I spotted Gail Provenzano standing in the pub entrance scanning the room trying to find me. A tiny lady, she stood there floating in an enormous burgundy football team jacket that was about five sizes too big and nearly hung to her knees. It was her son’s 2010 Junior Champions jacket –number 61, St. Mary’s College.
As I sat across from Gail at the tall pub table, I became uncomfortable. We had a lot in common. We both had sons that loved to play football in high school, loved to spend a quiet afternoon playing video games, and loved family and friends. Both of our sons did well in school and stayed out of trouble. And both full of all the hope and excitement promised to young men whose eyes are brightly focused on the future. But that’s where the similarity between our families, our sons ended because her boy was dead and mine was not. Her son lost his life to suicide. The taboo subject, the one that nobody wants to talk about. And as I sat there I began to wonder if maybe we avoid discussing this topic because it forces us to consider how this tragedy can touch every single one of us. Our children, our loved ones and none of us have immunity to suicide. And who wants to think about that?
*****
The most recent data indicates that suicide is the second leading cause of death among youth aged 10-19 yrs. –second to accidents. Suicide accounts for 11% of deaths among youth aged 10-14 yrs. and 23% of deaths among 15-19 yrs.
The information below from the Office of the Coroner provides an account of the number of suicides in Sault Ste. Marie and Algoma District but identifying information is withheld to ensure privacy within a small demographic.
| Year | Algoma | Sault Ste. Marie |
| 2010 | 11 | 6 |
| 2011 | 18 | 14 |
| 2012 | 27 | 19 |
| 2013 | 18 | 12 |
| 2014 | 23 | 13 |
*Complete data for 2015 was not available in time for this article.
One in 5 Canadians will have a diagnosis of mental illness in their lifetime. Approximately 90% of those who die by suicide have a mental illness, and the risk is increased with a substance abuse disorder. The Office of the Coroner provided that in the Algoma District in 2010 less than 5 individuals who lost their life to suicide were known to be in receipt of psychiatric treatment, in 2011 -5 received treatment, 2012 – 9 received treatment, in 2013- 8 received treatment, in 2014 -11 received treatment.
In Sault Ste. Marie, the Canadian Mental Health Association (CMHA) has partnered with Algoma Public Health and Algoma Family Services to deliver a mental health walk in clinic to serve area residents. Between November 2015 and October 2016 the walk in clinic supported over 500 walk-in sessions –that could be individuals, families or couple sessions. The general counselling program offered through the Sault’s CMHA supports anywhere between 3,000-5,000 sessions per year. Each session could include more than one individual. People seeking support through these services tend to be struggling with general mental health issues and relationship issues. Also, there has been a noted increase of clients that struggle with co-occurring diagnosis, eg. Depression or schizophrenia plus addiction plus abuse.
*****
Gail and her husband were north of Sault Ste. Marie –gone fishing. Their daughter was out of town on her grade 8 graduation trip and their 15 year old son, Brett, was staying with friends of the family. The school year had wrapped up and the family was gearing up for balmy summer days at camp. Brett was also looking forward to beginning a new summer job.
“He always had a smile on his face. He was a quiet kid- when he was with his friends and at school and at football or hockey he was a joker. At home he was a little more reserved, he was quiet. He loved to be outdoors, he loved fishing, he loved swimming, he loved to be out helping his grandpa. He was very close with his grandparents. He spent a lot of time with his sister and they were very close. He loved his video games. He’d play video games and his sister would watch him or hang out and read a book while he played his games. They’d hang out forever. And I think that might be my favourite memory that he spent so much time with his sister.” ~Gail Provenzano
Gail and her husband enjoyed their quick two days on the lake and were tearing down their camp that Saturday morning when the O.P.P. rolled up.
Gail’s stomach churned and her heart filled with dread. Like every mother that leaves her child for a quick break-away, Gail left town that weekend diligently harbouring her worry for her two children. “I had a gut feeling prior to going up north that something was going to happen.”
