Can we change the course of suicidal paths? | Monique Seguin | TEDx Gatineau

This talk was given at a TEDx event using the TED conference format but independently organized by a local community.

Doctor of psychology, Monique Séguin is a tutor in the Department of Psychology and Psycho-education at the University of Québec in Outaouais. She is a researcher at the McGill Group of Suicide Studies and at the Québécois Network of Research on Suicide, Depression and Associated Problems. She is interested in the courses of suicidal people's lives. She has written several books on suicidal crisis. She was invited as an expert to a consensus conference on suicidal crisis by the French Federation of Psychiatry. On the request of the Directorate-General for Health in France, she has formed a network of tutors who teach intervention in suicidal crises. She is also interested in grief after suicide and has developed an expertise in 'post-vention' in the school environment which is accepted by Québecois intervention specialists. A common practice with regard to intervention after grief from suicide has been born in Québec. Monique Séguin received the research prize awarded by the Canadian Association for the Prevention of Suicide and a prize for excellence from from the Québécois Association for the Prevention of Suicide in recognition of her work and research on suicide. Her message is, "We all know, near or far, someone who may have had suicidal thoughts. That's why I think it's important to make the population aware of the fact that suicide is a social problem. We must all work to decrease the suffering of those who are thinking about suicide, because suicide prevention affects everyone."

I think it can be said
that everybody knows somebody

who has thought about suicide,
over the course of their life

or has perhaps attempted suicide
or has died from suicide.

Or perhaps you know people
who have supported a suicidal friend.

Or maybe you know someone
who has been bereaved

following a suicide.

The World Health Organisation

informs us that over the course of a year,

there are more deaths by suicide

than deaths from terrorist acts
from homicides,

and from all the wars put together.

Unbelievable, isn't it?

All these statistics hide
the real human tragedies,

and the news regularly brings us
these human tragedies.

Whether it is the suicide
of adolescent boys or girls,

who have been victims of bullying,

whether it is the suicide of older
people who die alone and lonely,

or whether it is the suicide of soldiers,
exhausted by their post-traumatic stress.

The American army
has said that in recent years

more soldiers have died of suicide
than have died in combat.

It's hard to hear these realities.

In Quebec, The National Institute
of Public Health

recently revealed their data for 2011.

In 2011, in Quebec,

28,000 Québécois people
attempted suicide,

and 1,105 Québécois people
took their own lives.

1,105 human tragedies.

Three per day.

Most people who die through suicide
are men,

80% are men,
most of them are adults,

who leave behind them
more human tragedies:

partners, children, parents,
brothers, sisters, friends, colleagues,

trying to understand why.

I imagine that you are asking
yourselves, "But why?"

Well, the answer to that question
is extremely complex.

Because there is no one reason,

there is no one cause,
there is no one way.

People come to suicide
by many different paths

but there is one common
factor among suicidal people

which is that these people
are not seeking death,

absolutely not,

they are looking for a way
to end their suffering.

They come to a point in their life,

where their suffering becomes intolerable.

A suffering that they carry with them
for weeks, months and years,

sometimes lifetimes,

but these people come to a point,
where their suffering is unbearable,

and each of them is looking for
a way to stop their suffering.

They come to believe they will never be
able to change their life.

In fact, a life which is very different
from one to the next.

So how have these people,
who all end up at the same point,

at the same stage,

how have they had such varied journeys?

We can see the journeys of people

whose lives do not get off to
a great start, from the very beginning.

And those who face up
to lots of adversity very early on:

separations, losses, foster homes,
violence, abandonment, and so on,

and we get the impression these people
are on some kind of path,

which goes from bad to worse.

And these people eventually develop
mental health problems,

which are essentially an expression
of the suffering they are living through,

and they often commit suicide,

and people who are
somewhat characterized by this path,

are those who commit suicide
the earliest often as young adults,

exhausted by suffering,
by disappointments, and by adversity.

Another kind of path,

is the path of those whose lives
begin relatively well,

in kind and caring families,

but they meet adversity
much later on in life,

often in the form of several events
that happen over a short space of time

that happen one after the other,

and that drag that person into a spiral
where they feel discouraged

and can no longer bring themselves
to believe that their life could change.

Often people on this kind of path
commit suicide

when they are going through a separation,

perhaps with one of the last people
they still have a bond with.

