A response from the Ministry of Health on suicide bereavement and support services in BC

In light of the fact that today is World Health Day with the focus on depression, I would like to share the response I received from the Ministry of Health regarding a letter that a group of suicide survivors, including myself, addressed to BC’s Minister of Health, various levels of the Canadian government and relevant organizations. The letter (below) basically was about making sure that SAFER, a suicide education and support service, is provided to all British Columbians. Its services, particularly bereavement counseling, has been reduced/limited to only residents of Vancouver.

It’s not a very encouraging response from the Ministry of Health regarding broadening suicide support and grief services outside Vancouver. On top of that, the link in the letter to find local services doesn’t work when I tried the online mapping tool (Update: the govt fixed the link after I contacted them). Also I think they don’t get that suicide bereavement support isn’t the same as “normal” bereavement support services due to the stigma around suicide and various issues related to it.

With the Prime Minister committing “$5 billion over the next ten years to support mental health initiatives“, I hope that part of this goes to suicide prevention and support/bereavement services particularly for person-to-person support… online resources and tools are not enough!

20 February 2017

Honourable Terry Lake

Minister of Health

PO Box 9050 Stn Prov Govt

Victoria, BC V8W 9E2

Subject: SAFER – a unique and essential service for all British Columbians

Dear Minister,

We are writing to show our support and request that SAFER (Suicide Attempt Follow-up Education & Research) continues to be provided for all British Columbians.

We have been using the grief counselling services at SAFER since the death of our loved ones by suicide. For many of us, we felt lost and unsure about how to handle our grief, as well as the challenges to our mental health after such a tragic event.

Understanding, processing and accepting the grief from a death is already difficult as it is. Death attributed to suicide is even more challenging given the unique context and stigma associated with it. When we found SAFER, we were relieved to discover that BC has such a unique and essential service. Early on, many of us were reluctant to accept or even discuss our loved one’s death. With SAFER, it was a live-saver to be able to talk and receive counselling about surviving suicide and the grief in a safe and supportive environment. SAFER continues to help us to understand, accept, and move through the feelings, emotions, and conditions surrounding grief from suicide.

Unfortunately from our understanding, due to resources and organizational restructuring, SAFER has now limited their services and outreach geographically to only residents of Vancouver. Most of us do not live in Vancouver, but in other parts of the Lower Mainland. In addition to only servicing people living in Vancouver, it has come to our attention that SAFER counselling is limited to one year following intake and people have been turned away from this essential service.

While an average of 10 Canadians die from suicide every day, the loved ones, family members, friends, coworkers etc. who have to live with the grief number much more. SAFER provides a safe and accepting place for survivors to process this grief. It also provides essential services such as counselling and education to help people living with mental health issues, thoughts of suicide and those who have to live through suicide death.

We hope that SAFER will be able receive the support and resources it needs to continue and expand its services for all British Columbians.

We look forward to your response.

4 April 2017

Dear Mr. Fung et al:

Thank you for your letter of February 20, 2017, requesting that the Suicide Attempt Follow-up Education and Research (SAFER) program expand to become available to all British Columbia residents. The Honourable Terry Lake, Minister of Health, has asked me to respond on his behalf and I apologize for the delay.

Firstly, I would like to acknowledge the loss of your loved ones. I understand that the grief following the suicide death of a loved one can be complicated and affects everybody differently.

While the supports provided by SAFER are well respected, we at the Ministry of Health also understand that health services need to be provided as close to home as possible in order to be accessible for all British Columbians. The Ministry is working with the health authorities to provide services to people within or near their communities through a model of primary care homes linked to specialized community care services. In alignment with this model, the health authorities have been reviewing their services. This has resulted in the redesign of some programs, including the changes made by Vancouver Coastal Health to SAFER.

As you are aware, the SAFER services are now focused on Vancouver area residents only. If needed, clients may review their needs with the SAFER program and plan their transition to other services after one year. These changes were made in order for the SAFER program to continue to provide core services and meet the demands of Vancouver area residents. To support the focus on Vancouver area residents only, the SAFER program refers people from outside of their catchment area to local services available in the person’s community.

