Suicidal teen left note critical of health care

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This article was published 19/11/2017 (2894 days ago), so information in it may no longer be current.

Melissa Winter clutches a letter from her 17-year-old daughter, Jaedra. She found the handwritten note, along with three others, on Jaedra’s bed the night she took her own life.

Jaedra addressed the letter to her doctors. It criticizes the quality of Manitoba’s youth mental-health care.

“Recently, I said to a psychiatrist that I need meds and that they should try to discover what’s wrong,” Jaedra wrote. “He said, ‘No, I don’t think you need them.’ Didn’t even try to check to see how my brain was feeling or working. So here is to prove a point. Get better doctors and people who are actually willing to help.”

‘The treatment we have for suicidal people in the health system is abysmal. There is no suicide-specific treatment in Manitoba. Imagine if you walked into the emergency room with a broken bone and they said, ‘Sorry, we don’t have any treatments for broken bones’– Dr. James Bolton 

Photos of Jaedra — two of her smiling on a Florida beach and another with flowers weaved in her hair — are scattered about Winter’s living room.

“There were no signs Jaedra was suicidal,” Winter says. “She wore the mask: she was bubbly and happy all the time. She loved everyone but herself.”

Jaedra tried to end her life four times in 21/2 years. The first time she attempted suicide, Winter took her to Health Sciences Centre emergency room at 8 p.m. on a Friday. They waited seven hours to be admitted to the adolescent psychiatric unit, only to find there were no psychiatrists available on weekends.

Jaedra was never diagnosed with a mental disorder, and received little therapy. Winter says the family could not afford private care, and long-term in-patient treatment does not exist for youth. After being released from the hospital, it took a month and a half for Jaedra to see her psychiatrist again. Winter says she slept in the same bed as her daughter and watched her like a hawk.

After Jaedra’s second and third attempts, Winter demanded better services from Health Sciences Centre. They did family counselling, and Jaedra attended outpatient therapy sessions. But it was not enough.

“By June 2015, she had killed herself,” Winter says. “They tell you there’s help out there, but where is it? They kept saying to me, ‘Once you’re out of the hospital, we’re going to set you up with all these supports,’ but nothing ever happened.”

According to a report published in July — titled Toward Quality Mental Health Services in Canada – Manitoba has the highest youth suicide rate in the country, with about 18 attempts per 1,000 teens.

Dr. James Bolton, medical director of the Winnipeg Regional Health Authority crisis response centre, assisted with the study that compared services in five Canadian provinces: Manitoba, Alberta, British Columbia, Ontario and Quebec. The report used health data, including documented suicide attempts, hospital discharges and physician followup rates, to analyze the state of Canada’s mental-health system.

“The overall message is youth with mental illness and addiction in Manitoba are not doing well,” Dr. Bolton says. “The report encourages not just the health system, but also policy makers and politicians, to say, ‘This is a real problem we need to focus on.’”

Finland faced a suicide epidemic among young men in the early 1990s. In response to the rising attempt rates, the country implemented a new prevention program, slowly over a decade. The government, schools, churches, defence forces, welfare organizations and mental-health professionals worked together to develop supports across all community sectors. Followup care and communication between patients, their family and health-care professionals were also improved. The overall suicide rate in Finland fell by 25.8 per cent between 2000 and 2011, according to the Organization for Economic Co-operation and Development.

Bolton says the Finnish model is one Manitoba could use as an example.

“They had to go across a variety of domains, and that’s what makes a suicide-prevention strategy work,” Bolton says. “You’re not just targeting health, especially when it comes to young people. You have to target all areas that intersect with their lives, like religion, school and friend networks.”

Bolton says looking at the services other Canadian provinces have could also help Manitoba improve youth mental-health supports. Québec, for instance, cut its suicide rate in half after introducing its own prevention strategy in 1999.

“The treatment we have for suicidal people in the health system is abysmal,” Bolton says.

“There is no suicide-specific treatment in Manitoba. Imagine if you walked into the emergency room with a broken bone and they said, ‘Sorry, we don’t have any treatments for broken bones.’”

Outi Ruishalme, director of the SOS Crisis Centre at The Finnish Association for Mental Health, says Finland still has a long way to go.

“We still have over 700 suicides each year, but the project was a success because professionals learned to pay attention to depression,” Ruishalme said in an email. “It also proved people in crisis need help early on.”

Ruishalme says the country implemented mental-health skills training in elementary school curricula in 2016. There are also targeted youth programs, including bullying education and child-welfare clinics.

“We currently have a project going on, applying the attempted suicide short intervention program developed in Switzerland to Finland,” Ruishalme says. “They had a two-year followup with good results, which means their suicide attempts decreased remarkably.”

Finland is not the only country to reduce suicide rates. Twenty-eight others have a national suicide-prevention strategy, and 13 are developing one, according to the World Health Organization. Canada is not part of this.

Melissa Winter knows changes to Manitoba’s youth mental-health system will not bring back Jaedra. She does, however, believe they could prevent another family from experiencing the same loss.

“It’s been two years, but it still feels like it happened two months ago,” Winter says.

“It’s doesn’t get easier; it just gets more real.”

Kelsey James is a senior journalism student in the creative communications program at Red River College in Winnipeg. This article was a product of a feature writing assignment.

kjames37@Academic.RRC.CA