Again, the 90 days is a problematic time frame. I come back to the Manitoba study that I mentioned. This was a study that looked at groups of people who had suffered from some physical ailment, and from the time of diagnosis and 90 days hence they found that these people were at their maximum in terms of suicidal ideation. We know that there is a period of adjustment after one has had a change in one's physical status as a result of physical or mental illness that can manifest itself as a wish to die.
There's the other study I mentioned, and I think it's worth looking at the numbers. There are studies that have followed people who have had strokes or who have suffered disabilities as a result of spinal cord injuries or head traumas for as long as two years after the fact. Interestingly enough, when you look at those people who were initially depressed and then received treatment for depression, you see that all of them will go from a state of being suicidal to a state of no longer being suicidal.
Again, I would underscore that in the case of people whose death is not reasonably foreseeable, what these people need are disability supports and a limitation of access to means, because we know that the more people have access to means, such as guns.... Just as a side note, the suicide rate in the United States is more than double that in Canada. It's thought that it's probably because of access to guns.
If we limit the access to means and if we provide people with treatment, we know that people will renege on their suicidal ideation. As a psychiatrist, I have worked with people who had chronic suicidal ideation, even over periods of years. They continue to struggle, but what one does in good psychiatric care is give an unwavering commitment that we will be there with that patient, and we engage in a relationship with that patient, and these individuals have gone on to lead productive lives. They are loved and they do love. They have raised families and they have a meaningful existence.