People living in Ontario’s poorest neighbourhoods are about twice as likely to be hospitalized for cutting, burning and other forms of intentional self-harm than their wealthiest counterparts, according to an analysis of data released by the Canadian Institute for Health Information.

The analysis found that as neighbourhoods get poorer they also experience higher rates of people being hospitalized for self-injury. While 97 per 100,000 people were hospitalized for harming themselves in Ontario’s poorest neighbourhoods in 2015-2016, that rate fell to 50 per 100,000 people in the province’s wealthiest neighbourhoods.

These findings don’t surprise Dennis Raphael, the director of York University’s program in health policy and equity. “Depression, hopelessness and self-blame” are reasons people living in poverty may self-harm, he said in an email.

Living in poverty can have “health-threatening effects,” including on mental health, according to a report published by Raphael. He explained that people experiencing homelessness have a “much higher rate” of mental health concerns than the general population.

One of the reasons people living in poverty may have poor mental health is the stress that comes with being unemployed, according to Raphael. “Lack of employment is associated with physical and mental health problems that include depression, anxiety and increased suicide rates,” he said.

The Canadian Institute for Health Information’s data separates neighbourhoods in Ontario into five categories, from lowest to highest income. Although there was a large difference in the rate of self-injury hospitalizations between the poorest and wealthiest neighbourhoods, there was not as big of a difference between middle- and higher-income areas.

Although the wealthiest neighbourhoods had a rate of 50 per 100,000 people being hospitalized for intentionally harming themselves, that rate only increased to 57 per 100,000 people for middle-income neighbourhoods. However, when considering the second-poorest areas the rate increases significantly to 72 per 100,000 people.

The high rates of mental illness among lower income communities doesn’t go unnoticed by counselling services in Ontario. According to Family Services Ottawa, an agency that provides accessible counselling services to people in distress, 70 per cent of its clients live below the poverty line.

“There is a lot higher volume of folks who are looking for services that have lower fees,” said Tasha Levenick, the intake worker for Family Services Ottawa. She said she receives about 60 to 80 calls per day from people who are looking to access counselling services.

However, Levenick also said there are not enough subsidized counselling services to accommodate the demand. “As a result of the high volume and the limited staff, supply and demand says there ends up being an inflated wait list for the services,” she said.

While people wait to access counselling, Family Services Ottawa provides some free, drop-in services that people in distress can access immediately. From there, Levenick said she directs people to community resource centres that offer low-fee therapy sessions. “There are some limitations,” she admits.

“There is a lot higher volume of folks who are looking for services that have lower fees.”
— Tasha Levenick, Family Services Ottawa

Despite the services made available by organizations such as Family Services Ottawa, Raphael said not enough is being done to address the mental health concerns faced by lower-income communities. “Things are getting worse,” he said in an email, pointing to growing income inequalities and increasing numbers of people in precarious work.

To address this issue, Raphael said more focus should be placed on improving people’s living and working conditions. “Citizens experience better physical and mental health when they have a secure basis for living a productive life,” he said.

Until that happens, Raphael said lower-income communities in our province will continue to be faced with higher rates of hospitalizations attributed to mental illness.

Females were hospitalized 66 per cent more than males last year due to some form of self-injury according to a report from the Canadian Institute for Health Information.

In a yearlong period from 2015-16, 11,730 females were hospitalized across Canada from self-injury compared to just 7,746 males.

CIHI defines self-injury of a 15+ year old who deliberately injures their body, which is a result of suicidal or self-harming behaviours.

“Self-injury could be described as something that causes tissue damage,” said Dr. Sanjay Rao, who is a lead clinician at the Royal Ottawa Mental Health Clinic and a professor at Ottawa University.

Rao argues that people use self-injury as a way to relieve themselves of stress as well as providing a distraction to everyday life. He even mentions that for some it can be enjoyable.

The gap between males and females as well as the number of hospitalizations has grown since CIHI started tracking the data in 2010. In fact, there were nearly 1,500 more self-injury hospitalizations in 2015-16 than in 2010-11. Females accounted for over 1,100 of the increase.

For Rao, the reasoning for the glaring gap between males and females is simple but he argues that the difference is actually bigger than what the statistics show.

“Females tend to significantly self-harm more. They are more likely to do it, therefore they are more likely to get admitted,” said Rao.

He says that women self-injure three to four more times than men do, but not everyone goes to the hospital for his or her injuries.

“The data on self-injury is not easy to get and not as accurate because often times people will not tell you that they are self-harming,” argues Rao.

Erin Christine, a Carleton University student who has experienced self-injury in her past, says that the expectations that girls have makes them more likely to experience mental health issues.

“Girls have expectations on their physical appearance, academic performance and just overall capability,” said Christine. “I think that girls often feel that they can’t meet those expectations which eventually leads to anxiety, depression and self-injury.”

Although she did not comment further on her own self-injury experience she described it as an outlet when she couldn’t control her pain and as a way to express the pain she was feeling inside.

