for a moment from her role as a clinician, she talks about a client who died by suicide several years ago.
“I remember it very clearly as if it was yesterday. I just felt numb. It was a feeling of disbelief at what I just heard. I cried.
What was really helpful was seeking the help and support of colleagues. You want to learn from it. I learned we can’t talk about mental health and mental illness without talking about suicide. The best way to promote suicide prevention is to promote mental health, to encourage people to seek help early so we have a much better chance at reducing the risk of suicide.
I tell my clients every day how proud I am of them, the strength and resiliency they show, the stories they share, the way they overcome adversity.
It’s not a job, it’s my passion. You care for people and people care for you.”
Vivian DelValle, Social Worker, CAMH
Vivian’s mother died by suicide in her native Mexico at the age of 80. Her initial reaction of shock and anger soon gave way to a feeling of peace and acceptance. Her mother had been sexually abused as a young girl, and was addicted to pills for much of her adult life. No longer able to care for herself without medical assistance, one day when her caregiver was not in the house, she put on her favourite dress, and chose what Vivian came to see as her way of dying with dignity.
“I wish we lived in a society where my mom could have said ‘I’m tired, I can’t hold my coffee cup anymore, I’m done’, and I wish I could have supported her through her choice.
I know that she felt she didn’t have any control in her life but she was able to take control at the end. She ended her life on her terms.
I went into social work to study addictions and mental health because of my mother’s struggles.
My life experiences are a crucial part of my practice as a therapist – there are times that I have been in my clients’ shoes in some way or another and that, combined with my professional experience and training, is what helps me provide empathetic support to every one of my clients.”
Rebecca McDonald, Client, CAMH
Rebecca lived with depression and suicidal ideation through most of her teenage years. At the age of 20, she experienced first episode psychosis and was diagnosed with Schizophrenia. Now 26 and an aspiring comic, she is a powerful reminder that even the most serious forms of mental illness can be treated.
“The chemical balance in my brain was just off.
I barely remember the reasons I was suicidal. it feels like such a distance memory being so mentally ill. I just didn’t like living with the sadness every day and that was a reality for most of my childhood.
Because of the medication I didn’t feel like killing myself. I got treatment and it worked.
To go through so much and be happy at the end of it all, I’m super goddamn lucky.”
Julie Rosenberg, Manager Public Affairs, CAMH
Julie is my boss, the one I report directly to most regularly. Every Friday morning, we have a “check-in” where I report on the status of various projects. On many of those check-ins, once we are finished with our official business, we talk about ourselves. She has an ability to make you feel that she is genuinely interested in you as a person. It was on one of those occasions that she told me about the death by suicide of a former co-worker, and how that influenced how she lives her own life.
“She was very open about her struggles, with a new job in a new field and her marriage ending. I knew she was struggling with all the changes in her life and that she was battling with depression, but no one knew the extent of her despair.
At her funeral, her father talked about the importance of hugging your children whenever they are near. I always had an open line of communication with my children, but now I make sure I act on the smallest of cues from my children that may mean they are struggling, or just need to talk. I never say goodnight or goodbye to my children without giving them a hug.”