The Big Picture
Some people have thoughts about ending their own lives. They may feel that life has become unbearable. They might even believe their family and friends would be better off without them.
When someone talks about suicide, their words must be taken seriously.
As a Continuing Care Assistant (CCA), your response matters. You need to tell your supervisor at once, stay with the client, and listen without dismissing their feelings.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Suicidal behaviour disorder involves repeated thoughts about ending one’s own life or being preoccupied with suicide.
- A mental health disorder, especially depression, bipolar disorder, or schizophrenia, is an important suicide risk factor.
- Previous suicide attempts, major losses, isolation, and feelings of hopelessness or helplessness are also risk factors.
- If a client talks about suicide, take the person seriously, tell your supervisor at once, and do not leave the client alone.
- Listen carefully. Do not dismiss the client’s concerns or make promises that everything will improve.
- Older persons, especially those over age 85, face important suicide risks related to illness, losses, loneliness, and reduced independence.
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Course Notes: Key Ideas You Need to Know
1. Understanding Suicide and Suicidal Behaviour Disorder
Suicide means ending one’s own life.
Suicidal behaviour disorder is a disorder involving repeated thoughts about suicide or a continuing focus on ending one’s life.
A person experiencing suicidal thoughts may feel that life is too painful or difficult to continue. Some believe their death would make life easier for their family or friends.
These thoughts must be taken seriously.
Suicide occurs among people of different genders and ages. It is a leading cause of death from adolescence through middle age. Suicide also occurs among some school-aged children and older persons.
Mental Health Disorders and Suicide
A mental health disorder affects how a person copes with or adjusts to stress. It can change the person’s thinking, mood, or behaviour and interfere with their ability to function.
Other names include mental illness, mental disorder, emotional illness, and psychiatric disorder.
People with mental health disorders have a high risk of suicide. Depression, bipolar disorder, and schizophrenia are especially important risk factors.
Key fact: A suicide attempt is a sign of a serious mental health issue.
A person who attempts suicide needs professional care and a suicide prevention program.
Children and adolescents need particular attention. Any child or adolescent who expresses suicidal feelings, talks about suicide, or attempts suicide should be taken seriously and receive immediate help from a mental health specialist.
2. Important Suicide Statistics and Patterns
Suicide affects different age groups and genders in different ways.
Numbers to Remember
The following figures are important for review:
| Group | Suicide Statistics |
|---|---|
| Ages 15 to 24 | Suicide accounts for 24% of deaths. |
| Ages 25 to 44 | Suicide accounts for 16% of deaths. |
| Men compared with women | The suicide death rate among men is four times the rate among women. |
| Women compared with men | Women attempt suicide more often than men. |
These figures show an important difference between suicide attempts and deaths by suicide.
Suicide Attempts Compared With Deaths
Although women attempt suicide more frequently, men have a higher death rate from suicide.
One reason involves the methods used.
- Men tend to use more violent methods, such as hanging or firearms. Their attempts are therefore more likely to be fatal.
- Women tend to use less violent methods, such as medication overdoses. More women survive their attempts.
Difference: The group with more suicide attempts is not necessarily the group with more deaths by suicide.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition includes suicide statistics from its source material. For Nova Scotia CCA students, it is important to separate these textbook figures from current statistics.
The Public Health Agency of Canada reports that the suicide death rate among men is now almost three times the rate among women, rather than four times. Its recent national findings generally show the highest suicide death rates among men ages 45 to 64 and women ages 20 to 24. These are Canadian figures, not Nova Scotia-specific rates.
Why this matters in Nova Scotia: Keep Sorrentino’s figures for studying the original course content, but do not assume they describe today’s suicide rates or that people over age 85 currently have the highest rate.
Official source: Suicide, self-harm, and suicide-related behaviours in Canada: Suicide mortality
Last checked: October 9, 2026
3. Risk Factors for Suicidal Intent or Behaviour
Several experiences, conditions, and circumstances may trigger suicidal thoughts or behaviour.
Mental Health and Personal History
Important risk factors include:
- Mental health disorders, particularly depression, bipolar disorder, and schizophrenia
- A history of abuse
- A family history of suicide
- The suicide of a friend
- A previous suicide attempt
Difficult Life Experiences
Risk factors also include:
- A major crisis, such as the loss of a relationship or family problems
- Loss of social position or problems involving work, money, or the law
- Pressure to succeed
- Social isolation
- Significant losses early in life
- Issues involving sexual identity
- Deep feelings of hopelessness and helplessness
These factors may involve personal relationships, difficult circumstances, or the way someone feels about their life.
