We are a research team on teen and young adult suicide. With international experts, we identify risk and protective factors from large representative population samples in Canada, Europe, and Asia. We test the effectiveness of prevention programs using randomized controlled trials. We also inform public health policy on teen mental health issues.
L'équipe de recherche est dirigée par Dre. Marie-Claude Geoffroy. Elle est titulaire d'une chaire de recherche du Canada de niveau 2 en prévention du suicide chez les jeunes. Elle est professeure en psychologie scolaire et appliquée de l'enfant et membre associée au Département de psychiatrie de l'Université McGill. Elle est également psychologue agréée et offre une formation en évaluation du risque de suicide et en interventions brèves.
Le suicide est l'une des causes de décès principales, et en croissance, chez les adolescents et les jeunes adultes au Canada et dans le monde. En outre, les confinements liés à la pandémie de COVID-19 ont entraîné une augmentation de 50 % des visites à l'hôpital pour les tentatives de suicide suspectées d'adolescents. Les preuves sont malheureusement insuffisantes pour éclairer la prévention. La suicidabilité des adolescents est un problème difficile et complexe.
Until recently, the field was hampered by short-term studies examining only the days/weeks preceding suicide. In accordance with the developmental origin of health and disease, our research focuses instead on longitudinal data: large epidemiological, representative population samples, followed from birth, in Quebec (Étude longitudinale québécoise sur le développement de l'enfant, Étude longitudinale québécoise des enfants de la maternelle), Canada (Enquête longitudinale nationale sur les enfants et les jeunes), UK (National Child Development Study, Avon Longitudinal Study of Parents and Children), and Asia (Korean Children and Youth Panel Survey). As a clinically trained psychologist-researcher in early career, Dr. Geoffroy leads our team of 11 graduate students and postdoctoral fellows, in partnership with multidisciplinary international clinician-scientists, in linking these databases to other administrative databases and to patients enrolled in randomized controlled trials. We further explore genetic and environmental interactions using a large genotype datasets. Our focus also extends to specific populations such as LGBTQ2S+ to inform personalized care. Results from these linkages, combined with heterogeneity in suicidal individuals, their unique developmental trajectories and unique risk/protective factors at multiple levels including individual, family, peer group, school, and community, will be key to developing and implementing successful preventive and therapeutic strategies.
Idéation et tentatives suicidaires – un appel à l'action
Notre équipe a été la première à déterminer de manière prospective la prévalence des idéation et des tentatives de suicide chez les adolescents : 22% reported thoughts about suicide, 10% seriously considered it, and 7% attempted (Orri et al., 2020). Half of attempters attempted again later in adolescence. They were more likely to have had symptoms of attention deficit and hyperactivity disorder (ADHD) in childhood or been exposed to someone’s suicide. Others, especially girls, attempted suicide only in adolescence and reported depressive symptoms in childhood. These two distinct groups would benefit from early, but differential, school/clinic intervention (Geoffroy et al., 2020). South Korea and UK are currently replicating our findings. We are now conducting the first systematic review documenting suicidality in preschool/elementary school children (ages 3-12 years).
Harcèlement, cyberintimidation – risque de suicide
We found higher rates of suicidal ideation and attempts in teens previously bullied (Geoffroy et al., 2016, JAACAP), particularly with l'intimidation chronique par des pairs, independently of prior or concurrent mental health problems (Geoffroy et al., 2018, CMAJ). La cyberintimidation était un déterminant encore plus fort que l'intimidation en face à face. (Perret et al., 2020, JCPP). A British cohort revealed associations with suicide up to 5 decades later (Geoffroy et al., 2021, submitted). For knowledge translation, we disseminated findings through international conferences (UK, Korea, US), podcasts (Canadian physicians), and lay articles (psychologists). Bullying/cyberbullying is common, often hidden from parents and teachers, modifiable through intervention, and requires vigilance to prevent scars months and years later.
Renforcer la résilience – prévention communautaire
In Canada, the healthcare system lacks professional resources, psychotherapy is expensive and often not available in the public system, and mental health stigma can prevent youth from seeking care. While evidence-based interventions exist, many young people do not receive the care they need. Our search for alternate/complementary strategies demonstrated that physical activity (Pereira, et al., 2014), contact with nature (preliminary evidence), and strong social support (Perret et al., 2021, Scardera et al., 2020) can help coping and reduce suicidal ideation and attempts. Teens reporting higher levels of perceived social support were at 40% lesser risk the following year. We communicated findings to parents, teens, and professionals.
Problèmes de la petite enfance – sur la voie du suicide
In 2014, we linked information on 18,000 people born in UK in 1958, with death certificates to trace childhood origins of suicide (Geoffroy et al., 2014, 2018; Devantoy et al., 2020). Cela a permis d'identifier, dès la naissance, les personnes les plus à risque de suicide.. Notably, boys with severe disruptive problems at age 7 years were 4 times more likely to kill themselves 5 decades later. In subsequent studies with adolescents (Orri et al., 2018, 2019), nous avons constaté que le risque de tentative de suicide était 3 à 5 fois plus élevé en présence de problèmes perturbateurs associés à la dépression et à l'anxiété.. Disruptive behaviour, but not depression, predicted transitioning from ideation to attempts (Commissio et al., 2021). We are investigating whether a 1984 program for disruptive boys in Grades 1-2 in low-income neighbourhoods successfully reduced medical visits, costs, and suicide attempts by middle age (40-44 years).
Training psychologists in suicide assessment/intervention
Suicide assessment and intervention are some of the most complex processes psychologists face in their practice, but mandatory courses for Quebec and Canada licensing do not include such training. When offered, quality and quantity of training remain variable. To bridge the gap, we developed a comprehensive evidence-based workshop, with pedagogical clinical psychologists. After validation, if effective, this program should be widely implemented.
Informer les politiques sur la santé mentale des jeunes
We advise governmental and non-governmental agencies on suicide prevention. Since 2017, we helped develop a Canadian Research and Knowledge Translation Agenda on Suicide and Prevention, co-led by the Public Health Agency of Canada and Mental Health Commission of Canada. With Wisdom2Action, we undertook a research and stakeholder engagement initiative to identify and confirm gaps in youth suicide prevention research. Dr. Geoffroy was recently named Director of the Mental Health Axis of the Observatory for Children’s Education and Health, a $5-million provincially funded centre on COVID-19 pandemic-related repercussions.
Vision à long-terme
To summarize, in innovative and exciting research, we conduct prospective longitudinal cohort studies linked to administrative databases to discern trends and test hypotheses for teen suicide prevention. In addition to the Observatory, Dr. Geoffroy heads the McGill Division of the Research Unit on Children’s Psychosocial Maladjustment, an interdisciplinary research network of 50 researchers from 7 universities focusing on pediatric biopsychosocial development. Our team has authored 60 papers in high-impact peer-reviewed journals. We aim to collaborate widely with national and international experts and decision-makers from various spheres to strive for new advances and applications for day-to-day knowledge transfer in reducing teen death and improving mental health and quality of life.