An internationally acclaimed suicide-prevention program has resulted in more Manitoba First Nations people thinking about ending their life -- that's the conclusion of a study conducted by a University of Manitoba professor of psychiatry.
ASIST (Applied Suicide Intervention Skills Training) is a two-day program intended to help professionals and community caregivers identify and help people who are at risk of suicide. The company's website says more than one million people have been trained worldwide.
The theory is suicide can be prevented with the help of prepared caregivers.
In the summer of 2010, the University of Manitoba's Dr. Jitender Sareen completed an ASIST analysis with the Swampy Cree Suicide Prevention Team (SCSPT). The hypothesis was that participants would have "increased knowledge and preparedness to help people with suicidal ideation." Researchers also expected to find participants wouldn't have higher levels of distress or suicidal thinking after their training.
They were wrong.
Every literate member of the Swampy Cree Tribal Communities over 16 was eligible for the study. Swampy Cree is made up of eight First Nations in northwest Manitoba.
Sareen's research, done for the Canadian Institutes of Health Research and finalized in January, found some members living on reserve didn't get positive results from their training.
"Our study also showed a concerning trend toward an increase in suicidal ideation among people receiving ASIST training compared to those receiving the resilience retreat," Sareen's unpublished results read.
"There are several explanations for this finding. First, ASIST training could have led to an adverse effect of creating distress and suicide contagion."
Resilience retreats bring together youth and elders for two days to talk about the loss of identity and culture.
"Second," his report continues, "it is possible that the resilience retreat group had a greater impact on decreasing suicidal ideation than ASIST training. Third, there could have been other factors associated with suicidal ideation."
In layman's terms, taking the training was enough to make some people think about suicide themselves. First Nations communities are overrepresented in suicide statistics, with rates three times the national average.
Aboriginal people comprise roughly 14 per cent of Manitoba's population. Between 1994 and 2001, aboriginals accounted for 25 per cent of suicides.
Sareen has worked extensively with First Nations youth. He would not comment on the results, which are under embargo.
Fran Schellenberg, executive director of mental health and spiritual health care for the province, said ASIST-type training is a "very important component" in the suicide-prevention field. Regional health authorities offer the training on a cost-recovery basis. There's no charge for the training, but participants pay for their manuals.
She said further evaluation of Sareen's results will be necessary and the government is taking this "potential trend" seriously. There is no evidence anyone committed suicide as a result of taking the training.
In a March 7 memo to health-care providers and First Nations community members, Schellenberg wrote:
"(W)e want to emphasize the importance of engaging in a dialogue with individuals and communities regarding their vulnerability to suicide (i.e. current or past suicidal ideation or behaviours; bereavement by suicide) as part of a decision-making process gauging training readiness as well as the importance of making any communities or individuals being considered for ASIST aware of the sensitive nature of the content of the training.
"We are currently in discussions with relevant partners and we will undertake additional research on ASIST that will further our knowledge about this training, including its benefits and impacts."
The WRHA would not comment on the results because it was not directly involved in the study.
The Province of Manitoba has a dedicated suicide-prevention strategy in place. If that "additional research" proves ASIST is giving some First Nations people ideas about suicide, it should be pulled from vulnerable communities.