Category: Suicide

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Remote Northwest Territories Lacking Mental Health Care

00Environment, Featured news, Health, Self-Harm, Suicide, Therapy, Trauma November, 16

Source: Gloria Williams on Flickr, Creative Commons

On April 26, 2015, 19-year-old Timothy Henderson, a resident of the North West Territories in Canada, was taken off life support after sustaining self-harm injuries, the culmination of a long battle with depression and other mental health issues.

Beginning in adolescence, Timothy struggled with symptoms of ADHD and Asperger’s syndrome (Autism spectrum). When he felt overwhelmed by his condition, he reached out for support, but felt dismissed, and began to lose hope that the help he needed would be available.

Shortly before his death, Timothy admitted himself to Stanton Territorial Hospital for the fifth time in a year, where he again disclosed details about a tendency to self-harm. He was released two days later, without adequate follow-up or a long-term care plan. Later that month, he sustained self-inflicted injuries that led to his death.

Timothy’s case is not uncommon in the Northwest Territories, a remote region of northern Canada. The NWT Mental Health Act states that a medical practitioner can only detain an individual for psychiatric assessment for a maximum of 48 hours. This time limitation often results in rushed and insufficient care—a result of a system that is understaffed and overworked.

The territory’s current Mental Health Act, introduced in June 1988, has been cited as a main cause of inadequate services for individuals suffering from mental illness. The act is out-of-date and has not been modernized with strategies to address the current mental health climate of the NWT.

In a report by the Alternative North Health Coalition, the mental wellbeing of residents in the NWT is shown to be much lower than that of the average Canadian, with a national rate of suicide three times greater than those living in the more populous south. Lack of access to staff, resources, and community-based treatments are all relevant aspects of the act that impede adequate treatment and prevention strategies.

Timothy’s mother, Connie Boraski, believes Timothy’s mental health began to worsen when he turned 17, and no longer qualified for the pediatric healthcare program. This transition resulted in lengthier waits for treatment and drastic changes in privacy laws that prevented Timothy’s parents from having access to information about their son’s treatment. Mental health legislation regarding the legal rights of family members and other caregivers is an aspect of the Mental Health Act that restricts parents, like Timothy’s, from intervening to support their children.

After being repeatedly dismissed, Timothy eventually stopped asking for help. Boraski explains:

“Timothy never wanted to be a burden to anyone. That was a real challenge for him, to ask for help.”

Deficiencies in the quality and quantity of staff and resources reflect the isolation and socioeconomic climate of the NWT. Due to the small and relatively isolated nature of the region, accessing facilities within the community can be difficult. Timothy had to travel between hospitals in the NWT and Alberta to obtain psychiatric help, which resulted in seeing a different doctor on each occasion. This kind of disjointed doctor-patient relationship makes it difficult to stay connected.

The public outrage following Timothy’s death eventually drove NWT Health Minister, Glen Abernethy, to open a review into Timothy’s case and bring changes to mental health legislation. In addition to other important components, the new act will include information on services such as Assertive Community Treatment (ACT), which will allow patients to have access to specialized treatment and supervision within remote communities of the NWT.

The revised act, if passed, is expected to come into effect sometime in 2016. Though implementation of a new mental health act is too late for Timothy Henderson, the hope is that a new mandate will provide the Northwest Territories with better preventative measures and resources for residents suffering with mental illness.

– Nonna Khakpour, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Semicolon Punctuates Mental Health Awareness

00Addiction, Featured news, Health, Resilience, Self-Harm, Suicide, Trauma September, 16

Source: Brittany Inskeep on Flickr

Sure, writers dismiss it. But the semicolon—the otherwise underwhelming punctuation mark—has had its share of fans like American physician and poet Lewis Thomas, who said the semicolon leaves “a pleasant little feeling of expectancy; there is more to come; read on; it will get clearer.”

Amy Bleuel echoed this sentiment when she founded Project Semicolon on April 16, 2013. This global non-profit movement is dedicated to providing support for those struggling with mental illness, suicide, addiction, and self-injury.

In a recent interview with the Trauma and Mental Health Report, Amy shared the meaning behind the semicolon:

“It represents continuance. Authors usually use the semicolon when they choose not to end the sentence. You are the author and the sentence is your life, and you’re choosing to continue.”

In 2003, Amy lost her father to suicide.

“I’m kind of continuing his story by telling it to raise awareness. It took 10 years for me to do it but I was able to use his story to bring hope to others and that was my inspiration.”

Since the project’s humble beginnings, the semicolon has evolved into something much bigger. After one of Amy’s blog posts went viral, many decided to get inked with the symbol. What’s more: they started sharing their stories online and creating awareness around mental illness.