Health and Substance-Related Factors
Other risk factors include:
- A recent diagnosis of a life-threatening condition
- Substance abuse
A person may experience more than one of these risk factors.
4. Supporting a Client Who Talks About Suicide
When a client talks about suicide, the CCA must respond seriously and appropriately.
The following actions are important.
Take Suicidal Talk Seriously
If a client talks about suicide, take the person’s words seriously.
Do not dismiss suicidal thoughts or assume the client does not mean what they are saying.
Tell Your Supervisor at Once
CCA action: Notify your supervisor immediately when a client talks about suicide.
This is an important reporting responsibility.
Do Not Leave the Client Alone
Stay with the client.
Safety: Do not leave a client who is talking about suicide alone.
The client needs support while help is being arranged.
Encourage the Client to Talk and Listen
Encourage the client to express their feelings.
Be a good listener. Give the client an opportunity to speak without dismissing their concerns.
Conversation serves two important purposes:
- It shows the client that you care.
- It gives your supervisor time to arrange help.
Do Not Minimize the Client’s Concerns
Avoid comments that dismiss the client’s feelings or suggest their problems should be easy to overcome.
For example, do not tell the client:
- That they should not think about suicide
- That everything will turn out fine
- That they should simply focus on positive things
Key fact: Listening is appropriate. Minimizing the client’s concerns is not.
In Home Care, Stay Until Help Arrives
When a client talks about suicide in a home care setting, remain with the person until help arrives.
Your supervisor may arrange for:
- A nurse
- A case manager
- Emergency personnel
Your responsibility is to remain with the client while appropriate help is being arranged.
Nova Scotia CCA Note
Sorrentino emphasizes telling your supervisor at once and staying with a client who talks about suicide. Nova Scotia also has current crisis services that people can use when urgent help is needed.
If someone is in immediate danger or there is an emergency, Nova Scotia advises calling 911 or the Provincial Mental Health and Addictions Crisis Line at 1-888-429-8167, or going to the nearest emergency department. People can also call or text 988, the Suicide Crisis Helpline, for support 24 hours a day.
These services do not replace the CCA’s responsibility to report suicidal talk immediately or remain with the client. Follow your workplace’s emergency procedures while help is arranged.
Why this matters in Nova Scotia: Knowing the available crisis services helps you understand how urgent professional assistance can be reached without delaying your immediate CCA responsibilities.
Official source: Mental health and wellbeing, Government of Nova Scotia
Last checked: October 9, 2026
5. Suicide Risk in Older Persons
Older persons face particular suicide risks.
In Canada, people over the age of 85 have been identified as having the highest suicide rate of any age group.
Older people may experience several significant losses, including:
- Deaths of family members and friends
- Declining physical health
- Reduced cognitive abilities, meaning changes in mental abilities
Depression is also common among older persons.
Suicide Statistics for Older Persons
Important Canadian figures and patterns include:
- Approximately 31 out of every 100,000 older persons die by suicide, especially among those over age 85.
- Research has indicated that suicide rates are increasing among older men.
- Most of the deaths described in these older-person statistics involve white men.
- Violent methods account for most of these deaths.
Why Some Older Persons Consider Suicide
For some older persons, loneliness becomes difficult to bear.
Others may struggle with losing their independence. Losing a driver’s licence is one example.
A serious illness may also affect the person’s feelings about continuing to live.
Some older persons consider suicide because they fear:
- Long periods of suffering
- Becoming a hardship for their families
- Losing the ability to live independently
These concerns help explain why physical health, independence, relationships, and emotional well-being are important when considering suicide risk in older persons.
6. Additional Suicide Risk Factors in Older Persons
Older persons may have additional risk factors involving personality, health, life events, and daily functioning.
| Risk Factor | Examples |
|---|---|
| Personality factors | Personality disorders, emotional instability, rigid personality, and poor coping skills |
| Medical illness | Chronic pain and sensory impairment |
| Negative life events | Personal losses and financial difficulties |
| Functional impairment | Loss of independence and difficulty performing ADLs |
A personality disorder belongs to a group of disorders involving rigid behaviours that are considered socially unacceptable.
Poor coping skills and emotional instability are also listed as personality-related risk factors for older persons.
Functional impairment in this context involves reduced independence or difficulty performing ADLs.
These additional factors help explain why older persons may face suicide risks connected to both health and life circumstances.
