SuicideSuicide deathsdeaths andand attemptsattempts by Stéphanie Langlois and Peter Morrison This article has been adapted from “Suicide deaths and suicide attempts” in the January 2002 issue of Health Reports, vol. 13, no. 2 (Statistics Canada Catalogue no. 82-003). Please see Health Reports for a full bibliography. uicide is a tragic and perplex- ing phenomenon that touches CST What you should know about this study the lives of many Canadians. S Data in this article come mainly from Statistics Canada’s Vital Statis- Around the world and across the cen- tics Database, Hospital Morbidity Database, and Person-oriented turies, suicide has stolen lives and Information Database. Supplementary data are from Statistics inflicted grief and guilt on those Canada’s Adult Correctional Services and Homicide Surveys, and left behind. The reasons for suicide the National Longitudinal Survey of Children and Youth, as well as and notions of what to do about it from the World Health Organization. Population estimates used to cal- have varied with time and place, culate rates were provided by Statistics Canada’s Demography but suicide continues to exact a Division, and were adjusted for net census undercoverage and non- relentless toll.1 permanent residents. According to researchers and pro- fessionals, suicide is associated with This article examines suicide deaths rarely discussed, suicide results in the and hospitalized suicide attempts loss of more lives than many other a complex array of factors such among Canadians aged 10 years or causes of death: between 1993 and as mental illness, social isolation, older between 1979 and 1998. Both sui- 1998, for example, suicide claimed a previous suicide attempt, family cide and attempted suicide rates are considerably more lives than motor presented for men and women of vari- vehicle accidents. As well, Canadians violence, physical illness, and sub- ous ages to highlight the demographic are seven times more likely to die stance abuse. Some risks vary with groups most at risk. The social, from suicide than to be the victim of age, while others occur in combina- economic and psychological factors a homicide. In fact, from adolescence associated with suicide and suicide to middle age, suicide is one of the tion. Approximately 90% of those attempts are not discussed in this study. who commit suicide are suffering from depression, another mental ill- Suicide rate fairly stable over past 1. Knowledge Exchange Network. Sum- mary of National Strategy for Suicide ness or a substance abuse disorder, 20 years In 1998, approximately 3,700 Canadi- Prevention: Goals and Objectives for which could potentially be diagnosed Action. http://www.mentalhealth.org/ ans took their own lives, an average of publications/allpubs/SMA01-3518/ and treated. about 10 suicides per day. Although default.asp (Accessed March 8, 2002.) 20 CANADIAN SOCIAL TRENDS AUTUMN 2002 Statistics Canada — Catalogue No. 11-008 leading causes of death for both men and women. Suicide rates remained stable between 1979 and 1998 The total number of suicide deaths CST reported among Canadians aged 10 or older in 1998 represented a rate of 14 per 100,000 population suicides per 100,000 population.2 Since 1979 the rate has remained fair- Total Males Females ly stable with a peak of 18 in 1983. 30 The risk of suicide is not the same for all members of the population. Certain groups may be considered 25 “high-risk” because they often have higher than average suicide rates: Abo- 20 riginal peoples, the young and the elderly, inmates, homosexuals, people who have previously attempted suicide 15 and those suffering from mental disor- ders.3 While a number of studies have 10 attempted to estimate suicide rates for those at high-risk, accurate national rates are not available for these groups. 0 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 Men much more likely than women to commit suicide Source: Statistics Canada, Canadian Vital Statistics Database, 1979 to 1998. Earlier studies have found men to be at least four times more likely than women to commit suicide.4 Men are also more likely to die in their first Men are consistently more likely to commit suicide than women attempt. In 1998, the rate for Canadi- CST an males aged 10 or older was 23 suicides per 100,000 compared with per 100,000 population Males Females 2. Unless otherwise indicated, all rates in 26.5 this article have been age-standardized 25.0 24.7 24.5 to the 1991 Canadian population aged 10 or older, adjusted for net census under- 21.1 coverage and non-permanent residents. 18.2 3. Health Canada. 