But according to Amy, Project Semicolon was not intended to become a tattoo phenomenon:

“It was not meant at all to be a tattoo campaign. It was just picked up as that. I got a tattoo. People started getting a tattoo. It became something people apparently wanted to say.”

It also became something people were willing to stand behind. As a registered charity, Project Semicolon raises funds to help fight stigma and present hope and love to those in need. Dusk Till Dawn Ink, a tattoo shop in Calgary, even donates a portion of the proceeds from semicolon tattoos to the Canadian Mental Health Association.

But the semicolon isn’t the only mental health tattoo out there. Casidhe Gardiner, 20, has an eating disorder recovery symbol tattooed on the inside of her arm, alongside the words “take care.” To her, the tattoo serves as a reminder to look after herself and to avoid relapse:

“If I branded myself with a recovery symbol in a place that I could see all the time, it would remind me in a hard time when I’m spiraling down again that I’ve recovered. I’ve done all this hard work to get there. Why go through the negative parts of the disorder when I have all these amazing parts of recovery?”

What is it about mental health tattoos that help in the healing process?

According to Casidhe, the tattoo works as a conversation piece—sparking discussion when it might not happen otherwise. When asked about the role the semicolon tattoo plays in her healing process, Amy felt the concept was more opaque:

“You know I’m not really sure how that works. I have a lot of people say they look at the semicolon and it gives them inspiration. It’s a reminder that says you get to keep writing. Yeah it sucks sometimes but you get to keep going and choosing how you write that story.”

Supporters of the project have declared April 16th ‘National Semicolon Day.’ On this day, everyone is invited to post their semicolon tattoo on social media platforms like Twitter and Pinterest with the hashtag #ProjectSemicolon, raising awareness and celebrating the network of people who believe in moving forward despite their challenges.

On their website, the project states that they are not a helpline, nor are they trained mental health professionals. But what makes Project Semicolon special, according to Amy, is that it emphasizes the importance of community and non-judgmental support in recovery:

“These people need somebody who cares, who understands them. Not just people who say everything will get better. I wanna be open and honest about my own struggles, I don’t want them to think I’m a person who doesn’t struggle. I want people to be able to come up and say, ‘I struggle too.’ Why do we need to hide?”

A simple punctuation mark; a tattoo; a network of support. Perhaps by wearing a symbol that represents the struggles and victories of the human spirit, the invisible becomes visible. And visibility is important when striving for universal acceptance.

 “Stay strong; love endlessly; change lives.” The phrase appears on the mission statement on the project’s website. It was borne of a phrase close to Amy’s heart:

“I use the phrase “love endlessly” and I truly believe that it’s love that can save a life. And my father showed me that in the short time I had with him.”

–Marjan Khanjani, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Failed Mental Health App Highlights Pitfalls of Social Media

00Depression, Featured news, Health, Media, Social Networking, Stress, Suicide July, 16

Source: Jayson Lorenzen on Flickr

On October 29, 2014, The Samaritans—a suicide-prevention organization in the United Kingdom—launched an app for Twitter called Samaritans Radar. Its purpose: to detect alarming, depressive, and suicidal tweets to help prevent suicide. Less than a week later, the app was suspended due to public outcry over privacy concerns.

Social media are being used increasingly for marketing and advertising, with privacy a growing issue. Many marketing apps, like Hootsuite, track users’ social media posts in fairly covert ways. Yet, when social media pits privacy against mental health, ethical conflicts are concerning.

Traditionally in mental healthcare, there are few reasons to break confidentiality between client and therapist, such as harm to self or others.

The Samaritans Radar app worked by tracking tweets from every account the individual follows on Twitter. If alarming content was found—ranging from “I’m tired of being alone.” to “Feeling sad.”—the app would notify the user by email. Along with the email, came a link to the flagged tweet, as well as suicide intervention and prevention resources that the individual could provide to the writer of the alarming content.

At the launch of the app, the organization said that:

“Samaritans Radar turns your social net into a safety net by flagging potentially worrying tweets from friends, that you may have missed, giving you the option to reach out and support them.”

The app was quickly criticized for allowing users to track people’s tweets without their awareness or consent. The Samaritans replied by highlighting that everything posted on Twitter and all the information the app uses was public, and that it was up to the app’s user to decide whether they wanted to respond to any particular tweet.

Adrian Short, who started a petition to shut down Samaritans Radar, stated that it “breaches people’s privacy by collecting, processing, and sharing sensitive information about their emotional and mental health status.”

He also noted that the app may be used by less-than-scrupulous individuals for all sorts of purposes, not just helping individuals overcome mental health issues.