The police delivered the news no parent ever wants to hear –their son was dead. Brett was dead. With no details provided by the O.P.P. Gail and her husband, distraught and confused, drove into Wawa to call the Sault Ste. Marie Police. Was Brett trying to defend himself? Was Brett killed in an accident? These questions and myriad horrific scenarios swirled through their heads until they finally learned that Brett, their loving and happy son, died by suicide.
On June 26th, 2010, a tragic confluence of events collided that night. It was, as the police would explain to Brett’s family, ‘a perfect storm’. There weren’t any observable signs that Brett was suicidal.
“He didn’t know what he was doing that night. He was in a different world.” Gail runs through the circumstances that eventually led to her son’s death that night. She speaks to me succinctly and pointedly, hurrying to get it all out in the open so she can get past what she doesn’t want to remember.
We agree that some information will be withheld for this story. Her motherly instinct continues to protect her son.
“Brett didn’t have typical suicidal thoughts. He wasn’t depressed. He wasn’t avoiding people. He wasn’t taking medication. There was nothing. The triggers were there and they came together all at once, in one night.”
*****
“Often times you’ll hear people say things like ‘well suicide is a very selfish act’ and ‘how can somebody do that’. When a person is thinking about suicide that is not a selfish thing. They are in so much pain and the only way to end that pain is to die. Often times when someone is in that position they are thinking that their family would be better off without them. They feel like that is their best option,” commented Lisa Carricato, mental health educator with the Canadian Mental Health Association.
“Our will to survive is very strong and when people are thinking about suicide they are trying to get other people to recognize that. Knowing what these invitations might look like and then having some help in how to ask that person in a very direct way is important,” remarked Carricato.
“Invitations,” Carricato explained, “are how we refer to certain behaviour or speech that provide an opportunity for us to speak with someone who may be showing suicidal thoughts. We don’t refer to those cues as ‘signs’ anymore. Signs can be overlooked and ignored.”
Carricato elaborated that friends or family of a loved one struggling with thoughts of suicide may hear or observe signs. Someone experiencing suicidal ideation may drop phrases like “I feel so alone” or “it’s hopeless” or “nobody cares” or “I need a way out”. They might also demonstrate high risk behaviour, turn to substance use or socially withdraw. These invitations might be motivated by the loss of a loved one or a job. Personal trauma or mental health challenges may also be factors.
“It is important to pay attention to what we are seeing, hearing, sensing and maybe learning about that person. And then we’re going to use those things to ask about suicide,” remarked Carricato.
Carricato was blunt when she addressed long-standing myths about raising the concern of risk to suicide with someone. “There’s a common belief that if you asked someone about suicide and they weren’t think about it that you might give them the idea about it. That’s absolutely not true. Human beings are not easily suggestible. Asking is the only way to find out and you’re not going to give someone the idea.”
Most people realize that individuals who openly struggle with suicidal ideation bear a lot of stigma. Carricato attempts to break down these barriers and misconceptions every day. But we often forget that it is not only the person experiencing suicidal thoughts that experiences society’s judgement. Discrimination, conviction, discomfort and avoidance are items of collateral damage survivors, the loved ones left behind, must live with in the wake of such a tragedy.
“If a family member has lost someone to suicide it is very important to talk about it openly,” commented Carricato. “And for those that have lost someone, it is important that they talk to family and friends about it and with professionals as well. We also need to understand that everyone’s journey of grief is really important. We have our own times in the way we can work through these things. But there’s no hard and fast rules about how to deal with it.”
*****
In Northern communities where some people don’t have a family doctors and where wait-lists for specialized care like psychiatry are endless, Gail was fortunate to access emergency psychiatric services after the loss of her son. Gail was detached in the early months following the loss of her son.
“I had my fourteen year old daughter and my husband so I had to function but I was numb. I cried myself to sleep every night and I would wake up and try to figure out ‘why’. Where is he? Why did he go? Why isn’t he here?” Gail holds her breath as tears escape her eyes.
