Suicide rates among Canadian girls rising

[-Pastor-Dale-Morgan-]

Perilous Times

Suicide rates among Canadian girls rising
 
 
By Sharon Kirkey,
Postmedia News April 2, 2012
 
 
Suicide rates for girls aged 10 to 14 increased 50 per cent, from 0.6 per 100,000 in 1980, to 0.9 per 100,000 in 2008. And among girls aged 15 to 19, the rate nearly doubled — from 3.7 to 6.2 per 100,000 during the same period.


Suicides are increasing among Canadian girls, with hanging, strangulation and other forms of suffocation now the predominant methods used by children and adolescents — regardless of sex — to kill themselves.

It's a disturbing phenomenon that researchers speculate may be linked to the increasing popularity of the "choking game", raising the possibility that unintentional strangulation deaths from the "game" — in which children strangle themselves or friends in order to cut off the flow of blood and oxygen to the brain and induce a euphoric high — are being recorded as suicides, say the authors of the report, which also suggests the Internet may be fuelling the trend.

The study by the nation's public health agency spans nearly 30 years and shows traditional patterns of suicide among young people in Canada are changing: Overall, while suicide rates for boys and male teens remained stable or decreased over the study period, the proportion of girls dying by their own hand is increasing.

Suicide rates for girls aged 10 to 14 increased 50 per cent, from 0.6 per 100,000 in 1980, to 0.9 per 100,000 in 2008. And among girls aged 15 to 19, the rate nearly doubled — from 3.7 to 6.2 per 100,000 during the same period.

Young female deaths by suffocation increased by an annual average of eight per cent in both age groups, researchers from the Public Health Agency of Canada report in this week's issue of the Canadian Medical Association Journal.

Suicide is the second leading cause of death — after unintentional injuries such as car crashes — among young Canadians aged 10 to 19; in 2008, there were 233 suicides among 10- to 19-year olds, accounting for 20.4 per cent of all deaths for that age group.

By way of comparison, suicides accounted for 1.5 per cent of all deaths in Canada during the same year.

Overall, the researchers found that the suicide rate among 10 to 19 year olds decreased by an average of one per cent per year during the study period.

However, when they broke the numbers down further, by age, sex and the method used, a troubling story emerged: "Among female children and adolescents overall suicide rates have increased, with suffocation becoming the most common method used," the researchers report.

Among their findings:

- In 2008, the suicide rate among 10 to 14 year olds was 1.2 per 100,0000, accounting for 10 per cent of all deaths in this age group; 88 per cent were the result of suffocation.

- Among 15 to 19 year olds, the overall suicide rate in 2008 was 9.2 per 100,000, accounting for 23 per cent of all deaths. Suffocation was also the primary means, accounting for 73 per cent of suicides in boys (102 deaths) and 78 per cent of suicides in girls (53 deaths).

- Suicide rates among boys aged 10 to 14 showed no significant change during the 29-year study period; in 2008, the overall rate was 1.6 per 100,000, and suffocation here, too, was the primary method. Suicide rates among males aged 15 to 19 decreased, from 19 to 12 per 100,000. While suicides involving guns began to decline in the early 1990s, suicides by suffocation increased every year. By 1994, suffocation had overtaken firearms as the leading method of suicide for this age group.

- For girls, deaths by suffocation increased by an average of eight per cent each year, while deaths from guns and poison decreased.

The study wasn't designed to answer why the trends are moving the way they are, or why suicide by suffocation is increasing, said co-author Robin Skinner, a senior epidemiologist at the public health agency.

In a study published in 2010, British researchers who interviewed 12 men and 10 women who had survived a near-fatal suicide attempt — eight of whom had attempted hanging — found those who chose hanging expected a "certain, rapid and painless death with little awareness of dying." Hanging, the researchers said, was considered a "clean" and simple method that wouldn't damage their body "or leave harrowing images for others" — perceptions that need to be changed to help prevent suicides by hanging, they suggested.

But the Canadian researchers also raise the popularity of the choking game — also known as blackout, flatliner and other names.

Children use computer cords, belts, ropes or their bare hands to choke themselves. They start to feel light headed; the plan is to release pressure just before they pass out. Others push on their chests or hyperventilate. But the "game" can turn deadly, Skinner and her co-author Steven McFaull write: "if the participant being choked is physiologically susceptible or if the pressure is not released quickly enough after the loss of consciousness."

Children who unintentionally die while playing the choking game might be misclassified as suicides, they said, "especially when the 'game' is played alone."

Other researchers have suggested these deaths aren't likely to account for a substantial portion of the recent increases in suicides by hanging or self-suffocation.

Sharron Grant's 12-year-old son Jesse died in their Ontario home seven years ago after playing the choking game alone in his bedroom.

He learned it at summer camp the year before.

"My son was probably very typical of kids who are doing this. He was a higher achiever, an A student, he was into athletics. He hated smoking and drinking," said Grant, of GASP (Games Adolescents Shouldn't Play). "When he came home from camp he told me all about it, because he thought it was funny. When I told him all the things he would be doing to his body, he said, 'I didn't do it. I just watched it happen mum.'"

The day he died, Jesse and his younger brother had been playing a video game when Jesse got up and went to his room to wait for his turn. He used the cord from his Xbox. He had been gone only 10 minutes when Sharron found him dead.

She learned only later that Jesse had been playing the "choking game" with his younger brother, Joshua, until Joshua told Jesse he didn't want to play it anymore. Sharron said she missed the signs in Jesse: the headaches and bloodshot eyes. "I thought he was just tired. I thought it was adolescence more than anything."

She said schools should explicitly be including the choking game as another form of risky behaviour in their health curriculum.

"If his brother had been taught that this is really dangerous, he would have told me," she said. "If any of these children had been educated on the dangers of this activity there would be a less deaths and injuries."

The Canadian researchers also raise the influence of the Internet and the proliferation of "pro-suicide" websites, chat rooms and blogs that detail ways to commit suicide, ranking how effective one method is over another, the amount of pain involved and even estimated time to death.

Although the actual numbers "are not enormous," any increase in suicide rates is worrisome, said Dr. Laurence Kirmayer, James McGill Professor and director of the division of social and transcultural psychiatry at Montreal's McGill University. The trend might be due to a convergence between the experiences of boys and girls, he said.

In the past, males — young and old — have tended to use more lethal means, "so that even though women and girls make more suicide attempts, men have been more likely to die by suicide," he said. Girls have been much more likely than boys to use pills.

If girls start using more lethal means — in this case, strangulation — the percentage of attempts resulting in actual death is going to increase, he said.

"The overall message is that if things have gone down, they've gone down partly because of means restriction — in this case restrictions of firearms," he said.

And while the new statistics are presented as global numbers for the entire country, "suicide is not evenly distributed in the population," he writes in the CMAJ. The suicide rate among Aboriginal youth is three to five times that for non-Aboriginal young people, he said.

It's vital that young people have a positive sense of the future, Kirmayer said.

Risk factors for suicide include depression, substance abuse, family history of suicide, family factors and life stressors such as relationships and bullying.