Karen Letofsky’s thoughts on the Canada Suicide Prevention Service

Award Winning Suicide Prevention Advocate Sees Dawn Of National Virtual Multi-Media Suicide Prevention Centre

At noon on November 28th, Crisis Services Canada (CSC) launched the Canada Suicide Prevention Service (CSPS), the first national suicide prevention service in Canada. This service will enable individuals to communicate via voice, text and chat in order to get suicide prevention support, whether for themselves or those they care about.

Along with her peers from various dedicated pilot distress centres from across the country, Karen Letofsky, a nationally recognized leader in suicide prevention and recipient of the Order of Canada and Queen Elizabeth II Diamond Jubilee Medal, has spent the last decade laying the groundwork for this innovative service.

CSC: You have been recognized as a national leader in the field of suicide of prevention. What has drawn you to this work and why is it important?

Karen: Originally, I was drawn to this work as a child of refugees who had been personally impacted by the sudden, violent death of their families. As a result of their experiences, I developed an affinity for and interest in supporting others in the aftermath of traumatic loss. It was through my work with survivors of suicide loss that I joined the distress centres movement. And, it was there that I came to understand the power of the human connection in preventing suicide and promoting life. Partnering with an individual in crisis at a critical time can make a true difference in the outcome. This collaboration between the person in need and the responder has the potential to change both.

CSC: A national suicide prevention service has been a long-term goal for suicide prevention organizations across the country. Tell us a little bit about the journey to get here.

Karen: The distress centres movement is 50 years old in Canada and has always operated in the spirit of collegiality, often informally but sometimes in more structured ways, such as the development of the Canadian Distress Line Network, launched just over a decade ago. This national collaborative, although unfunded for much of its existence, was comprised of a group of helpline leaders who were passionately committed to both the development of a national service and excellence in standards of practice.

A changing cast of 20 regional representatives spoke regularly with one another in order to share and compare, and to fuel the continued passion for both of these goals. Special thanks must go to Ian Ross of Vancouver and Joan Roy of Calgary whose dedication to this cause never flagged throughout the long journey to get to this point. Over the years, there was also support from CASP (Canadian Association for Suicide Prevention) and DCO (Distress and Crisis Ontario) enabling us to continue to build a framework and organize more effectively. Short-term funds provided by an anonymous donor in 2014/15 provided us with the resources to finally successfully petition for the financial support required to launch this initiative.

Known for a short period of time as the National Suicide Prevention Service, we are now incorporated as Crisis Services Canada operating the Canadian Suicide Prevention Service. The Public Health Agency of Canada as a founding funder, with support from the Mental Health Commission of Canada, has helped turn this vision into a reality. A lot has evolved to make this possible but what has not changed is the initiative, drive and expertise of the centres’ staffs—their contributions have made this transpire. They continue to be a joy to work with.

CSC: Historically Canadians have accessed suicide prevention services through regional crisis lines. Why is a national service needed?

Karen: Regional crisis lines, since their rollout across the country from the late 1960’s on, have provided essential links to life-sustaining support. Unfortunately, while the numbers of these organizations grew over the years, there still remain large gaps across the country without direct access to a helpline service. Moreover, since the existing services provide a range of emotional and crisis support, they tend to be very busy. This may mean it is a bit more challenging for someone experiencing suicidal distress to get immediate access. A national suicide prevention service with central access and regional delivery will eliminate the gaps and allow crisis calls/contacts to receive priority response. This will augment and complement the existing crisis services to ensure that no one needs to fall between the cracks.

CSC: What have you and other leaders involved in designing and launching this innovative, transformational service learned throughout the process? What were some of the biggest hurdles you faced?

Karen: The launching of this transformational service has highlighted both the power of and challenges of working within a collaborative partnership model. Engaging stakeholders in the sharing of information, the determination of best practices and the design and implementation of a viable service model has involved compromise, mutual respect and a willingness to learn and evolve. While this has contributed to the high energy required to launch a project of this magnitude in such a short period of time, without a doubt, there have been moments of frustration.

They have paled in comparison, though, to the excitement in exploring the possibilities that new technologies bring to evidence-based best practices in suicide prevention. We are pioneering the evolution of this sector, bringing together the human, personal connection with those technologies—opening the doors for our own and other services of the future.

Truly, I am so proud to be a part of this new service, having experienced that, despite needing to continually address issues of sustainability, we have simultaneously been able to build a new service, build the organizational framework in which to house it and to do all of this while engaging with a broad range of national and regional stakeholders. There are always hurdles, and lessons learned in any new venture. It is a testament to this organization and its members that they have proven to be doorways to movement forward rather than barriers to success.

CSC: Approximately 4000 individuals in Canada die by suicide each year. How does a national suicide prevention service support those at risk? What about individuals seeking support for friends and loved ones?

Karen: A national suicide prevention service is a dedicated resource accessible to anyone that is affected by suicide. Service users comprise those dealing with their own suicidal feelings, attempt survivors, family/friends who want to help and survivors of suicide loss. We know that suicide risk follows a path that looks more like a circle than a straight line—survivors and caregivers can themselves experience a change in their suicidality. This new service will be available to anyone needing the support of a trained, compassionate responder who can provide immediate crisis intervention as required as well as links to regional resources for complementary and ongoing support. It is a priority service for those impacted by suicide, utilizing telephony and online service delivery channels. Given the growing body of evidence-based research confirming the importance of these services in reducing the impact of suicide, it is our goal that every individual in need will be able to connect to help.

CSC: How have you seen the communications needs change for people thinking of suicide or those supporting them?

Karen: People of all ages are moving from accessing crisis support only by phone to the use of other methods, i.e. text and chat. Some individuals seeking help are even wanting to use multiple types of communications. People are on the go and need the flexibility of different types of access. Although organizations are responsive to the needs of service users, trying to provide support utilizing all possible service delivery channels, for individual sites, was not feasible or economical. For individual distress centres, balancing increasing demands for service and often inadequate funding, the design, support and the management of the various complex technology alternatives would be too onerous to undertake on their own.

With the advances in cloud technologies, combined with affordable, reliable high-speed internet, access to web-based applications and shared technology, training and best practice professionals, this innovative service design will enable the initial pilot distress centres and their growing ranks of service partners to combine forces in order to build overall response capacity as a virtual distress centre.

The Canadian Suicide Prevention Service will be able to provide the people of Canada with immediate access to trained professionals via the preferred communications method of their choice, across time, distance, language and location.

CSC: What do you think the impact of the national suicide prevention service will be over the next 3-5 years?

Karen: The existence of a national suicide prevention service will strengthen the crisis response safety net for individuals in need, no matter where they are located in Canada. Working with other national organizations and services, it will serve as a leader and innovator in helping to coordinate, integrate and enhance crisis response services in Canada. Contributing to the existing information about suicide risk, assessment and management, it will also serve as a centre for knowledge exchange, best practices and innovation in service delivery. The hoped-for effect of this initiative will be to contribute to reducing the impact of suicide in this country.

CSC: What are the main points that would you like the people of Canada to know about the Canada Suicide Prevention Service?

Karen: It is the goal of the Canada Suicide Prevention Service that no individual affected by suicide remains unconnected—that there is always a door to immediate, compassionate, culturally appropriate and helpful support. Utilizing innovative technology to bring together organizations with a history of providing impactful suicide prevention services, we can ensure that every individual in need can receive life-sustaining support.

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