The Samaritans addressed these concerns by launching a “white list,” where people could sign up if they wanted to deny the app access to tracking their account. Many did not see this as a solution since opting out would require people to be aware of the app’s existence, leaving privacy in jeopardy.

But the problem that the app was trying to address is not trivial. In the UK, where the Samaritans are based, suicide is the leading cause of death among males under the age of 35. A free mobile app could be an easily accessible way to reach out to people who are alone and lacking other forms of support.

As one of the few supporters of the app, Hannah Jane Parkinson wrote for the Guardian:

“It is estimated that 9.6% of young people aged 5-16 have a clinically recognised mental health condition. Anything that helps to better this situation is great, and particularly as it is crucial to catch mental ill health early on.”

Yet as Adrian Short and others pointed out, this same easy access also poses potential threats. Internet bullying is common, especially among vulnerable users that Samaritans Radar targeted. The app could therefore be used for nefarious purposes.

“The app makes people more vulnerable online. While this could be used legitimately by a friend to offer help, it also gives stalkers and bullies and opportunity to increase their levels of abuse at a time when their targets are especially down,” says Adrian Short.

The app was an attempt to reach out to people in need of emotional support and to raise awareness about mental health using new media. But it highlighted the potential pitfalls of such platforms for dealing with mental health concerns. While the incidence of mental health problems is concerning, putting peoples’ mental health into the hands of anyone with access to a smartphone is naïve.

Perhaps this unsuccessful launch did successfully show that a greater understanding of social media users and platforms is needed before apps like Samaritan Radar can become commonplace.

– Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

4 Non offending pedophiles-ffad755e986d4bc3244f02437f2166f0ebe71d25

Non-offending Pedophiles Suffer from Isolation

00Featured news, Law and Crime, Self-Control, Self-Help, Suicide, Therapy March, 16

Source: Simon Prades, Used with permission

The stigma of pedophilia and the fear of criminal consequences often prevent non-offending pedophiles from seeking help. Non-offenders who confess sexual urges toward children are usually turned away by professionals who are untrained or unwilling to help, leaving these adults or adolescents to struggle on their own.

The Diagnostic and Statistical Manual of Mental Disorders defines a pedophile as someone who has “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviours involving sexual activity with a prepubescent child or children.” To be diagnosed with pedophilia, the person must experience these symptoms for at least six months, and feel serious distress from the sexual urges and fantasies.

As an under-researched population, it is hard to know the precise number of non-offending pedophiles. Michael Seto, Director of the University of Ottawa’s Forensic Research Unit, estimates that up to 9 percent of men have fantasized about having sex with a prepubescent child. It is now believed that approximately 1 to 5 percent of men identify as a pedophile.

Adam (name changed), a non-offending pedophile, first noticed his attraction toward young children when he was 11. In a Matter Magazine interview with award-winning journalist Luke Malone, he describes his adolescence as a period of agonizing self-hatred:

“I was passively suicidal for a long time […] A lot of it was, ‘I’m a monster’ for having viewed [child pornography], but also just for having these attractions.”

There is currently no system in place in Canada to treat those who are sexually attracted to children, but have not acted upon these urges. Mandatory reporting laws, which make professionals responsible for reporting suspicion of child abuse to Child Protective Services, often deter non-offending pedophiles from seeking treatment. In Ontario, this requirement exists under the Child and Family Services Act.

Elizabeth Letourneau, Director of the Moore Center for the Prevention of Child Sexual Abuse at Johns Hopkins University, is a leading force in prevention programming targeting non-offending pedophiles. In an interview with TIME Magazine, she describes her experiences working with this population.

“I’ve spoken to young men who were horrified to realize they were attracted to younger children in adolescence, and that they were not growing out of their attraction. They described appalling childhoods, living in self-imposed isolation for fear of being discovered and labeled a pedophile. Several expressed self-loathing. Many considered suicide. As adolescents, they wanted help controlling their sexual impulses, but had nowhere to turn for help.”

A U.S. researcher in the field of primary prevention, Letourneau calls for the development of a “culture of prevention” around pedophilia. She advocates for preventative therapy for both non-offenders and offenders alike:

“If they could have just turned to someone to talk about this, a professional who’s going to treat this objectively and see them as a person of worth, who’s going to know that they’re not bad kids, that they’re good kids but they have this aspect of them that they really need help controlling. That’s what they’re looking for and that’s what I hope we can provide.”

Many non-offending pedophiles like Adam desperately turn to the internet for social support. In his words:

“For a pedophile, there is almost no place to go and get information or any sort of help, I’m sure that there are pedophiles who kill themselves who will never reveal or admit to it, even in a suicide letter. I think there’s probably a lot more than people would realize.”

