MUN psychiatry chair talks suicide prevention with St. John's Morning Show

Following CBC reporter Meghan McCabe's story on the death of Hailey Baker, our inboxes were flooded with stories of people in similar situations. As journalists, we are not equipped to provide the help these people deserve.

The topic was one of several raised on the St. John's Morning Show on Thursday, when host Anthony Germain spoke with Dr. Kim St. John, head of psychiatry at Memorial University and a practicing psychiatrist at the Janeway.

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Below is a transcript of that interview, edited for clarity.

Germain: As you can imagine, as journalists we cover a lot of stories about mental health but when we get these kinds of emails we are out of our element. We really don't know what to do. When someone writes you about these things, what do you say?

St. John: "Well, I think it's always that we need to talk about it more and talk about what those thoughts are and that kind of thing. For many people who aren't in the mental health profession, you feel anxious, you feel powerless, you feel like"

Nervous?

We are human beings and we do the best we can- Dr. Kim St. John

"Yeah, you feel nervous."

Are there ways to tell when a person is in more critical need of care than a person who might be making a cry for help? That must be hard to distinguish.

"I think we get it right the vast majority of the time but I think just as surgeons or cardiologists don't 100 per cent get it right, we are human beings and we do the best we can with what we understand about what the risk factors are and those sorts of things. Someone that has severe persistent mental illness, who seems increasingly withdrawn, who is maybe giving their things away, who seems to have disconnected, would probably give us real warning bells."

We often do stories when somebody's cancer is cured, or somebody's heart is fixed or their vision is restored Those patients are more than willing to come talk to us. But somebody with schizophrenia who is on the right medication or somebody with bipolar disorder who gets their life back in order, they don't want to come and talk about how well they are doing.

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"No, and that's the unfortunate thing. I think what the public hears is the failures. They don't hear about the people who get better, or get back to work. They don't hear about the young people that finish school and graduate and go on to university, get married and have children."

In the instances when you're dealing with a case in which somebody attempted to kill themselves and were unsuccessful, are you then in a situation where you are not only treating that person but everyone around them?

"Absolutely. Most of my clinical work is with adolescents and children and what (suicide) does to parents, and grandparents, and siblings. How do you put that back together so that they can move on? When the attempt has been unsuccessful, the goal is to always make somebody better, to have them continue on with their life and go back to school and not to be disabled by their mental illness."

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I can be a patient of an oncologist and there's nothing that can be done for me other than pain management. I can be a person in a car accident where I'm going to bleed out and there's nothing that can be done because I'm so badly injured. Is it safe to say there's people whose mental illnesses are so deep and so profound that even with all the therapies modern psychiatry can offer and all the medications, suicide cannot be prevented?

"I believe there are a group of people who, particularly those with severe persistent mental illness, have exhausted treatment and come to a point where their illness claims their lives. The Netherlands allows, in severe treatment-resistant depression, assisted dying. If you have a severe persistent mental illness that keeps you from working and keeps you in the hospital for most of your life, I think there comes a point where going on with life has to be balanced. That's a very individual decision."

So, if an oncologist says "We did everything for this patient," it's a lot more accepted than if a psychiatrist says, "For some reason, it just didn't work."

"Sometimes the patient doesn't get better even though the doctors and the treatments were the best anyone could do."