By Daniel Tarade

Note: Stories of suicide can be difficult to read. If you're dealing with mental-health concerns, help is available. If you're in crisis or in need of assistance, call 416-408-HELP, go to your nearest hospital or call 911.

It is an early Sunday afternoon sometime last summer. I am riding on the Toronto subway, heading downtown to the office. A self-described subway surfer, I often refuse to hold onto the poles. This is not a choice motivated by a phobia of germs but rather by playfulness; my commute becomes a game of maintaining stability as the subway jerks to and fro. As we pull into Ossington station, a thud reverberated through the subway, followed immediately by the train coming to a screeching stop. As a subway surfer, I have become intimately aware of what a subway coming to a normal stop feels like. This did not feel normal. So, I’m not surprised when the subway powered down. I’m not surprised when the doors did not open. I’m not surprised when people didn’t audibly complain. We have all become participants in a morbid Toronto ritual. After five minutes, a transit worker begins manually opening the subway doors, a grim process preceded by an announcement of an “injury at track level.” We are corralled out of the subway, walking past the front of the subway train, where no visible signs of “injury” are present. As we emerge from the bowels of the subway system, several ambulances are already on the scene as two firetrucks pull in, lights flashing. I began my slow saunter towards work, replaying those moments in my mind. I was standing by the subway doors, body perpendicular to the direction of travel. As the person was hit by the train, the unexpected deceleration caused my body to be thrown to the left, where a wall halted my momentum. Of course, the deceleration was only unexpected from the point-of-view of a habituated animal, one that has memorized how a subway accelerates and decelerates in intervals of one to two minutes. but, from a mechanical perspective, Newton clearly described that for every action there is an equal and opposite reaction. Perhaps, I shouldn’t have been so surprised.

I have often thought about that Sunday afternoon in the year that has since lapsed. Who was this person? What could have been done differently? What should be done differently? I mean, it does not take much research to find that an “injury at track level” is not uncommon. An article in Now Magazine similarly details the experience of a subway-riding reporter during a collision between a train and a person. Only upon reading about such a similar experience did I realize the sacrament that many Torontonions will receive. Peter Watson, writer of the above article, also notes that in 2017, suicide attempts were considerably higher than other years in recent memory, increasing from 16 in 2015 to 45 last year. A spike in suicide attempts, as well as a recent homicide where a person was pushed in front of a subway, again led to discussion about installing platform barriers. But, the discussion surrounding platform barriers is frankly callous. Given equal play are the non-mental health issues that are peripheral to the issue, clearly shown in this passage from The Toronto Star.

Each incident not only results in the injury or death of the victim and inflicts trauma on witnesses and transit workers, but brings the subway system to a halt, stranding thousands of passengers. The transit agency says it typically takes between 70 and 90 minutes to get the subway running again after a suicide.

Installing platform barriers will save lives. A recently published review states that installation of physical barriers at train stations was the only method that has resulted in a reduction of suicide attempts, with little spill-over into other methods of suicide.[i] This academic article is also the first I read that highlighted, first and foremost, that suicide impacts the individual and their friends and family. Most newspaper articles instead take for granted that pain, assume that suicide is a societal constant, and that the only strategy is to shift those suicides away from our subway system, so that no one has to suffer the indignity of inconvenience. From a Globe and Mail article earlier this year, also covering the increase in suicide attempts in Toronto’s subway system;

The unusual succession of incidents – two of them coming within 4½ hours on the last day of the year – prompted hundreds of minutes of subway delays, affecting tens of thousands of subway passengers. And they took a toll on the TTC staff involved in them.

I am sympathetic to all those who are traumatized after witnessing a suicide, and I agree that TTC staff should have resources available to work through that trauma. But, that is at the crux of the issue; mental health resources need to be more accessible in our province, our country, our society. Ontario is facing a psychiatrist shortage. Less than half of individuals hospitalized following a suicide attempt saw a psychiatrist within six months. Our system is truly one in crisis. I recall my own experience with mental illness, which I have written about previously here and here and here. When faced with generalized anxiety disorder and a panic disorder, I turned to University of Toronto’s health and wellness centre. They were not in the position to offer me one-on-one care. My family doctor told me that OHIP-covered services had a waitlist of six months. For me to get the healthcare that I needed, I turned to the private sector. Since then, I have heard of other similar anecdotes. Campus-provided services are so taxed that they can only focus on crisis situations. Of course, mental health crises are not conjured out of thin air — mental illness develops over time. Any system that tries to deal only with full-blown crises will always be playing catch-up. At a round table lunch with Vice Dean Allan Kaplan, I asked if campus services were adequate to deal with a swell of mental health issues among graduate students. He said yes but only recently, touting his own leave of absence (LOA) initiative for graduate students. Although paid LOA is a welcome addition, a conversation with my peers is all it takes to see that more needs to be done.

Personally, cognitive behaviour therapy (CBT) worked wonders. But, expedient care requires paying out of pocket for private care. For a country that often touts the superiority of our universal health care system over that of our American neighbours, the lack of universal mental health care is glaring. This province, this country needs more psychiatrists working for a public health system. There needs to be a concerted effort to provide resources for those faced with mental health issues.