Adam now leads an informal online support group for pedophiles in their teens and early twenties who want help battling this issue. There are a total of nine members, between sixteen and twenty-two years of age. All members need to abide by two rules: no previous history of offending and complete abstinence from child pornography.

Other self-help resources exist online for non-offending pedophiles. Virtuous Pedophiles, the largest online pedophile support group in the U.S., currently has 318 members and operates under the simple belief that sex with children is wrong.

In Germany, prevention efforts are already in place. Thousands of self-identified pedophiles reach out to Prevention Project Dunkelfeld, a therapeutic program that targets non-offending males attracted to children. Germany does not have mandatory reporting laws, making it easier for non-offending pedophiles to seek treatment.

In accordance with recent research on pedophilia claiming a neurobiological basis to the disease, Klaus Beier, director of the German project, believes that, at the very least, a minor attraction to children is a fixed part of a pedophile’s identity.  Dunkelfeld operates within a harm reduction framework. Rather than trying to change behaviour, the program works to manage their clients’ attraction towards children. The project offers both weekly cognitive behaviour therapy sessions and libido-reducing medication.

Paradigm shifts towards relieving stigma and treating pedophilia as a disease are key to enacting real change. It is vital to differentiate between fantasy and behavior and to offer resources to those who want to manage their condition willingly.

– Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

When A Loved One Attempts Suicide

When A Loved One Attempts Suicide

10Depression, Featured news, Forgiveness, Post-Traumatic Stress Disorder, Suicide, Therapy, Trauma January, 16

Source: Wayne S. Grazio/Flickr

About two years ago, I personally came face to face with the suicide attempt of my best friend, Bella.  Distraught, she had called to tell me she loved me and that I was the best thing that ever happened to her.  I listened to her cry for a few minutes until she suddenly disconnected.  I was immediately filled with a sense of fear and dread.

Soon in my car breaking the speed limit, I was yet unaware how my life was about to change.

Bella suffered from clinical depression and although she kept it a secret from most, I was well aware of her struggles.  She had two kinds of days:  bad and terrible.  Her boyfriend had just broken up with her, which sent her into a tailspin.  She was in an inescapable depressive state, filled with thoughts of suicide.

Many parents who experience such episodes with their children are plagued with mixed emotions of self-blame, anger, shock, and grief.  They often feel powerless, not knowing how to help their children, and the threat of losing them is ever present.  Bella’s parents were no different.  They were emotionally exhausted and needed a break.  When I got to Bella’s house I told her parents that I would stay with her for a couple of hours.

We watched TV in silence, and soon Bella looked toward me decidedly, as if she had finally settled on a course of action.  She told me she had to go to the washroom downstairs.

Minutes passed and she had not returned.  An overwhelming anxiety came over me, I had to check on her.  As I walked down the stairs –my heart beating rapidly and my mind venturing to the unthinkable– I saw her.  Face blue, eyes red.  She was attempting to strangle herself with a rope she had found in the basement.

Although sparse, research on the effects of witnessing a peer’s suicide attempt shows that the event can have a strong impact on the witness.  Individuals may develop varying degrees of post-traumatic stress disorder (or PTSD) or other anxiety disorders.  Experiencing powerful and recurrent memories of the event and avoiding situations that may remind one of the trauma, create a cycle of negative thoughts and emotions that can make treatment challenging.

According to clinical psychologist, Daniel Hoover of Baylor College of Medicine, anyone in direct contact with a suicide attempt should seek out treatment following the event (which doesn’t necessarily have to be one-on-one counseling to be effective).

When I saw Bella trying to kill herself, I immediately rushed over, removed the rope and hugged her.  She cried, gasping for air, furiously yelling at me for stopping her.

For a long time afterward, this image of Bella was embedded in my mind.

And I felt profoundly guilty after the incident:  If I had not let Bella leave my sight, she might not have attempted suicide.  This thought often came to mind.  A vicious cycle of uncertainty plagued my daily activities.  I was holding myself accountable for actions that were ultimately out of my control.

I kept her suicide attempt a secret from everyone in my life.  I didn’t want to hurt her reputation or break her trust, and I became tormented by the trauma, but I couldn’t confide in family or friends for fear of having to explain Bella’s story.  For the first time in my life, I felt utterly alone.

Brian L. Mishara, author of The Impact of Suicide, suggests that telephone support programs can reduce the emotional burden on family and friends.  Counselors build a relationship with their client and provide information on healthy coping strategies and useful resources –all over the telephone.  Counseling calls tend to continue weekly over a period of time until the person feels comfortable coping with their traumatic experience.