“You just get through the days as best as you can. You just don’t believe it happened. Life goes on and you just exist. That’s pretty much it. Life just continues on. Every morning- you get up. Whatever happens -next happens. If you get hungry- you eat. You get thirsty- you drink. I slept a lot. Because I was trying to get rid of the pain too. Because the pain is unbearable. I would sleep in the afternoons and rest and I’d want to go to bed at night because I didn’t want to be awake to feel the pain. You just exist.”
The experience of losing a child compelled Gail to seek support from a grieving group composed of parents who had lost their children to perhaps illness, accidents, violence or suicide.
“The pain of losing a child consumes your life. It consumes every movement, every breath, every action. Everything you do is consumed by the loss of your child.”
Losing a child under any circumstance does not follow the natural order of things but compounding Gail’s tragedy was that Brett’s death was to suicide. A “double-whammy” she calls it.
“When you lose a child to suicide you have so many questions. When you lose a child to illness it is awful and the pain is the same but you have a little bit of a closure –I think. It’s painful to watch your child to go through what they go through but when you lose a child just like that,” Gail snaps her fingers, “…why? And that’s the question. Why. And that question is never answered.”
It is commonly acknowledged that speaking openly with loved ones who may be at risk to suicide and finding support when struggling with suicidal ideation is difficult, and that as a society we need to overcome these barriers. However, it seems to be just as challenging to find resources that inform people how to be supportive towards someone who lost a loved one to suicide.
What can you say? What can you do?
These questions are what brought us together today.
“You’re looking for support but not a lot of advice. People can’t give you advice. You just lost your child to suicide. Don’t tell me ‘it’s going to be ok’ or ‘it will get better’ or ‘time is going to heal all wounds’. It will never be ok. My son is gone. It’s not going to get better. You’re just looking for support, a hug, a shoulder,” shared Gail.
“You just have to let them ride that rollercoaster- that’s what it is. You have to let them go through it. And when they need support be there for them. When they want to talk about their child, let them. And when they want to be alone, let them. You just have to follow what they are going through …But be there. If they are saying they don’t want to be around anyone- they’re not pushing anybody off or saying that they don’t love or need you. They’re just trying to say to you that ‘I need to be alone and I need to take this pain inside and hold it and try to figure out what’s going on’.”
Gail weeps openly, dabbing her eyes with a napkin. She speaks through her tears. “And that’s what they are doing –they’re just trying to take some time for themselves –to try to feel that child or just figure out …and you get bombarded with thoughts and you need a break.”
Gail distracts herself with a sip of coffee and adjusts some cutlery on the table. Her tears retreat for the moment and she continues.
“You have to talk about it too. And you need to talk about your child …that helps with healing. And that might make other people feel uncomfortable but most of the time when I bring up Brett’s name it makes me feel good and happy.”
There were some buzz words and phrases people dropped on Gail that though well intended, went over like a lead balloon.
“People said to me in the beginning that ‘time heals’. It doesn’t. You never get over it. But I think the worst phrase I hate is the ‘new normal’. I got that a lot and that word frustrated me a lot. This isn’t new –this isn’t a new life. This is the life that you’ve been dealt. You got dealt a bad hand and now you have to do something with it. Something was taken away from you. You have to learn how to live without your son. Try to get up every morning and not do his laundry, not feel him, not hear him…not set a place at the table for him. It’s not a new normal.”
To this day Gail cherishes the last basket of laundry Brett accumulated. It sits next to her laundry machine, untouched for the past six years.
From time to time Gail will reach out to Brett’s friends. “And they reach out to me every once in a while and it feels good. I do believe keeping in touch with his friends is important because even though Brett isn’t here you have something in common that you are keeping alive and that is his memory. And that feels good. As a parent that feels good.”
Brett Provenzano, #61, St. Mary’s Knights Junior Football, 2009.
Of her 6’2, 180 pound son Gail recalls how proud she was when the ninth-grader won St. Mary’s linesman of the year award and was nominated for linesman of the year for the City. St. Mary’s retired Brett’s number and that award is now named after him –the Provenzano Linesman of the Year.
“He would have played for the Sault Sabercats,” wept Gail. “I miss those days. He loved his friends. He loved being part of a team. He had great friends, and he still does. He won’t be forgotten. I believe when his friends grow up and have their own kids their going to say ‘in high school, I had this friend…’.”
