Hektoen International

A Journal of Medical Humanities

A love-driven model of suicide prevention

Kate Baggott
St. Catharines, Ontario, Canada

 

Burgoyne Bridge reconstruction – Cranes mid bridge. Photo by Matt Clare. Taken 2016.
CC BY 2.0.

The suicide barrier on the Bloor Street Viaduct in Toronto is called the Luminous Veil. The beauty of the title is that it is intentional and intelligent.

Construction of the barrier started in 2003 after more than a decade of advocacy. It was installed just a few years after the poet and author H.S. Bhabra took his own life at the bridge. The day before he died, witnesses saw him writing at the local library. He was penning a series of suicide notes.

“He tells her everything was a lie. He tells her he was not a legal immigrant. That there is no book no publisher, no money,” The Globe and Mail quoted a friend who had read H.S.’s suicide note to his lover.1

Writers work in the realms of persuasion and description. The suicide notes of authors are no exception. Those works have done much to inform clinicians of the pathologies of suicidal thoughts. They record the lies the brain tells itself under the influence of depression.

“I am always bitchy. No Fun – for anybody,” Hunter S. Thompson wrote his wife.

The idea that suicide is in anybody’s best interest is a repeated theme in suicide notes.

“If anybody could have saved me it would have been you,” Virginia Woolf wrote her husband Leonard in her suicide note. “Everything has gone from me but the certainty of your goodness. I can’t go on spoiling your life any longer.”

Hunter S. Thompson did not ask his wife if she would prefer no Hunter to the no fun Hunter. Virginia Woolf did not ask her husband if or how her death would somehow unspoil his life.

No one wants to be called out on the lies they tell. Even if, when they penned their notes, the authors were convinced they were writing the truth. Belief does not turn a lie to truth.

The truth is, if people who have committed suicide had indeed asked their beloved friends, parents, or children if their suicide would make anyone’s life better, the answer would be no.

“No,” we would say, “I cannot be the person I am without you.”

The truth of love has seen more of the arts of persuasion and description than any lie.

The Luminous Veil is persuasion and description expressed through infrastructure. In 2018, a study was released by the City of Toronto that showed barriers are indeed successful in reducing deaths by suicide.

“Many jurisdictions have erected barriers at bridge locations and found them to be effective in preventing or reducing suicide deaths,” Kate Bassil, Toronto Public Health’s acting associate director for healthy public policy, told the Canadian Broadcasting Corporation (CBC).2

The study found that there was a 93 per cent drop in suicide deaths from bridges in the city following the construction of suicide nets and barriers. Prior to the installation of the Luminous Veil, there were nine suicides from the Bloor Viaduct every year for twenty years. There has been only one since the barriers were installed and no increase in the number of suicides at other bridges. The pause that prevents someone from jumping off one bridge, appears to prevent them from just finding another bridge.

I left Toronto just over a year after H.S. Bhabra died. I was not there to notice that there were fewer stories of grieving anguish circulating in the streets, fewer obituaries suggesting — but not stating — a death by suicide.

Now, I live in another mourning city and the debate about suicide barriers is following the same plot as Toronto’s did from 1997 until the barriers were completely installed in 2004.

Here critics are repeating the same financial arguments. Barriers cost money that would be better spent on mental health supports in the community, they say. The same critics, however, tend to champion government cuts to healthcare saying we cannot afford to live beyond our means. The deaths of others are not their tragedies.

Those who have experienced the tragedy of a loved one’s suicide are comforted by the fact that barriers are effective deterrents. They have been sharing the stories of their losses in the hope that others might be spared that kind of pain.

The Regional Municipality of Niagara has fierce advocates campaigning for suicide barriers. It is a love-driven initiative that may just change how mental health issues are approached in the same way that Alcoholics Anonymous has reformed how we approach problem drinking, or in the way that home hospice initiatives have changed attitudes toward death and dying.

At the center of advocacy efforts is Niagara United, a grassroots group determined to help those who are suffering and their families. They are the loudest voice lobbying regional government for suicide barriers at the Burgoyne Bridge. Opened in 2017, the bridge quickly became a landmark. Like the Golden Gate Bridge in San Francisco and the Lion’s Gate Bridge in Vancouver, the Burgoyne Bridge is a point of architectural magnificence and, like the other two locations, has become a place where desperately depressed people seek to end their own lives. It is a place of beauty that needs its own Luminous Veil. The place of beauty needs to become a place to pause and be infected by some suggestion of poetic hope.

