Suicide among youth and young adults in Canada: bereaved parents' perspectives on the systems of care.

backgroundSuicide 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.

methodsThis 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.

resultsSeventeen 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.

conclusionsYouth 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.