Another path is that of people
who carry within themselves

a certain vulnerability,
a certain malaise,

they find it difficult to live
and feel well in life.

At times, those people
who live with this malaise

will keep it a secret,

will live without ever
talking to anyone about it.

Even worse, sometimes,
they will play the clown

to give the impression
that everything is OK,

to try to make themselves believe
that everything is going OK.

And these people will hope

that one day their difficulties
will disappear.

And when these people commit suicide

exhausted, as all their energy
has been gradually frittered away,

when they commit suicide,

they leave around them
a group of loved ones who are stunned,

who do not understand how it has happened,

that that person has committed suicide.

I imagine that as I describe
these different paths,

as I have just done,

you might be asking yourselves,
"So are these paths inevitable then?

Is there nothing to be done?"

Far from it, really, far from it.

Quite the opposite.

We can change
the course of suicidal paths.

Indeed, in Quebec, since the beginning
of the millennium,

the rates of death by suicide
have fallen to 25-30%

How has this happened?

Well the ministry established a national
policy, at the beginning of the millennium

for the prevention of suicide.

So what is a national policy?

It is made up of several initiatives,
and many initiatives have been set up,

such as raising awareness
of mental health problems.

Meaning campaigns across
the country giving people insight

into the signs and symptoms of depression.

Because there is a difference
between Sunday evening blues,

a passing pessimism,
and a state which persists, which stays,

and which may not change
of its own accord,

and which requires professional help.

Often people don't make
the distinction between one and the other

and continue to think
that these difficulties

will take care of themselves.

But from the moment we identify
that we are having this kind of problem,

or that a loved one is having
this kind of problem,

it is important to seek professional help.

The second problem across the country.

Perhaps you know people
who don't like to go to the doctors,

and you will not be surprised

if I tell you that lots of men,
lots of young men,

do not want to go to the doctors

they won't go to a doctor
for help with their mental health.

And, in fact, that is often the barrier.

Because the barrier is not
always access to help,

but the acceptability of getting help.

And if we can change that aspect
that stigma around getting help,

maybe we can help a few
more people.

Another initiative has been
training first points of call:

doctors, nurses, psychologists,
social workers, etc.

to quickly identify, the symptoms
of mental health and addiction problems,

as early as possible.

We know that two main problems
are associated with suicide,

they are extremely common
and play a big role

depression and addiction,

despite the fact that we know very well
how to treat those problems.

Another initiative has been

to secure suicidal locations.

By adding safety measures to bridges

to avoid people jumping from a hight,

and also for example,

by the mandatory regulation of firearms

because we know
that a firearm in the home

particularly in a home
where vulnerable people live,

increases the risk.

When it comes to means
and locations for suicide,

do we have complete control
of these situations?

Absolutely not.

We can still do certain things,
we can encourage pharmaceutical companies,

when they put their products on sale,

particularly those
which don't require a prescription,

to sell them in smaller doses

as they have done in England
since around the year 2000.

We can also encourage car manufacturers

to put a device in car engines
to make the engine stop

when there is a certain level
of carbon monoxide inside the car.

There are also actions
that are part of national policy,

to make the media aware
of their social impact.

We know, many test
and studies have shown,

that when a famous person dies,

or when someone dies dramatically,
or dies by suicide,

and the media do not report
it in socially sensitive way,

we observe an increase

in the following weeks and months,

of suicide attempts.

So, by imitation, people
will do the same thing

as that celebrity.

So it is important
that the media becomes aware

of it's social impact,
and the effect of its social message,

when we talk about suicide.

We have also tried to monitor people

who have attempted suicide
more closely,

because people who have attempted suicide

are at a higher risk
of making a second attempt.

Have we tried everything?
Is our work already done?

Absolutely not.

But I think that if we want to go further,

and if we want to decrease
the rate of suicide even further,

it is now going to take
the everybody's cooperation.

Not just ministries
and not just a few people taking action,

but all of you, all of us,

because suicide must become
everyone's business.

For example, in this room,
is anyone a business owner?

So if you own a business,
what you can do every year,

is to develop awareness campaigns
about mental health problems.

You can set up mentorship programs
in your businesses.

If your employees are gifted
with excellent social skills,

offer a training program
so that those employees

can go to those people in your company

who aren't doing so well,
to offer them help.