Although challenging, recovery is possible.  Two years later, I’m doing much better.  For one thing, I needed to realize that Bella’s suicide attempt was not my fault.  You can only do so much to help a loved one when they are suffering from suicidal thoughts.  We want to protect our friends and family members, but we also need to protect ourselves.

And, suffering alone doesn’t work.  Withholding your thoughts after a traumatic event can compromise your physical, emotional, and psychological health.

Coping with a loved one’s suicide attempt is not easy.  Finding someone you trust and expressing your thoughts is helpful.  It’s much easier to cope when you have a trusted ally by your side.

– Alessandro Perri, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

South Koreans Use Suicide to Preserve Honour.

South Koreans Use Suicide to Preserve Honour.

10Depression, Embarrassment, Featured news, Health, Stress, Suicide, Therapy December, 15

Source: Tanla Sevillano on Flickr

The suicide of a celebrity comes as a shock to fans. In the wake of Robin Williams’ death, there was an outpouring of grief. But suicide, like many aspects of mental health, varies across cultures. In October 2008, one of South Korea’s leading actresses and national icons, Choi Jin-Sil, hanged herself.

The importance of honour in Korean culture is evident throughout Choi’s story. She often spoke of the stigma of being a divorced, single mother in the public eye, which a national entertainment columnist likened to having a personality disorder. The divorce itself was a result of domestic abuse, yet a court cited Choi’s “failure of her contractual obligations” and inability to “maintain dignity and proper social and moral honour” in its ruling.

Choi’s death was only the beginning. It led to a wave of sympathy suicides in 2008, causing a 70% increase in suicides that October. In March 2010, Choi’s younger brother killed himself by hanging, and her ex-husband also hanged himself in January 2013.

This rash of suicides is exemplary of a common Korean belief: Psychological treatment is viewed with skepticism. An interview withKyooseob Ha, a psychiatrist with Seoul National University of Medicine, describes how Koreans are averse to seeking therapy, even for severe depression. Admitting to depression is seen as a character failure, shameful to the family. It is often concealed.

The same cultural norms dictate that preserving family reputation is paramount. Families asked about their loved ones who suffered from depression and committed suicide do not wish to speak about it. A common saying, “do not kill the person twice,” means that even if the person is gone, his or her “public face” can still be ruined.

Psychologist Hyong-soo Kim at Chosun University says this public face holds such sway that even in cases where people choose to see a therapist, Koreans will pay in cash to avoid their insurance companies finding out.

Research by psychiatrist Dae-hyun Yoon, at Seoul National University and the Korean Association for Suicide, shows that Koreans are more likely to seek the aid of a priest, psychic, or room salon (where a female bartender or hostess will listen to problems) than a professional therapist. Westernization hasn’t extended to mental health.

At the same time, Korea’s depression rates continue to rise and 80-90 percent of suicides are related to depression.

Refusal of professional treatment, along with wide public acceptance of suicide may be why South Korea was ranked by the Washington Post in 2010 as having the world’s highest suicide rate(in 2014, it ranked third-highest, following Greenland and Lithuania).

This has motivated South Korea’s government to develop intervention programs such as jump-barriers on bridges, glass doors along subway platforms, and 24-hour government-funded suicide hotlines. Though progress has been slow, some Koreans believe the traditional mindset to be flawed.

Currently, the Korean government is increasing funding for mental healthcare and suicide awareness. Online monitoring has led to the closure websites that encourage people to kill themselves. Gramoxone (a pesticide that was a common means of committing suicide) is now banned in Korea. And an expanded state pension system, as well as aid from major corporations, are giving less fortunate individuals the ability to access mental health services they could not previously afford.

Turning traditional ideals on themselves, public service messages now emphasize that the shame of a loved one committing suicide outweighs whatever circumstances led them to consider suicide in the first place. They focus on the idea that honour can be regained by living.

Local therapists know first-hand the values and lifestyles of their clients, and culturally based therapeutic approaches are key to curbing South Korea’s suicide rate. In a country where honour is tantamount to life, solutions must build on tradition, not break it.

– Olivia Jon, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

One Woman’s Suicide Reignites Right-to-Die Debate

One Woman’s Suicide Reignites Right-to-Die Debate

00Aging, Chronic Pain, Dementia, Featured news, Law and Crime, Philosophy, Suicide October, 15

Source: torbakhopper/Flickr

“I will take my life today around noon. It is time. Dementia is taking its toll and I have nearly lost myself.”

Gillian Bennett chose the right to die in the backyard of her home on Bowen Island. On August 18th, 2014, wrapped in the arms of her husband of 60 years, she said goodbye with a tumbler of whiskey and a lethal dose of barbiturates.

At age 85, Bennett had been living with dementia for over three years. During her lucid moments, she would ruminate on the impact of her suffering on family, and the burden she would become on the healthcare system at large.

