Review of Suicide in Canada.

ANTOON A. LEENAARS, SUSANNE WENCKSTERN, ISAAC SAKINOFSKY, RONALD J. DYCK, MICHAEL. J. KRAL, and ROGER C. BLAND (eds.) Suicide in Canada Toronto: University of Toronto Press, 1998, xxiv + 488 pp. (ISBN 0-8020-7791-9, C$29.95, Softcover) Reviewed by KEITH DOBSON Suicide in Canada is a major volume dedicated to an acute public health phenomenon in this country. book is divided into nine sections. Although there is overlap among the sections, they retain distinctions that warrant their separation. sections (history; epidemiology and the Canadian scene; theory and research; first nations and Inuit; family, community, and government approaches; youth suicide, schools, and communities; distress centers; survivors; the right to die) are laid out in a logical order. Each section has three or four chapters, and among these chapters are some that provide a theoretical approach to the issue, and others that focus on distinctively Canadian experiences or themes. Where possible, the editors have obtained experts on suicide in this country to write about programs, policies, or local initiatives, thus providing a Canadian focus to the book. For example, in the section entitled The Right to Die there is extensive discussion of the Sue Rodriguez case and its legal, moral, and practical implications. volume is appealing for its use of chapters that vary from being very formal and research focused, to those that are highly experiential and voiced in the first person. For example, the chapters in the sections on epidemiology, theory, and research are generally focused on the description of average tendencies, statistical summaries, and on developing and testing theoretical models of suicide. In large measure, except for the Canadian emphasis in epidemiology, these chapters could appear in any sound academic treatise on the nature of suicide. In contrast, the section on suicide among first nations and Inuit people makes greater use of narrative and descriptions of experience. Although one could argue that a certain unevenness emerges as a consequence of the different ways in which these chapters are written, it must be recognized that our understanding of different aspects of suicide is itself not even and that varied approaches to understanding this phenomenon are therefore justified. Further, with no less than 57 individual contributors to this volume, there is little surprise that different writers have elected to use different methods for writing and presenting their contribution. reader of this volume is led ineluctably to the following conclusions: -Suicide is, or ought to be, a very real concern in contemporary Canadian society. -Although rates of suicide vary among different groups within Canada, their rates have remained fairly constant over time. - Certain populations are especially at risk (e.g., first nations and Inuit people; youth; survivors of suicide; the terminally ill) and demand concerted efforts at understanding and intervention aimed at the special circumstances that put them at higher risk of suicide than the population at large. - Our models of understanding and intervention with suicide, while certainly now more advanced than in previous years, are still not adequate to respond to the challenge of suicide in Canada. …

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