If you take it upon
yourself to take action,

and go further than you normally would,

when you meet someone
who is suffering,

someone who is on a path of life
which leads them to suicidal thoughts,

rather than seeing a problem,

you can be moved by the difficult path
that this person has followed,

and let them see how their strength
is touching to you,

and let your confidence
that their situation can improve

give them confidence too.

And through this link with other people

we make their pain and their suffering
humanly bearable.

If you work with children,

and we all know that sometimes
we think of childhood as an idyllic time,

even though we know that children
do live through tragedies

and sadness, and disappointment.

We can very early on in life, teach
children to see themselves differently,

and we can teach them to understand

that life is not made up
only of moments of happiness,

there will be times of sadness,
over the course of our lives,

and we can teach them how to get
past those moments of sadness.

And in our personal lives too,
we can take all kinds of action,

and sometimes, what can seem
like a very simple act,

can have a great impact
in other people's lives.

For example, my colleague Yao Assogba,

who was a tutor
at the University of Quebec in Ottawa,

lost his son, a few years ago,
following a suicide.

He and his wife Andrée
went through a terrible time,

and they decided to set up a foundation,
the Lani Foundation named after their son.

This foundation helps vulnerable
young people, young people in difficulty,

offering grants so that young people
can fulfil their dreams.

So by their action, Yao, Andrée,

and their friends
who raise funds for them,

create contexts
for changing suicidal paths.

A colleague of mine, Mélanie,
a Swiss colleague who came to Quebec

to work with us for a while,

who had been trained in suicide prevention
while she was in Quebec,

she was on her way home one evening,
she was coming home from work,

and she was on a bridge,

and while she was crossing
he bridge to get back home,

she saw a woman on the bridge
who was behaving strangely.

So she slowed down,
she moved slowly towards the woman,

towards the barrier.

And the woman moved closer,
and more dangerously towards the barrier.

And Mélanie moved towards her,
and she saw that the woman was crying.

And when she saw that the woman
was crying, Mélanie started crying too,

moved by that woman's suffering.

And the woman, seeing
that a stranger was crying next to her,

not knowing whether she was crying
for her or with her,

took Mélanie into her arms.

Mélanie called a taxi,
and took the woman to A&E,

and called the woman's family
when she arrived at the hospital.

Maybe that evening, by her actions,

Mélanie offered that woman
a turning point.

Caroline, before studying psychology,

heard from a friend that her mum,

who had health problems,
chronic health problems,

sometimes thought about suicide.

Gathering up her courage,
one evening Caroline

brought up the question of suicide
with her mother,

who confirmed
that she had thought about it,

that she wanted to commit suicide,

and that she no longer wanted
her daughter to stop her,

and she didn't want
to be taken to the hospital.

Her mother told her,

"If you take me to the hospital,
I won't talk to you again."

And Caroline told her, "It would be
better if you stopped speaking,

because you could always change your mind,

but if you commit suicide
you can never change your mind."

Jean-François, who took part in a study,

- I'm going to call him Jean-François -

who took part in a study ´
that I was conducting,

told us that during a certain time
in his life,

he was going through a difficult time,
a bitter divorce with his partner,

he didn't see his children any more

he had the impression that his life
had become a failure.

He was angry, upset, depressed, suicidal,

and one day, one morning,
when he was at work,

his supervisor came over to him

and he said, "Listen. I know
things aren't going well at the moment.

I want you to stop what you're doing.

I want you to go to the hospital,
and see a doctor,

and take this, and call this place."

And he gave him a pamphlet
for a community organisation,

which helps men who are going
through the difficulties of separation.

So Jean-François told us that not only
did the actions of his supervisor

and the actions
of the community organisation

help him to find a turning point,

but they saved his life.

If you don't have
this kind of opportunity in your life,

you can still write,
you can sign petitions,

you can write to your local MP,
you can write to your health ministers,

you can write to the Prime Minister
of Quebec and of Canada,

and tell them
that we are holding on to life,

because life is important,

and we want our governments to take on
national programs for suicide prevention.

And if all our concerted actions,
help just one person,

if all our actions
contribute to helping one person,

contribute to changing
the suicidal path of a person,

then all our actions
will have been worthwhile.

Thank you.

(Applause)