SAFER continues to offer education and clinical expertise supports to the health authorities. In many communities throughout the province, there are suicide-specific bereavement support services, while in other communities people attend general bereavement support services or participate in individual counselling. Approximately 90 local mental health centres operated by the health authorities provide access to mental health treatment and counselling services and, if required, connect families to local community support services. You can locate these services through our online map tool, found at http://www2.gov.bc.ca/gov/content/health/managing-your-health/mental-health-substance-use/find-services-near-you.

Recently the government announced a mental health digital hub, which has been developed to help British Columbians find the services and supports closest to them. This new resource focuses on better integration and access to services by bringing together over 6,000 services from over 450 providers throughout the province. Information about mental health services in various communities, including grief support services, can be accessed through this hub at http://www2.gov.bc.ca/gov/content/mental-health-support-in-bc.

The Ministry recognizes that the SAFER program provides a specialised and unique service for Vancouver residents bereaved due to a suicide death. People in other areas of the province may go through their family physician or the local mental health centre for assessment and treatment if the impact of the suicide death has resulted in significant mental health and/or substance use problems. Referral to local community based bereavement support services may also be provided if appropriate.

In addition, the Ministry is currently working with all of the health authorities to review and improve services for people at risk of suicide and their families, including reviews of suicide prevention, intervention and follow-up support services.

Thank you once again for writing to share your support for the SAFER program. Input and experience like yours is highly valued as we strive to continuously improve our health care system and ensure that all British Columbians receive the standard of care they deserve. I appreciate the opportunity to respond.


Robin Pascoe



Honourable Terry Lake

Honourable Justin Trudeau, Prime Minister of Canada

Honourable Jane Philpott, Minister of Health, Canada

Honourable Christy Clark, Premier

Michael Marchbank, President and CEO, Fraser Health Authority

Mary Ackenhusen, President and CEO, Vancouver Coastal Health

Laura Case, Chief Operating Officer, Vancouver Coastal Health

Suicide does not discriminate.

Today is World Suicide Prevention Day… and by the time I finish writing this post, more people will have died by suicide. According to the World Health Organization, suicide kills one person every 40 seconds. That’s on average about 800,000 people a year – and for every person who dies by suicide, many more people attempt suicide every year.

Source: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/
Source: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/

It’s a staggering figure and a significant one that demands more attention. It happens to the rich and poor… young and old… the mentally stable and ill. Suicide does not discriminate. While we typically think suicide is linked to mental health issues (i.e. depression and alcohol use), many suicides also happen impulsively in moments of crisis and life stresses such as financial problems, relationship break-up or chronic pain and illness. Suicide rates are also high amongst people who experience discrimination, such as refugees, migrants, indigenous peoples, LGBTI persons, and prisoners.

Talking about suicide is no joke. There’s a fine line between joking about it and to actually thinking about self-harm and suicide. And if this leads to an attempt, then it’s definitely time to pay attention before it’s too late. The Canadian Mental Health Association has an easy way to remember the warning signs:


There are plenty of resources about suicide prevention and education. Ones that I’ve found useful in Canada include:

I found these resources useful because they focus on providing information about preventing and understanding suicide, as well as helping me process my experience with a suicide death. One of the best things when I moved back to Vancouver was to find that there’s a specific suicide support service called SAFER (Suicide Attempt Follow-up, Education and Research). Not only is SAFER a community-based outpatient service that provides counseling for people who are feeling suicidal, it provides free counseling for people bereaved by a suicide death.


From a public health policy perspective, suicide is a complex issue and so prevention requires coordination and collaboration between various health and non-health sectors – WHO’s recommendations for prevention and control includes:

  • Reducing access to the means of suicide (e.g. pesticides, firearms, certain medications)
  • Reporting by media in a responsible way
  • Introducing alcohol policies to reduce the harmful use of alcohol
  • Early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress
  • Training of non-specialized health workers in the assessment and management of suicidal behaviour
  • Follow-up care for people who attempted suicide and provision of community support

Suicide prevention is a good goal… in the meantime many people have to deal with the aftermath. I found the below video really helpful to connect with what I am going through, and also to share with people who want an insight into the grief from suicide.