Bennett wanted to live and die with dignity; she viewed spending her remaining days in a nursing home as anything but.

The retired psychotherapist voiced her wish to end her life on her own terms before losing “an indefinite number of years of being a vegetable in a hospital setting, eating up the country’s money but having not the faintest idea of who [she is].” Her family and friends supported her decision.

“In our family it is recognized that any adult has the right to make her own decision.”

Bennett’s conversations became the inspiration for deadatnoon.com, a website that hosts her goodbye letter. In it, Bennett explains her reasoning for wanting to die on her own terms and makes a plea to re-open the debate on assisted suicide for the elderly and terminally ill.

Every day Bennett felt she was losing another part of herself. Small lapses in memory were followed by an inability to keep the days straight and a decline in physical capacity. Soon, she would not have been competent enough to make decisions about her life. She wanted out before that happened.

She considered three options. The first was to “have a minder care for [her] mindless body” despite financial hardship on her family. The second, to settle into a federally funded facility at a cost to the country of $50,000 to $75,000 per year. The third, to end her life “before her mind [was] gone.”

She felt compelled to choose the third, dismissing the other options as “ludicrous, wasteful, and unfair.” At the end of her four-page letter, she encouraged readers to consider the ethics of assisted suicide.

Canadians are familiar with the debate on euthanasia. Beginning with the landmark Rodriguez v. British Columbia decision, euthanasia has been revisited by the courts many times.

In 1991, Sue Rodriguez, who was suffering from ALS, attempted to petition the Supreme Court of Canada to allow assistance in ending her life. The court refused her request.

Despite the decision, she passed away with the aid of an unknown doctor in 1994.

A similar ruling was made in the Robert Latimer case. Latimer was convicted of second-degree murder in 1997 after killing his severely mentally disabled daughter, Tracy, whose condition left her in constant, unmanageable pain.

In 2011, the B.C. Supreme Court ruled that the ban on assisted suicide was unconstitutional following a challenge from another ALS sufferer, Gloria Taylor. The federal government appealed the ruling and, in 2013, the B.C. Court of Appeal upheld the ban.

Bennett’s decision to end her life revived the debate. In February of 2015, the ban was struck down again by the Supreme Court of Canada. Federal and provincial government has been given twelve months to create legislation in response to the ruling. 

Bennett, a woman who saw life as “a party she was dropped into”, made it clear she felt she was losing nothing by committing suicide. Described as smart, funny, and irreverent, she faced death the way she lived life.  

“Each of us is born uniquely and dies uniquely. I think of dying as a final adventure with a predictably abrupt end. I know when it’s time to leave and I do not find it scary.”

– Magdelena Belanger, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Bipolar Disorder Makes For Up-And-Down Friendships

Bipolar Disorder Makes For Up-And-Down Friendships

00Bipolar Disorder, Featured news, Friends, Relationships, Suicide August, 15

Source: Farrukh/Flickr

Lauren and I have been friends for a long time.  More than once, she had mentioned to me that she had bipolar disorder, but I never gave it much thought.  It always seemed under control, and I knew she was getting help.  When we decided to move in together, I was not concerned.

But it became apparent immediately that she did not have her mental illness under control.  Long depressive episodes, where she did not talk to anyone, were followed by short manic ones (when she was great to be around).  As a friend, I had no idea how to help or how to help myself while living with her.  I was confused when she would suddenly get angry at me, and I worried about what to do if she hurt herself.  And if I were to call someone I didn’t know how she’d react.

Over the past year I’ve learned a lot about the disorder, how to deal with it; not as a psychologist or therapist, but as a friend.

Don’t take it personally

It is difficult to accept, but sometimes people in a depressed state don’t feel like talking, and not because they dislike you, or because they’re being rude.  Mdjunction.com tells readers that one of the “do’s” of dealing with a loved one is to “realize your friend is angry and frustrated with the disorder, not with you.”  I once asked Lauren why she would ignore me for days at a time and she told me that sometimes she doesn’t talk just to avoid crying on the spot.

Recognize triggers

Drinking made Lauren manic.  On the surface, mania doesn’t look all that bad.  The person is happy, exuberant, and outgoing.  But those with bipolar disorder who are manic often crash into a depression that lasts longer and is more severe than the mania.  I pointed this out to my friend, explaining that when she drank, her night usually ended in depression.

She responded, and cut down her drinking.  But some may not be as willing to take responsibility.  It’s impossible to force a friend to change, but pointing out triggers may give them some insight into their behaviour.

