It's one of the last truly taboo topics, the shameful secret that few want to talk about -- and that silence can inadvertently lead to people taking their own lives.
Mental health advocates say that while the recent highly publicized suicides of several prominent sports figures have shone a spotlight on the issue, the lack of frank public discussion about causes and prevention is leaving those at risk for suicide and their loved ones as much in the dark as ever.
"We are trying to encourage informed and sensitive conversations on the topic of suicide," said Tim Wall, executive director of the Canadian Association for Suicide Prevention. "There is so much secrecy and shame that often surrounds this issue that it can be a difficult conversation to have."
Wall believes people shy away from the topic because "it feels scary ... I think it's not knowing the words, not knowing what to say when somebody has died by suicide. What do you say to the family? So there's embarrassment, there's shame, there's an awkwardness."
There's also the fear that talking about suicide might plant the idea in a vulnerable person's head, but "that is a myth," he said from Winnipeg. "In fact, talking about suicide directly to someone actually lowers their risk for suicide.
"It's only by talking about it in an informed way that we can prevent suicides. We need to have those conversations."
With that goal in mind, the association and other groups are mounting a concert Saturday in Ottawa to mark World Suicide Prevention Day. The concert, featuring Canadian singer-songwriter Susan Aglukark and Irish rock band Friends of Emmet, will support local suicide-prevention programs as well as national advocacy organizations.
Scott Chisholm, founder of the Collateral Damage Project and one of the concert organizers, said the event is meant to raise awareness and get people talking openly about the issue.
"People need to understand that it can happen to anybody, any time. Nobody's immune to it and we need to talk about it if we're going to do something about it," Chisholm said from Thunder Bay, Ont. "We need to make it people's issue before it becomes their issue."
Close to 4,000 Canadians die by their own hands each year. Canada's suicide rate, as measured by the World Health Organization, is 15 for every 100,000 people. But the Canadian Mental Health Association says rates are even higher among certain groups, such as youth, the elderly and Aboriginals, with the incidence for males four times higher than that of women.
In Canada, suicide accounts for 16 per cent of deaths for those 16 to 44, says the CMHA. It is the second leading cause of death after accidental injury for 10- to 25-year-olds; 73 per cent of hospital admissions for attempted suicide are among those aged 15 to 44.
Two years ago, Chisholm began collecting the stories and photos of survivors -- the loved ones of people who had taken their own lives. "Collateral Damage: Images of Those Left Behind by Suicide," will be a book of portraits, a website and gallery exhibition.
The project, he said, is a way of coming to terms with his father's suicide at age 47 and a means of counteracting the stigma surrounding the act, which is considered a grave sin by most religions and was a criminal offence in Canada until 1974.
As a 17-year-old high-school student, Chisholm said he was left to grieve and ponder "why" in the isolation born of the hush-hush nature that encircled his father's death.
"My teachers didn't know what to do. They had no tools, they'd never been trained about suicide, and all that they had was their fear and myth and anxiety," recalled Chisholm, one of five siblings. "And with that, they did nothing. So they put up this wall that wouldn't allow me anybody to talk to."
His father had been in and out of the hospital, but the children were told he was being treated for hemorrhoids, recalled Chisholm, who believes his dad was an alcoholic and likely suffered from severe depression.
"But one thing I know, he would do anything for his kids. My feeling is that he thought he was a burden to us and that we'd be better off without him. It's a common theme I hear."
He said one man contacted him to say he had lost his job and had planned to kill himself to avoid being a burden to his four daughters. But a newspaper article he'd read about the emotional devastation experienced by Chisholm's sister, just 11 when their father died, stopped him cold.
The man took it to heart and instead sought help, said Chisholm. "We now can say there's four teenaged girls out there who have no idea about (their father's intention) because we chose to talk about it."
Chisholm said he hopes the Collateral Damage project will give pause to those struggling with depression, other mental health disorders or despair-ridden lives and show them that suicide isn't the only way out -- either for themselves or their families and friends.
"It rips apart families," he said, adding that loved ones are often consumed by guilt over not having recognized the warning signs or failing to get the person help. "It makes us question our relationships, the meaning of them. What is it that could drive somebody to get to that point?"
Aglukark has also experienced the loss of loved ones to suicide, among them three cousins and two close friends.
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