Being positive is good for health and communications

It’s been a while since I’ve flipped though my subscription of Communication Arts – I finally got through the 2013 Photography Annual and found a bit of inspiration, particularly drawn to photos related to health. Photos are a great way to share our emotions, relationships and connections with people and things. And there’s no more personal connection than to personal health.


A campaign pointing out the health risks caused by smoking in cars. Headline: Don’t ignore their wishes / Alex Telfer

What is it about the world of media that uses negative imagery to try to catch people’s attention? There’s that saying about news: it’s not “Dog bites man”, but rather “Man bites dog” that will get the headlines. Yet, a lot has changed when it comes to this kind of view on news, and more broadly communication. With the ever-growing access to information and communication channels, communication professionals might think about placing less emphasis on the negative side of issues – especially if we want people to take action and do something. For example, researchers in 2007 found that the more students were exposed to anti-smoking messages, the more inclined they were to smoke. Results from the study suggest that campaigns don’t work by convincing individuals to avoid tobacco, but rather by helping change the social norms surrounding smoking. This means positivity works better than negativity, especially in a time where positive messages are more likely to spread and engage people, as shown by this study “Upbeat Content Best Bet for Anti-tobacco Messaging” or this report by the New York Times “Good News Beats Bad on Social Networks“.

These photos from CA’s photography annual shows that communication can have an impact when it strikes a cord between something visual, emotional, and making a positive connection.


Assignment to illustrate a feature story, “Water for All” about the state of fresh water health and policies, or lack there of, governing right of capture rules / Woody Welch


“Senior Moments.” – for these senior Olympians, age is just a number, and competition is a lifelong passion / Gregg Segal


Trade advertising campaign to healthcare professionals for a new cancer drug. Portraits capture honest moments of joy as patients receive the good news / Peter Beavis

#IceBucketChallenge haters – Get over yourselves

At work, we recently released the Global Humanitarian Overview Status Update where there are no less than 25 major emergencies and crises around the world that are being funded (or underfunded). There are also plenty of smaller or less prominent issues and causes happening at the same time that deserve attention and support. The question is “how do you choose which one to support”?


For many people (including me) this summer, the cause they chose to support was the Ice Bucket Challenge, a viral campaign to raise awareness about Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, a fatal neurodegenerative disease. According to the ALS Canada website:

People living with the disease become progressively paralyzed due to degeneration of the upper and lower motor neurons in the brain and spinal cord. Eighty per cent of people with ALS die within two to five years of diagnosis unable to breathe or swallow. Ten per cent of those affected may live for 10 years or longer.

This sounds like a horrible disease, but we should celebrate that, through the Ice Bucket Challenge campaign, people are learning about, raising awareness for, and even donating to a cause that resonates with them. At the end of the day, people will know a little bit more about ALS, encouraged their friends and families to do the same, and organizations working on the disease will have the funds and resources to continue doing research and find answers to the disease… nothing wrong there, right?


So what’s up with all this criticism about about the campaign, from saving water to donating to a cause that deserves it more? Some of the points raised makes sense, but successful campaigns normally strike a cord with the heart rather than the head. Also if there are plenty of causes to choose to support, should we be slamming or shaking our heads at people who have made their choice and are doing something about it?

No campaign will be perfect and there will always be critics, but the fact that more people know about the cause and hopefully do something about it (ex. tell friends, donate, change their lives, etc.) is a good thing.

As for the #icebucketchallenge haters out there, you might not like the campaign, think that it’s foolish for people to dump water over themselves, and probably have better ideas/causes to support. You’re entitled to your opinion and I’d be happy to hear about the causes that interests you, how you’re supporting it and, if it resonates with me, how I can get involved. If the only thing you’re doing is to use the Challenge’s awareness and spotlight to blast an important health issue, who’s really doing damage?

By the way, here’s the true story about the Challenge for ALS.