Ottawa is no stranger to self-injuries as in 2015-16 there were a reported 453 female hospitalizations compared to 270 from males in the Champlain LHIN region. This total was higher than any year stretching back to 2013.

Rao stresses that this is not just a Canadian trend but rather something that concerns him worldwide. His theory is that as the world connects socially, people will continue to self-harm because they tend to follow the actions of others.

But for Rao and his fellow clinicians at the Royal Ottawa Mental Health Centre, self-injury is the most significant sign that that someone needs immediate help.

“We can have so many ideas on how to prevent suicide but when someone is self-harming that’s the most obvious risk,” said Rao. “That’s when we need to start worrying the most.”

According to the Canadian Mental Health Association, men are four times more likely to die from a suicide attempt but women are three times more likely to attempt an act of suicide.

When asked about this statistic, Christine replied with a plea for more mental health awareness in places where youth are affected the most.

“Mental health impacts all aspects of your health overall. It’s underfunded in schools and needs to get the point where it can become an open topic.”

“Durham Region Police celebrating Pride 2014” by Stacie DaPonte is licensed under CC BY-SA 2.0

Police-reported hate crimes against gays and lesbians in Canada dropped 13 per cent between 2014 and 2015, according to an analysis of Statistics Canada data released this summer.

Since 2012, the number of hate crimes against homosexuals has fallen nearly 30 per cent from 168 incidents in 2012 to 121 reported in 2015.

Still, those in the queer community remain amongst the top targeted groups over the past four years for crimes motivated by bias, prejudice, or hate as defined by StatsCan. In 2015, cases against blacks, Jews and Muslims were the highest for the year.

Canadian studies professor Marika Morris of Carleton University attributes the lower amount to what she calls “an enormous cultural shift” in views about sexual identity in the past thirty years.

She says the LGBTQ communities have been successful in outreach to the general public about inclusion. Morris adds that lower numbers of hate crimes based on sexual orientation could also be influenced by anti-bullying messages in schools, and health and sex education that teaches a variety of sexual orientations to students.

Carleton student Joanna Zebib, says she feels safe being seen with her partner in public, but adds, “there are a lot of moments where I feel like back in that space where I should be hiding.”

Morris says the decline in crime against gays and lesbians “may really reflect a diminishing number of crimes committed against those of a minority sexual identity.”

Zebib, who identifies as a queer Muslim woman, says, “for me, that kind of violence comes from every single direction.”

“It’s not that I’m being attacked as a Muslim, or attacked as a queer, I’m being attacked as a queer Muslim.”

Zebib says she feels the statistics do not always reflect this intersectionality, adding that her own identities are interconnected and cannot be analyzed separately from one another.

“My experiences are going to be a bit different from a white gay man,” she says.

StatsCan did not release data that addresses the groups that exist within sexual orientation, but Zebib says she feels white gays and lesbians tend to face less hate in public because it is now frowned upon to be homophobic.

“But if it’s a person of colour, it’s a different story,” she says.

StatsCan reported that 47 per cent of victims of violent hate crimes targeting sexual orientation listed the accused as an acquaintance or family member, compared to victims of violent crimes by race at 36 per cent and of a religion 26 per cent.

Zebib says when she came out, she faced alienation on social media when long time friends unfriended her on Facebook.

She says, “Those are very small, private, passive aggressive acts, but they tend to hurt a lot more then those like when I’m walking down the street with my partner and someone tries to harass us.”

“At least in that setting… I didn’t expect to be safe, as opposed to private situations where you folks called me your friend for years and yet I don’t feel safe enough to be myself around you.”

Zebib says she has been victim to hate crimes based on her queerness in the past, but declined to talk about her experiences. She did not report any incidents to police.

Zebib says, “It’s a great fact that the stats are going down, but you can’t overlook the ones that are happening.”

Morris says, “We all need to build on the good work of LGBTQ communities to continue to make our society more inclusive of everyone.”

She adds: “We all benefit when everyone can contribute to the best of their ability, without fear.”

This is a test from  Nadine Yousif.

Black people were the most common racial group to be victims of hate crime in 2015, according to an analysis of data Statistics Canada uses to track hate crimes.

Police-reported hate crimes against black people made up 35 per cent of racially motivated crimes in 2015—placing them top of the list, despite 6 per cent fewer incidents from 2014.

This does not surprise Rev. Anthony Bailey from Parkdale United Church, one of several targets of hateful graffiti in Ottawa last fall.

Although black people were the most common victims of race-motivated hate crimes even back in 2012, Bailey says not all Canadians are aware of the fact.

“I think there is a certain naivety about these kinds of statistics,” he says.

“Many people who are not conversant with the realities of racialized people are of the opinion that this is 2017, we’re past that sort of thing, we’re a tolerant society.”

Bailey, who was one of the speakers at a session on addressing hate crimes in Ottawa, says the reason crimes targeting black people are high has to do with racism and the history of black people in Canada.

Race is an “artificial category,” he says, that serves to oppress people and justified the use of black slaves in North America.