Talk to their family when necessary

Luckily, Lauren has a caring supportive family.  Her brother and I have exchanged phone numbers, and if something happens to Lauren where I’m in over my head, I can notify her brother and ask him to help.

Know when to call for help and own your decision

Once I had to call an ambulance for Lauren.  After finishing a bottle of prescription sleeping pills, she admitted to me that she wanted to die.  She could barely form a sentence and I feared the worst.  It was a difficult decision, I knew I risked losing Lauren’s trust but I called anyway.

Terri Cheney, author of, A Memoir and The Dark Side of Innocence: Growing up Bipolar writes “If someone you know or love talks about suicide, even jokingly or in a passing remark, stop and listen.  Ask if he or she has a plan….Above all, take it seriously.”

You don’t know how they feel

Don’t pretend to understand how someone with bipolar disorder feels.  Being empathetic and actively listening to what your friend has to say will go much further than telling them about that time you were sad and how it’s the same.  It’s not.  And most important, do not tell them to just “get over it.”  It’s not so easy.

Don’t put your friend’s needs before your own

Sociologist Jeanne Segal, author of The Language of Emotional Intelligence, writes that “Supporting your loved ones may involve some life adjustments, but make sure you don’t lose sight of your own goals and priorities.”

I used to invite Lauren everywhere.  I did enjoy her company; but on reflection, I think I was doing it largely out of fear.  I worried she’d hurt herself home alone.  Looking after her was emotionally draining.  I came to realize that not only did I have to learn to trust her alone, but I also needed my own time with friends, I needed to focus on my own life.

Having a friend or a family member with Bipolar Disorder can be complicated, and may require time and patience.  But the illness doesn’t have to define the individual.  Lauren is the same person I knew long before I knew of the diagnosis, and she is still a great friend.

But now I have learned to become more empathetic and accepting of people, whose moods I cannot justify…or even fully comprehend.

– By Anonymous, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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State of Emergency: Suicide in First Nations Communities

00Addiction, Anger, Depression, Education, Featured news, Grief, Health, Identity, Politics, Post-Traumatic Stress Disorder, Spirituality, Suicide, Trauma December, 14

On April 17th 2013, Chief Peter Moonias declared a state of emergency in the community of Neskantaga. Two suicides within days of each other are only the most recent in a string of sudden deaths that have ravaged the group. 

In the four months prior, seven people died, four of them from suicide, and twenty more made suicide attempts. In a community as small and remote as Neskantaga (the reserve is home to 300 people and is only accessible by plane), the residents are tight-knit. And the losses of their family members, friends and neighbours have left many struggling to cope.

Suicide is disturbingly common among some Inuit and First Nations groups, with the rate in some communities eleven times higher than the Canadian average. Overall, First Nations peoples have a suicide rate twice the norm in Canada, a statistic that has been stable for at least three decades.

Colonization of the Americas has had a profound effect on Indigenous populations. In the centuries since first contact, 90% of the American Indigenous population has been wiped out due to plagues, warfare, and forced relocations. The legacy of land seizures and residential schools still haunts these groups.

The immediate survivors of these incidents would undoubtedly be traumatized, but many of the people who have committed suicide in recent years were not personally exposed. How can trauma inflicted centuries ago have an impact on current suicide rates?

The answer lies in the concept of historical or collective trauma, which Maria Yellow Horse Brave Heart, Associate Professor at the University of New Mexico, defines as “cumulative emotional and psychological wounding over the lifespan, and across generations, emanating from massive group trauma experiences.”

Also known as generational grief, the trauma results from suffering profound losses in areas such as culture and identity, without resolution. Unresolved, deep seated emotions like sadness, anger and grief are passed on from generation to generation through parental practices, relations with others and culture-wide belief systems.

In everyday life, the trauma manifests itself through social problems like drug use, familial abuse and violence. These events can cause traumas of their own and result in depression and PTSD, both of which increase suicide attempts.

Young people are especially at risk. In the cohort of 15-24, the rate of completed suicides is five to seven times the national (Canadian) average, and suicide attempts are even more frequent 

Chris Moonias (no relation to Chief Peter Moonias), an emergency response worker in Neskantaga, told the CBC that since the end of 2012, “We average about ten suicide attempts per month, and at one time we surpassed thirty attempts in one month.”

In addition to unresolved grief, Cynthia Howard of Laurentian University identifies several factors that contribute to suicides in Aboriginal communities. These include: attendance at residential schools and abuse experiences there, forced assimilation, displacement, and adoptions. These experiences have left legitimate feelings of distrust towards dominant American and Canadian cultures and feelings of loss of culture.

Some people also feel strung between two cultures (dominant culture and their own band’s culture) while essentially belonging to neither. Feeling alienated and lacking a sense of belonging can leave many people depressed and feeling that their lives lack a sense of purpose.

