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December 5, 2019

A Community Approach to Youth Suicide Prevention

Suicide is something we hope will never happen to anyone we know and love. Sadly, rates of suicide in Canada have been fairly constant since the 1920’s, with up to 10 suicides occurring per day. And for every suicide death, there are an estimated 20-25 attempts.

Suicide is especially prevalent in our vulnerable children and youth. More than 1/5 of our youth have a mental health disorder which can contribute to suicidal thoughts and behaviours. Less than 10% of youth get the help they need.

The Child and Youth Mental Health Program (CYMHP) at McMaster Children’s Hospital has been a strong advocate in youth suicide prevention, and is working to improve support for youth at risk. Recently, the program, along with several community partners, created a new protocol for “Youth with Complex Suicide Needs” (YCSN). It identifies high-risk suicidal youth in the Hamilton community.

The YCSN Protocol was developed by the Hamilton Committee for the Collaborative Management of Youth Suicide. The committee formed in 2015, and grew out of the community’s sense that they could provide better, more coordinated care to the youth in the community who were at high risk for suicide.

How it works

Representatives from agencies across the community meet regularly to discuss high-risk youth who need additional support. Agencies include the Canadian Mental Health Association, school boards, child protection services, family health teams, police, mobile crisis, and more. Each agency is trained to identify youth that meet the criteria, and to activate the YCSN protocol, when needed.

For example, the school board could be concerned about a particular student exhibiting high-risk suicidal behaviours. The school board would activate the protocol by informing the committee about this at-risk youth. Then they would work together to treat the youth with a wraparound approach.

Dr. Jennifer McTaggart, a clinical psychologist in MCH’s Child and Youth Mental Health Program, is the protocol representative for the hospital, and co-chair of the committee. “Anyone actively involved in the youth’s care, or who needs to be involved, becomes part of the process,” she says. “We work together to share background information, talk about what contributes to the youth’s risk, and ultimately to form a comprehensive management plan”.

Some of those risks might be significant parent-child conflict. In this case, the treatment plan could be customized to take place outside the home, where the youth is temporarily removed from the stressors of that relationship. Or perhaps school is a trigger for the youth, in which case an alternative education placement could be arranged.

The management plan is shaped by the opinions and advice from all of the agencies involved, as well as the wishes of the youth and their family. It takes into account all of the risks and aims to reduce them.

“The YCSN Protocol develops a comprehensive and coordinated approach to high-risk youth in our community,” says Nicole Karki-Niejadlik, Clinical Director at the Lynwood Charlton Centre, and one of the protocol representatives and co-chairs of the committee.

Noticeable improvements

Since June 2019, this protocol has been activated with five high-risk youth in our community, resulting in noticeable improvement in communication among care providers and more well-informed treatment plans.

“Another measure of success it that, in some cases, there has been a decrease in visits to the Emergency Department for self-harm and suicidal behaviours,” Dr. McTaggart explains.

“We all have to work together in order to support these high-risk youth”

Participants across agencies agree that the protocol reinforces a shared responsibility for the youth in our community.

“We all have to work together in order to support these high-risk youth,” echoes Dr. McTaggart.