Six years following Brett’s death Gail still feels like she is “just existing”. The feeling of guilt some left behind by suicide may experience when they begin to feel happy again is not an issue for Gail because Gail doesn’t feel happy. She admits there are brief moments of being pleased when someone she loves has a good day or achieves some sort of milestone in life but those moments are fleeting.
Though she can intellectualize that Brett’s suicide was something she had no control over and that she was a good mother and can understand how the events that led Brett to suicide that night were unforeseeable, she dutifully hangs on to her feeling of guilt, her feeling that maybe she could have prevented her son’s death.
“I talk to other parents about losing a child. I know this was something that just happened. That I couldn’t have prevented it. But it is so hard to let the feeling of responsibility go. Because that is my child,” sobs Gail.
There are many days when opening her eyes feels overwhelming but Gail forces herself into her routines –running, going to boot camp, cleaning the house, making dinner. “You have to carry on. I have to get up in the morning. I have to take care of my dogs, spend time with my husband and daughter. Those are the important things to me now and that’s what gets me up now.”
Our conversation has been emotional and surely a courageous and painful act on Gail’s part. The plate of food we ordered two and a half hours ago at the beginning of our chat remains untouched.
“My main goal is to help somebody who has to go through this. And to maybe help somebody where there weren’t any signs like there weren’t any signs with Brett,” shared Gail. “It also allows me to talk about it. And I can talk about my son who I am so very proud of. It allows me to share my story. The pain is still there. I still don’t have him. But if I can help someone who might be going through or might go through this one day, to not feel so crazy, to be able to recognize that I felt or feel what they are going through, then I’ll tell my story. I’ll tell my heartbreaking story.”
ADDITIONAL RESOURCES
Connex Ontario Mental Health Helpline: 1-866-531-2600, http://www.connexontario.ca/
Algoma District, Central Access: 705.759.5989 or 855.366.1466
NATIONAL STATISTICS
http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx
- Nearly 4, 000 Canadians die by suicide each year
- More than 75% of suicides involve men, but women attempt suicide 3 to 4 times more often
- Suicide is the second leading cause of death among youth aged 10 – 19. Suicide accounts for 11% of deaths among youth aged 10 -14 and 23 % of deaths among youth aged 15- 19.
- First Nations youth die by suicide about 5 to 6 times more often than non-Aboriginal youth. Suicide rates for Inuit youth are among the highest in the world, at 11 times the national average.
http://camhblog.com/2014/09/09/suicide-prevention-three-steps-forward/
- Every day, 11 Canadians die by suicide and 200 attempt to end their life.
- A significant proportion of adults who die by suicide are intoxicated at the time of death.
- Approximately 90% of those who die by suicide have a mental illness, and the risk is increased with a substance abuse disorder.
STIGMA
http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx
- Just 50% of Canadians would tell friends or co-workers that they have a family member with mental illness, compared to 72% who would discuss a diagnosis of cancer and 68% who would talk about a family member having diabetes
- 42% of Canadians are unsure whether they would socialize with a friend who has a mental illness
- A majority of Canadians (55%) say they would be unlikely to enter a spousal relationship with someone who has a mental illness.
- 46% of Canadians think people use the term mental illness as an excuse for bad behavior, and 27% say they would be fearful of being around someone who suffers from serious mental illness.
PREVENTION
http://www.cmha.ca/mental_health/preventing-suicide/
- Seeking treatment, care and support for mental health concerns—and building a good relationship with a doctor or other health professionals
- Building social support networks, such as family, friends, a peer support or support group, or connections with a cultural or faith community
- Learning good coping skills to deal with problems, and trusting in coping abilities
- Connecting with family, friends, or a support group. It can be helpful to talk with others who have experienced thoughts of suicide to learn about their coping strategies
- Key people to call if you’re worried about your safety
- Phone numbers for local crisis or suicide prevention helplines
- A list of safe places to go if you don’t feel safe at home
If you are in immediate crisis call 911 or attend an emergency room for assistance immediately.
