Suicide among youth and young adults in Canada: bereaved parents’ perspectives on the systems of care
Bibliographic record
Abstract
BACKGROUND: Suicide is the second leading cause of death among youth and young adults aged 15–24 in Canada. Emergency departments often serve as the first point of contact for identifying suicide risk, particularly for youth and young adults, partly due to the inaccessibility and unavailability of community mental health services. Almost half of the youth who die by suicide visit an emergency department in the year preceding their death, and up to 90% have untreated mental health and substance use concerns. Studies have found that parents describe youth mental health services as harmful, fragmented, inaccessible, and inadequate in meeting their children’s needs. Significant gaps remain in our understanding of the experiences with the systems of care for youth who die by suicide. Parents are uniquely positioned to provide vital insights, enhancing our understanding of the role that systems of care play in addressing and preventing suicide. The aim of this study was to better understand how bereaved parents describe the systems of care that provided services to their youth prior to the suicide. METHODS: This qualitative study used a community-based participatory research approach in partnership with Eli’s Place, a rural residential treatment centre currently in development for young adults with serious mental illness. Participants were eligible if they were parents or caregivers residing in Ontario, Canada, of a youth or young adult under the age of 30 who died by suicide. Semi-structured interviews were conducted, and data were analyzed using thematic analysis. RESULTS: Seventeen participants took part in the study, including 12 mothers and five fathers. The ages of the youth ranged from 12 to 29 years, with a mean age of 18. Most of the youth had diagnosed mental health and addiction-related concerns, and most had received mental health services. Our analysis of parents’ experiences and perspectives identified eight key themes, highlighting critical gaps in the mental health systems involved in their youth’s care: (1) barriers in accessing services; (2) gaps in continuity and coordination of care; (3) absence of guidelines for assessments, treatment, and safety planning; (4) inconsistent quality of care; (5) inadequate training and education for service providers; (6) insufficient involvement of parents and caregivers; (7) limited psychoeducation for youth and families; and (8) experiences of bullying, racism, and discrimination, with a lack of accountability. CONCLUSIONS: Youth suicide is a serious public health concern that requires a systems of care approach, incorporating integrated services with coordinated care and child- and family-centred approaches. In 2024, Canada introduced its first National Suicide Prevention Action Plan, marking a significant and promising advancement in suicide prevention. However, its effectiveness in reducing suicides across Canada will depend on robust implementation, supported by strong political leadership, dedicated funding and resources, and multisectoral collaboration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.025 | 0.008 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".