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BC coroners urged to investigate sexual orientation in youth suicide

Coroners should ask ‘thoughtful and sensitive’ questions, new report says

Dr Evan Adams says it's important for coroners to ask the right questions to find out what happened in a youth suicide. Credit: Facebook.com

Coroners investigating youth suicide should pay special attention to the youths' sexual orientation and whether they were harassed because of it, says a report released Sept 26.

"Youth who identify with a sexual orientation other than heterosexual appear to be at greater risk for attempting suicide compared to their heterosexual peers," says the BC Coroners Service's "Child Death Review Panel: A Review of Child and Youth Suicides 2008–2012," a report to the chief coroner of BC.

The report says a study specific to BC says sexual-minority youth experience higher rates of suicidal ideation and attempts.

However, children and youth who commit suicide may not have openly expressed their sexual orientation, making it difficult to determine an accurate suicide rate among the LGBT population, the report notes.

Of the children and youth who died by suicide between 2008 and 2012, two were reported to be questioning their sexual orientation at the time of their death, the report finds.

"To accurately and systematically capture the sexual orientation of children or youth who die by suicide, coroners need to consistently inquire about it during the course of their investigation," the report says. "This should include thoughtful and sensitive consideration on the types of questions asked, how they are asked and who the questions are directed towards."

The report says that in any given year between 2008 and 2012, there were approximately 450,000 young people in BC between the ages of 10 and 18 years old. Within this population, there were approximately 120 deaths per year; on average, 18 of these were the result of suicide, the report says.

For the report, the panel reviewed 91 coroners' cases of child and youth suicide between 2008 and 2012.

Bullying was experienced by 12 of the children and youth who died by suicide, and one youth was reported to have a history of engaging in bullying behaviour, the report says.

The report says research conducted around the association of bullying with suicide continues to emerge, especially in the area of cyberbullying, and suggests bullying is a risk factor for suicide.

"This research has identified the importance of acknowledging that both the children and youth who bully and those who are victimized are at an elevated risk for suicidality," the report says. "Therefore, efforts to address bullying behaviour should focus on the children and youth who bully and those who are targets of bullying."

The report notes the risk of suicide is higher among aboriginal youth, the homeless and those who have had either a history of problematic drug use or were under the influence of drugs at their time of death, with the most common substances used being alcohol and marijuana.

Deputy provincial health officer Dr Evan Adams, who is both gay and aboriginal, was on the panel that created the report.

He tells Xtra it's important for coroners to ask the right questions to find out what happened in a youth suicide.

"We need to be able to discuss sexual orientation in an easier way," he says, adding that questions could be asked of parents, teachers and friends. "How do we ask those questions without traumatizing them?"

Adams says the queer community can contribute to the discussion by reflecting on how individuals and organizations can assist youth who are struggling.

"I have a few gay and lesbian nephews and nieces," he says. "I should be there for them. We, as a community, aren't there to help young people."

He says the queer community could provide better assistance to youth on mental health, substance abuse, housing and other issues.

There may also be a need to help youth with resilience problems in the wake of the end of a relationship, he adds.

"Reflect back on who was there to help us and who was not there to help us," he suggests.

The report says the BC government intends to establish an advisory committee of officials from social ministries involving health, justice, child welfare and education, law enforcement, and service agencies to share information and develop guidelines for risk assessment protocols for a number of issues related to the health, well-being and safety of children and youth.

The report acknowledges the ERASE Strategy (Expect Respect and a Safe Education), introduced in 2012 to address bullying in schools, and encourages ongoing training for educators on supporting the mental health and well-being of children and youth, including information about suicide.

The  NDP's Spencer Chandra Herbert, MLA for Vancouver-West End, tells Xtra the report indicates BC youth are facing a mental-health crisis.

“Aboriginal youth and gay and lesbian youth are among the hardest hit," he says, adding that government cuts to mental-health services are failing to address the needs of marginalized groups.

Chandra Herbert says much of the ERASE strategy is good but says, "it doesn't seem specifically targeted actually to deal with targeted hate.

"BC just seems to think one size fits all in this approach," he says.

A briefing note prepared for then-education minister George Abbott and signed by Abbott and Deputy Minister James Gorman Nov 28, 2011 (prior to the release of the ERASE strategy), notes the Ontario government faced public and political pressure to address bullying in schools after a teen suicide was profiled in the media.

"The student pointed to bullying in school," says the briefing note, obtained by Xtra.

"There are still high rates of bullying and serious risks and threats in schools around the world,” the briefing note continues. “In BC, there have been a number of serious incidents that involve school-aged children when in some incidents warning signs are not recognized, missing an opportunity to provide possible intervention and supports to students, parents and teachers.”

"There is no 'one size fits all' model," the briefing note says, supporting Chandra Herbert’s position.

The report says the coroners' service will hold a series of focus groups with young people across BC starting this fall to explore the topic of suicide from their perspective, including ideas to make access and engagement with services easier.

The BC report comes in the wake of a June report that Canada's coroners are debating instituting protocols to record data on the suicides of queer and trans teenagers.

Dr Dirk Huyer, regional supervising coroner for the Guelph branch of the Office of the Chief Coroner and chair of the Pediatric Death Review Committee, said in June that since queer and trans youth are at greater risk of self-harm, coroners should evaluate whether issues regarding their sexual orientation or gender identity play a part in their actions.

At present, data regarding the sexual orientation or gender identity of youth who commit suicide is not recorded.