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October 8, 2013

Mental health and suicide

The Canadian Charger

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Ottawa's Royal Ottawa Hospital (ROH) arranged an educational program on September 26 to help parents understand their children and to empower them to be effective in promoting their children's mental well-being. The program was triggered by a pair of child suicides which captured public attention.

Dr. Mario Capelli, Director of Mental Health Research at the Children’s Hospital of Eastern Ontario (CHEO) was the first presenter.

Capelli pointed out that suicides are far more common than homicides.  He spoke of two kinds of environments for suicidal people, labeling them Werther and Papageno. 

Werther, the tragic hero in Goethe’s story “The Sorrows of Werther,” commits suicide after being rejected by the married woman with whom he fell in love.  Following the publication of this short story, there was a rash of suicides in Germany.  The significant factor in Werther’s suicide and that of the copycats was the lack of a supporting network. 

On the other hand, Papageno, a character in Mozart’s “Magic Flute,” was saved from suicide because of his social network giving him support.

Capelli also addressed the treatment of suicide in the media. 

In the past, newspapers tended to avoid mentioning suicides except in exceptional circumstances or the death of prominent persons.  That is now changing.  However, there are some guidelines that media should consider to limit negative impacts. 

Reports should avoid mentioning the method used.  They should not describe a suicide as inexplicable, nor should they romanticize (for example, “He killed himself so that now they can be together for all time”).  Coverage should preferably be on an inside page, or if on page one it should be in the bottom half of the page. 

Talking about suicide, he said, is not exposure to it.  We have to go beyond seeing suicide as a dark secret, instead seeing it as a problem to be solved. 

He pointed out that adolescence is a time of significant biological, psychological, and social change.  Often mental illness begins to emerge at this period of life, while the brain is being rewired, a period characterized by stress.  “In the case of fierce, repeated stress, the body goes into overload.”

Nicole Loreto, an ROH social worker and Ph.D. candidate, spoke about resilience: “the ability to adapt to challenging situations and adversity, the ability to manage life’s challenges.” 

In the face of stress, a healthy response is of the three “R’s”: resiliency (the ability to bounce back), resistance (building immunity to stress), and recovery (chilling and relaxing).  It helps to tell a child what to expect, without being overly negative.

She related an experiment that illustrates the impact of building expectations.  Two matched groups of students were given a test.  The first group was told that this would be a very hard test, while the second group was told it would be easy.  The second group had significantly higher test scores.

There are, she said, simple things that can help to improve “brain architecture” in teens.  They should be physically active, have a healthy diet, get adequate sleep, have social supports, have a hobby, and engage in meditation.

The final presenter was Mary Lou MacFarlane, a nurse who is program director of Fawg Forest Therapeutic Farm, an agency that works with children with mental health issues and their parents and who assists schools in developing programs to promote positive mental health.

She noted that mental health involves interacting factors: biological (genetic), environmental (for example, family stress), and situational (different events). 

The role of the family in promoting good mental health is critical.  In the family, do members speak kindly toward one another?  Do the parents have a positive outlook on life?  Are there family activities?  The family needs to demonstrate kindness in helping others, something from which the child will learn. 

As a way of assessing parental influence, one might ask if the child can tell what the parents’ core values are. As well, the child needs to have pro-social connections outside the family and have positive peer relationships.

Besides the family, the school is also a place for promoting positive mental health.

A healthy classroom, MacFarlane said, promotes positive learning and is an important link between school and family, collaborating on pro-social effects.  Pro-social learning involves empowering, supporting, setting boundaries, and promoting constructive use of time.  And if a child is having a melt-down, the response needs to be supportive.  “How do you feel?  What can we do to help?”

Summing up the session, Dr. Raj Bhatla, Psychiatrist-in-Chief at the Royal, said, “We need to be able to talk about mental health and suicide.”  Talking about suicide, he said, does not cause it.  And we all need resilience.  “Resilience is not a destination.  It is a journey.”

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