He says the implications of racism today are evident in the high numbers of black people who are incarcerated or stopped by police.

“Those things are indications of the systemic way in which particular peoples are targeted.”

Just three weeks ago, Bailey says he was the target of racial profiling by police while driving in Ottawa.

“They followed me everywhere,” he says. “Each way I turned, they turned, until they could examine my license (plate) on their computer, and just drove off because there was nothing to be done.”

“There’s a systemic suspicion and it’s not a surprise that this also spills over into the general population.”

Racial profiling and over-policing of black communities are also among the concerns raised during a forum in Ottawa last summer where hundreds of participants discussed the effects of anti-black racism.

The forum, which was organized by Ottawa Local Immigration Partnership and the City for All Women Initiative, laid out recommendations as to how such concerns can be addressed. They include hiring officers from racialized communities and acknowledging issues of systemic racism.

Bailey also believes education is necessary to address anti-black racism. He visits schools and community organizations to talk about the stories of black Canadians and their contributions to the country.

“A lot of people don’t understand or know the achievements not only of ordinary black Canadians but also those who have excelled.” He cited the example of Viola Desmond, a black civil rights activist who was recently chosen to become the first Canadian women to appear on a dollar bill.

He says this kind of awareness can not only change opinions about black people, but also challenge systemic forms of racism, including racial profiling.

“I think that that’s important for how we mend the society,” says Bailey.

“Yes, we hold people to account, but we also try to put in place something that can change opinions and change behaviour.”

Canadian women are twice as likely than men to end up in the hospital for self-inflicted poisoning, burning, suffocation and cutting, based on an analysis of the Canadian Institute for Health Information’s (CIHI) 2015-2016 self-injury hospitalization data.

Women make up 62 per cent of self-injury hospitalizations, although self-injury rates in women have decreased by 4 per cent since 2010. But, women continue to outnumber men for self-injury hospitalizations in every province and territory.

Self-inflicted harm or injury means deliberately harming yourself, which may or may not result in death, according to the Canadian Institute for Health Information. Many actions, such as poisoning, drug overdoses, cutting with sharp objects, and suffocation fall under this self-injury classification. Self-injury can also be called self-harm, self-inflicting injury or even by the method of self-harm used, such as cutting.

Because self-injury is a specific personal response to an emotional, environmental, physical or cognitive problem, it is difficult to pinpoint exactly what the factors are that are causing more Canadian women to self harm, because they differ from person to person.

Stephen P. Lewis is a researcher at the University of Guelph, who studies non-suicidal self-injury, or self-injury without the intent to commit suicide. He has been open about his past struggles with self-harm, both as a teenager and young adult, and later founded SiOS, a non-profit self-injury and outreach support group.

“At its core, self-injury is a coping strategy, used by people who want or need to confront their strong emotions related to a particular problem or incident,” Lewis says.

Part of his research includes studying the connection between self-harm and social media blogging sites like Tumblr or Instagram. He believes that the biggest obstacle in self-harm recovery is that there is no “one size fits all” cause or solution, either for women or men. “Factors like the Internet or mental health, are a double-edged sword. What may aid in one person’s recovery, can end up triggering the next.”

Social attitudes towards self-harm may also contribute to self-injury rates. “Self-harm is heavily stigmatized, which means that those who need to seek help often don’t,” Lewis explains. “which could account for higher unreported injury numbers, when people are afraid or unable to reach out.”

Gundel Lake, an Ottawa-based psychotherapist that specializes in trauma and addiction, agrees that social attitudes contribute to self-injury, but believes that the imposed social attitudes create harder situations for girls than boys. She explains that the enforced gender and societal roles on women could play a role in higher self-injury numbers.

“Our society doesn’t value or support the expression of emotion, and girls and women are more often taught or encouraged to internalize emotional experience, whereas boys are taught or encouraged to externalize it,” she explains. “Emotions need to go somewhere.”

Another factor in the misrepresentation or the confusion around understanding self-harm may also be because of the data that’s used in studies. The Canadian Institute for Health Information does not specifically determine suicidal intent in self-injury hospitalizations, making it difficult to differentiate between non-suicidal self-injury versus suicide attempts. Additionally, this data is not broken down by age group, making targeted anti-self-injury groups difficult to coordinate.

Both Lake and Lewis remain hopeful that education and communication can help break the stigmatization and misconceptions shrouding self-harm and lead to higher recovery rates and lower hospitalization rates.

“It’s important to destroy misconceptions related to self-injury in order to break the stigma,” Lake says. “One thing that people can do to break the stigma is to remember that self-injury is a symptom of coping with a problem, not “the problem.”

Despite the misconceptions and double-edged swords that arise when trying to treat and understand self-injury, Lewis remains hopeful.

“Recovery is always possible. Always.” Lewis says. “A big part of it is teaching people to understand that self-injury is not manipulative or attention-seeking behaviour, but a coping strategy.”

This is a test from Arianna Paquette.

This is a test from  Salma Mahgoub