Other issues such as low socioeconomic status and extreme poverty, along with low levels of education and lack of opportunity have lead to feelings of hopelessness and helplessness.

“Learned helplessness” occurs when a group or individual, usually after a series of disastrous events, believes they have no control over the outcome of any situation, and that perceived failures in the present will likely continue into the future. Without hope, people sometimes feel that living is worse than not living. This feeling is only exacerbated by a shared history of trauma and its consequences, and can culminate in suicide.

Unfortunately, many people suffering do not receive adequate help. Their families and friends are also left without professional support, continuing the cycle of unresolved grief.

Perhaps it is fitting that Chief Moonias of Neskantaga called a state of emergency. His community has reached a tipping point and must be healed in order to move forward. 

As of now, the federal Canadian government has offered some monetary and human aid, but unless we go beyond band-aid solutions, frequent suicides and their consequences will continue to haunt Neskantaga.

– Contributing Writer: Jennifer Parlee, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

 Photo Credit: https://www.flickr.com/photos/kittysfotos/6235090832/”>Kitty Terwolbeck</a

This article was originally published on Psychology Today

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LGBTQ Refugees Lack Mental Health Care

00Addiction, Depression, Education, Featured news, Gender, Health, Identity, Politics, Psychiatry, Psychopharmacology, Sexual Orientation, Stress, Suicide, Trauma November, 14

In 2012, the Canadian government introduced cuts to the Interim Federal Health Program (IFHP), which provides health coverage for immigrants seeking refuge in Canada. Coverage was scaled back for vision and dental care, as well as prescription medication. At the same time, the introduction of Bill C-31, the Protecting Canada’s Immigration System Act, left refugees with zero coverage for counselling and mental health services.

The bill affects all refugees and immigrants, but individuals seeking asylum based on persecution for sexual orientation or gender identity have been hit especially hard by these cuts.

LGBTQ refugees are affected by psychological trauma stemming from sexual torture and violence aimed at ‘curing’ their sexual identity. Often alienated from family, they are more likely to be fleeing their country of origin alone, at risk for depression, substance abuse, and suicide.

On arrival in Canada, refugees struggle with the claim process itself, which has been cited by asylum seekers and mental health workers as a major source of stress for newcomers. For LGBTQ individuals, the process is even harder, having to come out and defend their orientation after a lifetime spent hiding and denying their identity.

In 2013, six Canadian provinces introduced individual programs to supplement coverage. The Ontario Temporary Health Program (OTHP) came into effect on January 1, 2014, and provides refugees and immigrants short-term and urgent health coverage. But it still lacks provisions for mental health services.

Envisioning Global LGBT Human Rights, an organization and research project out of York University in Toronto, has been collecting data from focus groups with LGBTQ refugee claimants both pre- and post-hearing. A recent report by lawyer and project member Rohan Sanjnani explains how the refugee healthcare system has failed. LGBTQ asylum seekers are human beings deserving respect, dignity, and right to life under the Canadian Charter of Rights and Freedoms. Sanjnani argues that IFHP cuts are unconstitutional and that refugees have been relegated to a healthcare standard well below that of the average Canadian.

Arguments like these have brought legal challenges, encouraging courts and policy makers to consider LGBTQ rights within the framework of global human rights.

In July of this year, Bill C-31 was struck down in a federal court as unconstitutional, but the government filed an appeal on September 22. Only if the appeal fails could immigrant healthcare be reinstated to include many of the benefits removed in 2012.

Reversing the cuts to IFHP funding would not solve the problem entirely. LGBTQ asylum seekers face the challenge of finding service providers who can deal with their specific needs. The personal accounts collected by Envisioning tell a story of missed opportunity, limited access to essential services, and ultimate disappointment.

In the last two years, programs have sprung up to address these special needs. In Toronto -one of the preferred havens for LGBTQ refugees- some health providers now offer free mental health services to refugees who lack coverage. Centers like Rainbow Health Ontario and Supporting Our Youth have programs to help refugees come out, and to assist with isolation from friends and family back home, and with adjusting to a new life in Canada.

Still, the need for services greatly outnumbers providers; and accessibility issues persist.

Organizations like Envisioning try to create change through legal channels, but public opinion on LGBTQ healthcare access needs to be onside for real change to occur. Recent World Pride events held in Toronto were a step in the right direction. But specialized training of healthcare professionals and public education would go a long way in providing the LGBTQ community with the care they need.

– Contributing Writer: Sarah Hall, The Trauma and Mental Health Report 

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

Photo Credit: https://www.flickr.com/photos/vhhammer/3238712773/

This article was originally published on Psychology Today