Question Period Note: Suicide prevention

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• Suicide is a significant public health issue that affects people of all ages and backgrounds across Canada.
• The Government of Canada recognizes the importance for all Canadians to have access to critical mental health resources and suicide prevention services, particularly in regions like our North that are facing high suicide rates and mental health challenges.
• The federal government is leading the development of the National Suicide Prevention Action Plan, formerly M-174, aimed at reducing suicide rates and improving mental well-being based on best practices and innovations in suicide prevention and life promotion.
• The federal government is investing $21 million to develop Talk Suicide Canada and $57.5 million to support crisis services during the pandemic, including $2 million to develop resources for distress centres that are tailored to meet the needs of diverse populations such as Inuit, First Nations and Métis communities.

If pressed on progress on 9-8-8 implementation
• The Government of Canada welcomes the Canadian Radio-television and Telecommunications Commission’s decision to adopt a 9-8-8 phone and text service for Canadians in need of immediate mental health crisis and suicide prevention support. This service will be launched across Canada on November 30, 2023.
• To prepare for this launch, the Government of Canada has announced that the Centre for Addiction and Mental Health (CAMH) will lead the coordination of 9 8 8 service delivery, building on its experience delivering Talk Suicide Canada.

If pressed on Federal Framework for Suicide Prevention Activities
• As part of our work to address stigma, the Government of Canada has developed a resource for Safe Messaging about suicide to help people in Canada talk safely about suicide. This resource is available in both English and French on the Canada.ca website.
• We have also helped to connect people, including those in the North, to crisis resources by supporting Talk Suicide Canada and we are accelerating research by working with suicide experts to identify key knowledge gaps that would benefit from further research.

If pressed on the review of the federal framework for suicide prevention
• The Standing Senate Committee on Social Affairs, Science and Technology launched a study of the Federal Framework for Suicide Prevention on September 29, 2022.
• We welcome the recommendations of the Committee to help inform our plans to evolve the Framework and implement a National Action Plan based on the best available evidence.

If pressed on progress on the national suicide prevention action plan
• Engagement on the priorities for the National Suicide Prevention Action Plan is expected to proceed over the coming months with federal departments, provincial and territorial governments, Indigenous organizations, stakeholders and People with Lived and Living Experience.

If pressed on COVID-19 mental health crisis supports
• The Government is providing over $14.8 million over 36 months to Kids Help Phone to deliver mental health crisis supports for children and youth during the pandemic.
• The 2020 Fall Economic Statement announced a $50 million investment to bolster the capacity of distress centres across the country.
• This includes new investments such as $2.0 million to Talk Suicide Canada to support resources for the increased demand on distress centres, and approximately $1.8 million towards 14 distress centres in Canada.

If pressed on the continued need for COVID-19 mental health crisis supports
• Through the 2020 Fall Economic Statement investment, PHAC provided grant funding to 71 local distress centres across Canada in 2020-21 and 2021-22, however the demand for crisis lines continues to increase.
• Local-level crisis supports are struggling to meet the demand and needs of their communities, and may not be aware that there is support available to them. The Government is working with national organizations, such as Kids Help Phone and Talk Suicide Canada, to leverage administrative capacity to hire new responders in local distress centres across the country.
• This work will also allow expansion of the Talk Suicide Canada network of local distress centres to better meet demand as well as support Kids Help Phone to bolster its capacity to address the heightened demand for their crisis services for children and youth across Canada.

According to preliminary data, there were 3,839 deaths by suicide reported in 2020. The 2020 data is provisional and incomplete, and could potentially increase by 5 to 15% over the next year. This delay is due to the length of time that coroners and medical examiners sometimes require to complete their investigations. At this time, caution should be used in drawing any conclusions regarding suicide trends during the pandemic. There is no single cause that fully explains or predicts suicide; a combination of factors are associated with suicide, such as mental illness, physical health, personal issues and loss, childhood abuse and neglect, and exposure to trauma.

Three-Digit Number for Mental Health Crisis and Suicide Prevention: The Canadian Radio-television and Telecommunications Commission (CRTC) recently announced that it will adopt 9 8 8 for Canadians to call or text when in need of immediate mental health crisis and suicide prevention support. This will be launched across Canada on November 30, 2023. In parallel, the Public Health Agency of Canada (PHAC) is preparing for implementation of a three-digit number for suicide prevention from a service delivery perspective. On August 31, 2022, PHAC announced that the Centre for Addiction and Mental Health (CAMH) was selected to lead coordination of 9-8-8 service delivery, building on its experience delivering Talk Suicide Canada.

