‘Suicide is not about dying’ – what a researcher wants you to know

January 28, 2021

By Jennifer Stranges

Dr. Sakina Rizvi

Healthcare providers are working long, stressful hours and can be witnesses to terrible loss in this pandemic. These factors can sometimes lead to feelings of severe anxiety and depression, an issue highlighted recently by the tragic death of a registered nurse at Halton Healthcare Services, who died by suicide earlier this month. We spoke to Dr. Sakina Rizvi, a scientist and research therapist in the Arthur Sommer Rotenberg Suicide Studies program at St. Michael’s Hospital. She explains the known risk factors, how employers can help and what she wants everyone to know about caring for their own mental health.

The pandemic has created an environment of increased stress, anxiety and depression. Is there evidence to support a link between the pandemic and increased suicide?

Yes. There is some Canadian data from the Canadian Mental Health Association in collaboration with the University of British Columbia that suggests that the number of people reporting suicidal thoughts has doubled and those with pre-existing mental health concerns are even more vulnerable. There’s also reduced access to mental health care and typical coping strategies that people would use to support themselves. So, it makes sense that with the uncertainty, financial stress, less social interaction, potentially problematic living situations, that there is an increase in suicidal risk.

As a suicide researcher, what do you wish more people knew?

Suicide is not about dying. It is about not knowing how to live with the immense pain a person is experiencing. Along with that pain are brain processes occurring that make it a lot harder to regulate emotions, inhibit behaviour, and make decisions. Asking someone about their suicide risk will not make them more suicidal. It is important starting point to start a dialogue so that people don’t feel so alone in what they’re going through. Don’t tell people not to feel suicidal. That is invalidating. Instead try to understand the pain someone must be in to make them believe that this is their only option and communicate that.

Why is talking so important?

Talking, so long as it is non-judgmental, is vitally important because it makes people feel validated, supported, and less alone. It also normalizes mental health concerns – there is nothing wrong with how you feel. Let’s talk about how intense your feelings get, how you get triggered, and the tools you can use to support yourself when it feels overwhelming. And if I can’t help, let’s get you connected to resources or people that can. Talking is the starting point to all of that.

How can employers help support staff in stressful workplaces?

Employers can help create an open environment so that employees feel safe and comfortable discussing their mental health concerns. As a supervisor myself, I always have an explicit conversation with all of my trainees and employees to let them know that if there’s something going on in their life, that I am available and want to talk to them about it. From there it is up to me to create an environment where they actually feel safe to do that. I recognize people who I know will come to me versus the people who “seem okay,” but I know to make the effort to check in with periodically. I also let employees know that letting me into their life experience helps me help them more in terms of finding resources to help them or to be more flexible with deadlines.

Your work explores the brain biology of suicide risk. How does your work “predict” suicidality and what are some of the risk factors for suicide?

I’m specifically interested in whether there are brain mechanisms that can help to determine whether a person is more at risk for suicide, so that we know that this person needs additional intervention. Some of those brain mechanisms may be related to how a person experiences things that are rewarding – like a sunset – brain resources for attention, or how the brain processes pain.

Some risk factors for suicide can include gender – for example, men are more likely to die by suicide while women are more likely to attempt suicide – age, isolation, hopelessness, feeling burdensome, or having certain diagnoses like major depressive disorder or a substance use disorder. These are group level risk factors. There is no one risk factor that is able to predict suicide at an individual level. It is important to understand your own risk factors for suicide as well as the protective factors you can draw on that can help you when you are feeling unsafe.

Is there anything else you’d like to add?

If you are feeling unsafe, please know your resources (go to your local emergency department, contact Crisis Service Canada at 1-833-456-4566 or text 741741, or have a family friend/family member that can be on speed dial).

At St. Michael’s Hospital, we are running a psychotherapy study using a single session intervention called Brief Skills for Safer Living. The study is enrolling individuals across Canada who are having suicidal thoughts. Read more about the clinical research study or email therapy@asrlife.ca for more information.