1994. Suicide in Canada: Update of the Report of the Task Force on Suicide in Canada (Catalogue H39- 107/1995E). Ottawa: Minister of Supply and Services Canada. 7.2 6.4 6.7 4. Federal, Provincial and Territorial Advi- 4.9 5.0 5.0 sory Committee on Population Health. 2.9 1999. Toward a Healthy Future: Second 1.5 Report on the Health of Canadians (Catalogue H39-468/1999E). Ottawa: Minister of Public Works and Govern- 10-14 15-19 20-29 30-44 45-59 60-74 75+ ment Services. For information on other Age groups related studies, a complete bibliography is available in “Suicide deaths and suicide attempts.” Health Reports Source: Statistics Canada, Vital Statistics Database, 1998. (Statistics Canada Catalogue no. 82-003) 13, 2. January 2002. Statistics Canada — Catalogue No. 11-008 AUTUMN 2002 CANADIAN SOCIAL TRENDS 21 6 per 100,000 for females. In every age was also significantly higher than the situation in the United States, where group, men had a higher suicide rate Canadian average, Newfoundland, nearly 60% of people who killed them- than did women. Ontario and British Columbia report- selves did so using guns. In 1998, suicide was the leading ed rates below the national level. The Men tend to use more violent cause of death for men between the Yukon and the Northwest Territories methods to take their lives than do ages 25 to 29 and 40 to 44, and for had rates of 26 and 56 suicides per women: 26% of men used firearms, women aged 30 to 34. And for ages 100,000 population aged 10 or older compared with 7% of women. In con- 10 to 24, it was the second leading (5 and 35 deaths, respectively).7 These trast, women most often committed cause of death for both sexes, surpassed provincial and territorial differences suicide by poisoning: in 1998 they only by motor vehicle accidents. in suicide rates likely reflect social, were nearly twice as likely as men to A major concern among parents economic and cultural factors. die using this method, at 41% versus and health professionals is the high 22%. The most common method for rate of suicide among young persons Men use more violent methods men was suffocation (40%); among in their late teens and early twenties. to kill themselves women, this method ranked second, Because suicide is a leading cause of In 1998, the most common means accounting for 34% of suicides. death during these years, the loss of of suicide in Canada was suffocation Between 1979 and 1998, the potential years of life is high, particu- (39%), principally hanging or strangu- proportion of men who committed larly for men.5 In 1997, suicide lation; poisoning, which includes drug suicide with firearms declined from ranked third after cancer and heart overdoses and inhalation of motor 41% to 26%, while those who died of disease in potential years of life lost vehicle exhaust, was the next most suffocation rose from 24% to 40%. for men; for women, it was fourth common (26%). Firearms were the The pattern among women was simi- after cancer, heart diseases, and motor third leading means of committing sui- lar with the most dramatic increase in vehicle traffic accidents.6 cide (22%). This contrasts with the suffocation (from 19% to 34%). Quebec records highest rate of suicide 5. Potential years of life lost is calculated by subtracting the age at which a death occurs Historically, suicide rates have tended from an arbitrary age, often 75. to increase from east to west. How- 6. Health Statistics Division. 2001. “Death — Shifting trends.” Health Reports: How Healthy ever, since 1993, Quebec has had the Are Canadians? (Statistics Canada Catalogue no. 82-003) 12, 3: 41-46. highest provincial rate. In 1998, Que- 7. Some of the difference in provincial suicide rates may be attributed to variations in cod- bec’s 21 suicide deaths per 100,000 ing practices for causes of death, as well as in the timeliness of reporting mortality data. population aged 10 or older was Particular caution is necessary when analyzing suicide rates for the Yukon and the North- west Territories. Because of their small populations and the low number of suicide significantly above the national aver- deaths, slight changes in the number of suicides may cause dramatic fluctuations in the age of 14. While Alberta’s rate of 16 rates when no substantial changes have actually occurred. CST Suffocation was the most common method of suicide for men Total % Males % Females % Total suicide deaths 3,698 100.0 2,925 100.0 773 100.0 Suffocation 1,433 38.8 1,171 40.0 262 33.9 Poisoning 965 26.1 646 22.1 319 41.3 Firearms 816 22.1 765 26.2 51 6.6 Jumping from high places 160 4.3 115 3.9 45 5.8 Drowning/submersion 122 3.3 79 2.7 43 5.6 Cutting/piercing instruments 59 1.6 48 1.6 11 1.4 Other1 143 3.9 101 3.5 42 5.4 1.