The Government of Canada is investing $21 million over five years in CAMH to implement and sustain a fully operational pan-Canadian suicide prevention service with its partners. Talk Suicide Canada currently provides 24/7 suicide crisis support via phone (1-833-456-4566) in English and French, 24 hours a day, seven days a week and by text (45645) in English and French in the evenings to people in Canada. This investment includes $2 million to develop resources for distress centres that are tailored to meet the needs of diverse populations, including Inuit, First Nations and Métis communities.

When a person reaches out to Talk Suicide Canada, their call or text is routed to the closest available distress centre that is a member of the network. If a responder is not available in that centre, the call is automatically routed to the next available responder, with the back-up hub responding to interactions when responders in a member distress centre are not available. This approach allows for support from a local centre where responders have a better understanding of resources available locally. All calls to Talk Suicide Canada are answered by a trained suicide prevention responder.

In 2021-22, almost 89,000 interactions took place, representing approximately 65% of incoming calls, and 76% of incoming texts (i.e. over this period, approximately 35% of incoming calls and 24% of incoming texts were unanswered). The service continues to struggle to meet demand. Incoming interactions continue a steady increase: there were 12,081 incoming interactions in June 2022, compared to 10,378 for June 2021. The voice answer rate for the service has declined over the past year. This is a challenge for all crisis services through the pandemic. PHAC is working with crisis services to help address these issues. There is potential for this volume to increase further as announcements in Canada and the USA create awareness of the existing service and prompt additional people to reach out.

COVID-19 Mental Health Crisis Supports: Through the 2020 Fall Economic Statement, the Government of Canada announced a $50 million investment to bolster the capacity of distress centres. PHAC administered an initial round of funding grants to 57 distress centres in 2021-22, and is currently distributing grants to 14 other distress centres in 2022-23 (following a second solicitation reaching organizations not included in the first round of funding). In addition, $2 million of this funding is supporting CAMH as it curates resources to assist distress centres in meeting the needs of priority populations.

PHAC is also administering time-limited funding of $150 million, provided in Budget 2021 to support the mental health of those most affected by the COVID-19 pandemic. $1 million of this $150 million in funding is being reprofiled in 2022-23 to allow PHAC to support additional projects and activities, and ensure equitable reach to priority populations.

Motion 174 – A National Suicide Prevention Action Plan: In April 2018, MP Charlie Angus (NDP, Timmins-James Bay) sponsored motion M-174, calling for the Government to establish a National Suicide Prevention Action Plan. On May 8, 2019, parliamentarians voted unanimously in favour of M-174, though it is non-binding. The proposed actions in the plan are aligned with the Federal Framework for Suicide Prevention. Activities in progress across the Government of Canada include the development of resources and tools to reduce stigma and raise public awareness about suicide and its prevention, research and knowledge translation (i.e. the synthesis, dissemination, and exchange of evidence-based information to improve the health of Canadians), and the implementation of a Pan-Canadian suicide service prevention service (Talk Suicide) and 3-digit number (988). An update on M-174 was included in the December 2020 Progress Report on the Framework. Efforts to develop the Action Plan will be included in the December 2022 Progress Report as part of legislated reporting on the Framework. PHAC is starting to facilitate coordination and collaboration on elements of the Action Plan with relevant federal departments, provinces and territories, agencies and key stakeholders, including those from First Nations, Inuit and Metis organizations, through its convening role on this Action Plan.

Survey on COVID-19 and Mental Health and Survey on Mental Health and Stressful Events: PHAC is currently conducting surveillance to understand the impact of COVID-19 on suicide and mental health. The Survey on COVID-19 and Mental Health showed that 2.4% of adults in Canada reported suicidal ideation since the pandemic began in 2020, which is not significantly different from the 2.7% before the pandemic in 2019; however, the percentage increased significantly in spring 2021 to 4.2%. Risk factors of reporting suicide ideation during the pandemic included being under 65, Canadian-born, a frontline worker, reporting pandemic-related income/job loss or loneliness/isolation, experiencing a highly stressful/traumatic event during one's lifetime, and having lower household income and educational attainment. Continued surveillance of suicide and risk/protective factors is needed to inform suicide prevention efforts.

• Between 2017 and 2019, there were approximately 4,500 deaths by suicide per year in Canada, which is equivalent to 12 people dying by suicide every day.
• In 2019, suicide was the 9th leading cause of death among all Canadians, and the 2nd leading cause of death among individuals aged 15 to 34, behind unintentional injuries.