7. Important Questions When Suicide Is Suspected in an Older Person
When there is concern that an older person may be suicidal, important questions explore three areas:
- Feelings about living
- Possible suicide plans
- Reasons for staying alive
The questions are meant to help explore the person’s thoughts and circumstances.
Questions About Feelings
These questions explore whether the older person is thinking about death or suicide:
- Do you feel exhausted by living?
- Have you considered ending your life?
- Have you thought about suicide?
The person’s answers may help reveal suicidal thoughts.
Questions About a Possible Suicide Plan
These questions explore whether the person has considered or begun taking action toward suicide:
- Have you thought about a particular way to end your life?
- Have you given away belongings?
- Have you asked anyone to help you die or to die with you?
- Have you saved pills because you planned to take an overdose?
- Have you already started acting on a suicide plan?
These questions address both thoughts about suicide and possible actions related to a plan.
Questions About Reasons to Live
Questions about reasons for living include:
- What has stopped you from harming yourself?
- Who or what makes your life worth continuing?
These questions explore the people, experiences, or reasons that have kept the older person from harming themselves.
Important: An older person who expresses suicidal intentions needs careful monitoring and medical treatment as soon as possible.
Nova Scotia CCA Note
Sorrentino includes questions that can help explore suicidal thoughts and possible plans. In Nova Scotia, these questions do not give a CCA authority to conduct an independent clinical suicide risk assessment.
The current Continuing Care Assistant Occupational Standards of Practice allow CCAs to perform observational point-of-care assessments. This means observing a person’s condition, behaviour, and changes while providing care. The standards make clear that these observations are not the same as a comprehensive nursing assessment.
A CCA recognizes concerns, reports changes to the supervisor, and follows the care plan and workplace procedures. A comprehensive clinical assessment and the decisions based on it are outside the CCA’s observational assessment role.
Why this matters in Nova Scotia: Asking supportive questions and listening to a client are different from deciding how serious the person’s suicide risk is. The CCA must not delay reporting while attempting to make that clinical decision.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Exam Clue Words
Pay special attention to words that make a response urgent or establish what the CCA must do.
- At once: When a client talks about suicide, tell your supervisor immediately.
- Do not: A client talking about suicide must not be left alone.
- Avoid: Do not minimize concerns or use reassuring statements that dismiss the person’s feelings.
- Until: In home care, stay with the client until help arrives.
- Immediate: A child or adolescent experiencing suicidal feelings, talking about suicide, or attempting suicide needs immediate help from a mental health specialist.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Men attempt suicide more often than women. | Women attempt suicide more often, but men have a higher suicide death rate. |
| Telling a suicidal client that everything will work out is the best response. | Listen carefully without minimizing the client’s concerns. |
| Telling your supervisor means you can leave the suicidal client alone. | Tell your supervisor at once and do not leave the client alone. |
| Suicide is mainly a concern for young and middle-aged people. | Suicide also affects children and older persons, especially those over age 85. |
| A suicide attempt does not always require professional attention. | A suicide attempt indicates a serious mental health issue requiring professional care and a suicide prevention program. |
Fast Review
Use these points to review the most important information before your exam.
- Suicidal behaviour disorder involves recurring thoughts about suicide or a preoccupation with ending one’s own life.
- People with mental health disorders have a high suicide risk, especially those with depression, bipolar disorder, or schizophrenia.
- Important risk factors include previous attempts, abuse, family or friend suicide, major crises, isolation, hopelessness, and substance abuse.
- A suicide attempt is a sign of a serious mental health issue. Professional care and a suicide prevention program are needed.
- Suicide accounts for 24% of deaths among people ages 15 to 24 and 16% among people ages 25 to 44 in the figures studied.
- Women attempt suicide more frequently, but the suicide death rate among men is four times the rate among women.
- In Canada, older persons over age 85 have been identified as having the highest suicide rate of any age group.
- Older-person risk factors include loneliness, illness, personal losses, personality factors, reduced independence, and functional impairment.
- Questions for an older person suspected of being suicidal explore feelings, possible plans, and reasons for living.
- If a client talks about suicide, take the person seriously and tell your supervisor at once.
- Do not leave the client alone. Encourage conversation, listen carefully, and avoid minimizing their concerns.
- In home care, stay with the client until help arrives. A supervisor may arrange assistance from a nurse, case manager, or emergency personnel.
Final Pep Talk
Suicide is a serious topic, and there are several risk factors and response rules to remember. Focus first on recognizing concerns and remembering what the CCA must do when a client talks about suicide. You can review the other details in smaller groups until they become more familiar.