Suicides

Key Messages

Putting suicides in context

The World Health Organization specifies that suicide is an “act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome.”¹ Mental illness is involved in most suicide cases, especially as a consequence of depression or substance abuse. However, no single determinant is enough on its own to cause a suicide. Rather, suicide typically results from the interaction of many factors:²

Whether these factors result in suicide, however, is also determined by the level of support a society gives to mediate these factors. The Organisation for Economic Co-operation and Development (OECD) observes that the intentional taking of one’s life “is evidence not only of personal breakdown but also frequently of a deterioration of the social context in which individuals live.”³

How do the provinces and territories rank relative to Canada’s international peers?

Ontario, P.E.I., and Yukon have the lowest suicide rates in the country and score “A” grades, finishing in the top five among Canada’s international peers. The U.K. is the top performer on this report card, with a suicide rate of 6.8 deaths per 100,000 population.

Overall, Canada ranks 10th with an average of 10.9 deaths per 100,000 population per year between 2009 and 2011, and earns a “B” grade. Most of the provinces score “B” grades. Saskatchewan and N.W.T. earn “C”s and Nunavut scores a “D-” grade. In fact, with an average of 63.9 suicides per 100,000 population, Nunavut is easily the worst-performing region among Canada’s international peers. Its suicide rate is three times that of the worst-ranking peer country, Japan.

How do the provinces and territories perform relative to each other?

Ontario and P.E.I. rank above average relative to the other provinces, with a suicide rate below 9 deaths per 100,000 population. Yukon has the third lowest suicide rate in Canada. Saskatchewan is the worst-ranked among the provinces. N.W.T. and Nunavut have the highest suicide rates in Canada. Nunavut’s suicide rate is over seven times higher than that of the top-ranked province, Ontario.

How do the rankings compare with self-reported mental health?

Mental illness is a common risk factor for suicide, and self-reported mental health is a subjective measure of overall mental health status. The relationship between self-reported mental health and suicide is evident among the worst-ranked regions. N.W.T. and Nunavut rank last on self-reported mental health and have the highest suicide rates in the country. Nunavut’s last-place finish on self-reported mental health is revealing. Only 55 per cent of the population 12 years of age and older in Nunavut perceive their mental health as either “excellent” or “very good,” significantly lower than the Canadian average of 71.6 per cent.

But the relationship between self-reported mental health and suicide is not evident in all regions. For instance, Alberta and Saskatchewan rank relatively well on self-reported mental health, yet both have high suicide rates relative to other provinces. The discrepancy in Saskatchewan is particularly glaring—the province has the third-worst suicide rate in Canada, yet 71.6 per cent of the population aged 12 and over reported their mental health as either “excellent” or “very good,” scoring the province an “A” grade on self-reported mental health. On the flip side, Yukon does poorly on self-reported mental health, like the other territories, yet receives an “A” for its low suicide rate.

Why is the suicide rate in Nunavut so high?

Mental illness is a serious concern among the Aboriginal population—particularly for youth. The Aboriginal suicide rate is two to three times higher than the non-Aboriginal rate for Canada. Even more shocking, the youth suicide rate for the Aboriginal population is five to six times higher than that of non-Aboriginal youth.⁴ Depression is the most common illness among those who commit suicide,⁵ and nearly two-thirds of those committing suicide in Nunavut experienced a major depressive episode at some point in their lives. Of this share, almost three-quarters were also diagnosed with another mental disorder, suggesting that it might be the combination of depression and another mental disorder that leads to suicide.

Those committing suicide in Nunavut are also more likely to suffer from substance or alcohol abuse, and a high share suffered from childhood abuse. A study by McGill University and the Douglas Mental Health University Institute examined all 120 suicides in Nunavut between 2003 and 2006. Researchers reviewed medical and police records and interviewed family and friends of the victims. The study revealed high rates of childhood abuse, depression, and alcohol and marijuana abuse among the Inuit who took their lives. Among the group, 72 per cent were diagnosed with more than one mental health disorder, and almost half had experienced childhood physical, sexual, or psychological abuse. The study raised questions about the availability of psychiatric care for the group suffering from mental health disorders—82 per cent of the group had never taken medication for a mental illness, and only 17 per cent had ever been hospitalized for mental health problems.⁶

Are there any gender differences in suicide rates?

Suicide is a predominantly male phenomenon. In every peer country, men are at least twice as likely to kill themselves as women. In Canada, the factor is three-to-one,⁶ while in the U.S. it is almost four-to-one.⁷

In most OECD countries, the frequency of suicides rises with age. This is not true in Canada, except for the very elderly (that is, those aged 90 and over). One reason may be the lower elderly poverty rate in Canada than in peer countries.

Is youth suicide an issue in Canada?

Youth suicide, while not as prevalent as suicide in those aged 30 to 60 years of age, is a concern, and raises issues about youth disengagement. This is particularly an issue among Aboriginal youth in Canada. Suicide rates are five to six times higher for Aboriginal youth than for non-Aboriginal youth, and rates among Inuit youth are among the highest in the world, at 11 times the national average.⁹ Indeed, in a report published in 2013, Statistics Canada estimated that male and female suicide rates among Aboriginal youth under 20 years of age were 30 and 25.5 per 100,000 population, respectively. These figures are especially troubling for regions where the Aboriginal population is greatest, like Nunavut, N.W.T., and Saskatchewan, which have the highest suicide rates in Canada.¹⁰

How has the suicide rate changed in the provinces and territories over the past decade?

Over the past decade, overall suicide rates in Canada have been on the decline, dropping from 11.5 per 100,000 population in 2000 to 10.5 per 100,000 population in 2011. Quebec and P.E.I. are the two provinces with the largest decline in suicide rates. And even despite the much higher suicide rates in Nunavut and N.W.T., there is a downward trend in suicides in all the territories.

What is concerning is that suicide rates have risen in half the provinces: Newfoundland and Labrador, Nova Scotia, Ontario, Manitoba, and Saskatchewan all had higher suicide rates in 2011 than in 2000.

Footnotes

1    R.F.W. Diekstra, “Suicide and Attempted Suicide: An International Perspective,” Acta Psychiatrica Scandanauica, 80, S354 (October 1989), 1–24.

2    Statistics Canada, Health at a Glance, Suicide Rates: An Overview, 2012.

3    Organisation for Economic Co-operation and Development, Society at a Glance: OECD Social Indicators—2006 Edition (Paris: OECD, 2006), 106.

4    Health Canada, Acting on What We Know: Preventing Youth Suicide in First Nations (accessed February 27, 2012).

5    Statistics Canada, Health at a Glance, Suicide Rates: An Overview, 2012.

6    McGill University and the Douglas Mental Health University Institute, Learning From Lives That Have Been Lived, 2013.

7    Statistics Canada, CANSIM table 102-0551 Deaths and Mortality Rate, by Selected Grouped Causes, Age Group and Sex, Canada (accessed October 28, 2014).

8    Centers for Disease Control and Prevention, FastStats (accessed October 28, 2014).

9    Health Canada, Suicide Prevention (accessed October 28, 2014).

10    Health Canada, National Aboriginal Youth, Suicide Prevention Strategy (accessed October 28, 2014).