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Injury prevention and suicide

What is it?

Injury prevention aims to reduce harm and increase safety for individuals, families and communities. There are two types of injury: intentional and unintentional.

UNINTENTIONAL INJURIES INCLUDE THOSE CAUSED BY:
• traffic collisions;
• falls;
• choking and suffocation; or
• fires and burns.

INTENTIONAL INJURY INCLUDES:
• self-harm;
• suicide; or
• domestic violence.

More people die by suicide than in motor vehicle collisions in many provinces: it’s often the leading cause of injury death. 526 In British Columbia (2011): 526 suicides; 292 motor vehicle deaths. In Ontario (2010): 1175 suicides/self-harm; 735 transport incident deaths. (BC Ministry of Justice, 2010; Paracute, 2015)Intentional injuries fundamentally differ from unintentional injuries, because intentional injuries are intended to cause harm, and are directly linked to mental health issues. Self-harming is a way for people with mental health concerns to ease their extreme psychological pain.

Who is at risk of intentional injury?

Anyone can be at risk of intentional injury. Here are some examples of high-risk groups:

CHILDREN WHO SELF-HARM
Children often harm themselves because of harms done to them. The intention of their self-harming behaviours may not be to die by suicide, but if not treated by a mental health professional, can escalate to suicidal behaviour (Centre for Suicide Prevention, 2014).

YOUTH WHO ENGAGE IN RISK-TAKING BEHAVIOUR
Youth who harm themselves are at greater risk for suicide and have underlying mental health issues or are trying to escape overwhelming and negative emotions (Klonsky, et al., 2014). Risk-taking behaviours, such as promiscuity, driving while intoxicated, or indulging in substance abuse, often lead to intentional and unintentional injury. Early intervention for youth effectively reduces suicide rates, however youth receive the least mental health assistance of all age groups (Standing Senate Committee on Social Affairs, Science and Technology, 2006). Getting vulnerable youth the medical and psychological attention they need should be a suicide prevention priority both nationally and provincially (Kutcher, 2008).

YOUNG AND MIDDLE-AGED MENIn 2010 injuries cost Canadians $26.8 billion with suicide and self-harm accounting for $2.9 billion (Parachute, 2015).
Generally, there is a reluctance by men to seek assistance for mental health issues. Men who live with depression and do not seek help may be at increased risk for suicide. This is especially true if there are co-occurring disorders such as substance abuse. Men will often mask their stress and cope with their depression through harmful behaviours and actions (Ogrodniczuk, 2011). Men die by suicide three times more often than women (Statistics Canada, 2014).

Evidence-based strategies to prevent intentional injuries in Canada

1. Reduce Access to Lethal Means

TO PREVENT DEATH BY HANGING:
• Redesign closet rods, window fittings and furniture to reduce ligature points.

TO PREVENT DEATH BY DRUG POISONING:
• Regulate dosages by reducing pack size of potentially lethal pills.
• Dispose of unwanted medications properly.
• Make ongoing recommendations to governments regarding the classification and access of medications
by health professionals and the public where concerns arise.

TO PREVENT DEATH BY FIREARM:
• Use locked gun storage.
• Restrict access to firearms.

TO PREVENT DEATH BY CARBON MONOXIDE POISONING:
• Require all cars to have catalytic converters.

TO PREVENT DEATH BY JUMPING:
• Post phone number of the local distress centre on bridges and other high places.
• Construct bridge barriers (Institute for Health Economics, 2010).

2. Educate

Skills-training programs, such as the Applied Suicide Intervention Skills Training (ASIST) workshop, aim to equip community members with the knowledge and skills to intervene with someone at risk of suicide.

Case Study: Bridge Barriers

Constructing physical barriers on bridges is a highly effective injury and suicide prevention initiative. In the face of opposition, the City of Toronto erected bridge barriers on the Bloor Viaduct. The construction of this suicide barrier allowed the second deadliest suicide bridge in North America to become virtually free of suicides. Some theories suggest that bridge barriers do not deter suicide and that people will look for another means of suicide, however, research has shown that after the installation of the Bloor Viaduct barriers, the overall suicide rate in the city of Toronto decreased. Read More.

RESOURCES: A SELECTION OF CANADIAN INJURY AND SUICIDE PREVENTION STRATEGIES

View the reference list.

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