# The Reasons To Go On Living Project



## NicNak (May 1, 2009)

The Reasons to go on Living Project
_Anchor Magazine_
Jennifer Brasch, MD, and Debbie Silva

_“The world breaks everyone. Some mend stronger in the broken places.” − Ernest Hemingway_

About 4,000 people in Canada die by suicide each year. For every completed suicide, there are 20-40 suicide attempts. A new study has been created to look at the reasons why someone chooses to live.

Researchers in the Mental Health and Addictions Program at St. Joseph’s Healthcare Hamilton and the Department of Psychiatry and Behavioural Neurosciences at McMaster University, Hamilton, Ontario, created a website called The Reasons to go on Living Project (Reasons to go on Living). The website is a tool that will enable the researchers to better understand the transition in suicidal individuals from thoughts of wanting to die to choosing to live.

The purpose behind such a study is simple: there has been very little research done on people who choose to go on living either during or after a suicide attempt. Suicidology—the study of suicide—is a difficult area of research because of the topic’s nature and stigma surrounding it.

“We don’t really understand how the shift takes place—how someone makes the transition from being desperate and feeling that they need to end their life, to recognizing how valuable and precious life is, and finding the resolve to go on,” says Jennifer Brasch, MD, medical director of Psychiatric Emergency Service, St. Joseph’s Healthcare Hamilton, and lead researcher of the project. “If we had a better understanding of that process, perhaps we could help people make that journey more quickly. We could reduce distress if we could more effectively help people overcome their thoughts of suicide. I think it would be a huge step forward.”

The Reasons to go on Living Project evolved from Brasch’s experiences working with patients in the Psychiatric Emergency Service at St. Joseph’s Healthcare Hamilton, many of whom were considering suicide or had made a suicide attempt. Brasch became aware of a shift that took place within some of those contemplating suicide from wanting to die to deciding to live and was keen to know what factors had led to the transition. Creating the website was her first step.

“There is a growing interest in using the Internet for research,” says Brasch. “Researchers have found that people with an illness associated with stigma or disability are more likely to reveal personal information on websites and chat rooms than to attend support groups where they have to be face to face. They are more comfortable with anonymous on-line contact. We hope people with a difficult but important story to tell will seek out our website.”

Individuals are invited to anonymously submit stories to the website about their suicide attempt, including how and why they decided to go on living. Collected stories are analyzed to determine what types of information people choose to include in their stories and any commonality of themes and structures. Some stories have already been posted on Reasons to go on Living for education and inspiration.

*Stories of life*
Helen Kirkpatrick, RN, PhD, the project’s co-researcher, notes that storytelling is one of the oldest and most common forms of human interaction and activity. Stories can be told at many levels—community, individual, society—and relate the unfolding of events, human action, or human suffering from the perspective of an individual’s lived experience. It is in the telling and hearing of stories that individuals disclose, arrange, and make sense of their own experiences as well as those of others. Stories of life are used to answer the fundamental questions: Where am I? What am I? Who am I? Studying the stories told by people who have made a suicide attempt and chosen life will help Kirkpatrick and Brasch understand this deeply personal and meaningful human experience.

The Reasons to go on Living Project will last at least until the end of 2009. So far, there have been 5,000 visitors to the website from across Canada, the United States, and around the world. Brasch and Kirkpatrick have already received 39 stories and each one is different. All of them are important to the research project. 

“I’m deeply indebted to each and every person who sub-mitted a personal story to this project and website,” says Brasch. “One story in particular grabbed my attention—it was so eloquent, and told the story of this person’s emotional and physical pain after jumping off the fifth-floor balcony of her apartment. It encapsulated the many themes that we’re trying to focus on with The Reasons to go on Living Project—indecision, regret, and the importance of connection with family and community.”

*Vital connections*
The importance of connection is a common and important theme in every story that has been received so far. The concept of studying stories to understand the recovery process after a suicide attempt was first proposed by Edwin Shneidman in 1996. Through his research, it was found that connection with others gave meaning to life. Connections are instrumental in overcoming negative self-perceptions, inspiring hope, providing meaning, and moving past being suicidal. Reconnection with others is associated with recovery or resolution of crisis. Hopelessness is associated with an increased risk of suicide, but hope is integral in recovery.

Brasch’s ultimate goal with The Reasons to go on Living Project is to improve the care of suicidal individuals by developing guidelines to help health care professionals caring for people who are suicidal. In turn, the project might also assist in reducing the stigma of mental illness through public education, awareness, and support.

“Maybe the stories will be inspiring to people who may be feeling desperate,” says Brasch. “They could read the stories and think ‘You know, that person was where I am now and they’ve come through it. Maybe I can get through this too.’”

If you or anyone you know is interested in submitting a story, please visit Reasons to go on Living.

_Jennifer Brasch, MD, is the medical director of Psychiatric Emergency Service at St. Joseph’s Healthcare Hamilton and an associate professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.

Debbie Silva is the media relations coordinator at St. Joseph’s Healthcare Hamilton _


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