For those of us who live in the community, it has been impossible not to see each of the losses of life at the bridge as a symptom of our chronically underfunded mental health system.

“When you’re talking about the Niagara Health System, you’re talking about a brand new hospital that replaced two older hospitals,” says Stephanie Farquharson, one of the founders and facilitators of Niagara United. “There just aren’t the same number of mental health beds or treatment spots that there used to be.”

As a result of the reductions, in Farquarson’s view, mental health assessments and re-assessments are happening too quickly.

“If someone says they want to harm themselves that used to trigger an automatic admission for 72 hours. Now? A patient might be re-assessed after just 24 hours,” Farquarson explains. “That’s enough time to think deeply about how to die and how to lie about your intentions.”

There are anecdotes of relatives begging doctors and nurses not to discharge their loved ones. There is the heart-breaking story of the parents who went home from the hospital for a rest after keeping vigil for days and, the moment their backs were turned, their young adult child was released on their own.

“Then there is only one outcome when someone who is determined to die has the opportunity to go out to find the rope, or the drug dealer, or the bridge,” Farquarson says. “The hospital is central to emergency care, but it has no connection to the services that operate independently to provide on-going mental health care. There is no one in the hospital to help them navigate the system once they are released. Learning how to navigate a complicated system can feel impossible for those in crisis.”

That is where Niagara United’s MAPS, or Mental Awareness Peer Support, comes in.

“They are group meetings where people share resources and experiences to advocate for each other,” Farquarson explains. “We help each other understand what we need to know and to do to make the system work.”

Held in church basements in towns and cities around Niagara, the group hopes to be able to offer a MAPS meeting every night of the week. All of their services are free and Niagara United has no source of funding outside donations from members of the community.

The idea of a peer-support group for mental health issues is controversial. Critics of Niagara United emphasize how important it is for those suffering from mental health issues to see qualified counselors and medical professionals whose practices are regulated and supervised.

Farquarson responds to critics by saying MAPS exists to help people find those resources and to support them while they wait to access services. In the meantime, they are de-stigmatizing mental illness by broadening the sphere of discussion.

“We’re talking about mental health, we’re talking about addiction, we’re talking about suicide prevention,” Farquarson says, “but there are so many rules and regulations governing how professionals talk about it that the community needs to respond too. Professionals can’t offer peer support, they can’t engage in direct action, or in political advocacy. Yes, we need more professionals who are caring and trained, but they are subject to systemic pressures. Only a caring community can act outside of those pressures by acting outside the system.”

That means everyone needs to step up to create a truly collaborative model of community mental health care. We have to collaborate to advocate for a Luminous Veil for the Burgoyne Bridge in St. Catharines, Ontario. We have to work together to provide on-going support for those who are suffering.

“Suicide prevention is everyone working together to bridge the gaps. I want people to know they can come to MAPS if they don’t have a counseling appointment until next week,” Farquarson says. “Then, if they never come again because they’ve found their professional support system, that’s fine. People feel the constraints of not being able to tell their own stories and those constraints are released when we work together as equals. Sometimes we laugh, sometimes it’s sad, but we all leave feeling better and that is all we want to accomplish. We get people through to the next day. In suicide prevention, the next day is a victory. One more day is a huge victory.”

 

References

  1. Gill, Gayle and MacDonald,Alexandra. 2000. “The unseen faces of H.S. Bhabra.” The Globe and Mail. Toronto, Ontario, June 3. https://www.theglobeandmail.com/life/the-unseen-faces-of-hs-bhabra/article768098/.
  2. Pelley, Lauren. 2018. “10 people die by suicide from Toronto bridges every year, but city aims to prevent that.” CBC Canadian Broadcasting Corporation. Toronto, Ontario, May 14. https://www.cbc.ca/news/canada/toronto/toronto-suicide-prevention-bridge-barriers-1.4662464.

 


 

KATE BAGGOTT is a Canadian writer and research consultant. Her published work spans from technology writing to creative nonfiction and from experimental fiction to chick lit.

 

Spring 2019 |  Sections  |  Psychiatry & Psychology

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.