At the Nunavut Legislature’s next sitting on February 24, all eyes will be on Paul Okalik, Minister of Health and recently appointed Minister responsible for Suicide Prevention. In October 2015, following a coroner’s inquest into youth suicide in the Canadian Arctic territory, Nunavut’s Premier Peter Taptuna declared the issue a crisis. He has since established a cabinet committee on quality of life, led by Okalik, to address the inquest’s recommendations. This February, Okalik is expected to request more resources from the territorial government’s budget to act on those recommendations.
Many of the recommendations echo those set forth by Nunavut’s suicide strategy of 2010, which included calling for greater resources to be allocated to mental health services in Nunavut communities, delivering culturally appropriate wellness programs and fostering greater collaboration between organizations to deliver services.
“It’s not rocket science,” said Jack Hicks, a social research consultant who was involved in developing the original strategy. He said the government of Nunavut has been slow to implement the recommendations over the past six years, due to lack of collaboration between departments and non-profit organizations.
In that time, the tragic statistics have not changed. Between the territory’s founding in 1999 and March 31, 2014, researchers have recorded an average suicide rate of 111.4 per 100,000 people, nearly 10 times Canada’s national average. Inuit men aged 15–24 have the greatest risk of dying by suicide, with a rate of 185.8 per 100,000, 40 times the national average; the rate of suicides among women in the same age bracket is 47.9 per 100,000 people.
Since the coroner’s inquest last fall, said Okalik, there has been progress toward hiring a mental health nurse for each of the territory’s 26 communities, as well as working with traditional counseling programs. The cabinet committee has also appointed a new deputy minister, and has so far held one meeting.
The issue is not limited to Nunavut; indigenous youth across Canada’s territories, as well as around the circumpolar region, show high suicide rates as well. But unlike other circumpolar nations, Canada does not have a national suicide strategy.
This might soon change. In October, Iqaluit will host the annual conference of the Canadian Association for Suicide Prevention. Although there are no confirmed plans to announce an official national strategy then, “it would be nice,” said Sheila Levy, a past president of CASP and board member for Nunavut’s Embrace Life Council, a nonprofit organization aimed at improving wellness in Inuit communities.
At present, programs dedicated to suicide prevention in Nunavut do not receive enough funding, especially when high living, real estate and travel costs in the territory are taken into account. Levy also sits on the board for the volunteer-run Nunavut Kamatsiaqtut, a 24-hour suicide helpline. Although it operates seven days a week and relies on paid operators in Ottawa for night shifts, Nunavut Kamatsiaqtut receives less than $100,000 in funding every year. A national suicide strategy, said Levy, could bring in more funding for such programs to expand their scope.
Yet focusing on programs that specifically aim to prevent suicide, rather than addressing broader social problems in the territory, only scratches the surface, says Hicks. In one follow-back study, Hicks and his team reviewed 120 suicide cases that took place between 2003 and 2006, and interviewed 120 individuals with similar demographics to the individuals who died by suicide.
“If you talk to 120 people in Nunavut and go into their lives in detail, you’re dealing with a lot of stuff,” said Hicks, indicating a slew of issues revealed in the study, including sexual abuse, addictions and housing shortages.
A new study now underway is making similar findings. Sappho Gilbert, a public health researcher at Dartmouth College in Hanover, New Hampshire, is conducting a study with Nunavut’s Embrace Life Council to document resilience and wellness in communities. She has interviewed Nunavut residents in Iqaluit, Pond Inlet and Rankin Inlet, examining how individuals define and achieve wellness. So far, Gilbert has noted common causes of stress include financial and food insecurity, the toxic role of alcohol both in the home and in the community and a lack of recreational community activities.
Having received funding during the summer before the coroner’s inquest was launched in the fall, Gilbert’s study came at a poignant time. “The suicide prevention strategy is going to identify forces of illness, but we also want to have our study be informative for wellness programming,” said Gilbert. “We want to make sure that what people have identified as helpful is heard. That’s important because the voice of the people from the vantage point of wellness has not yet been rigorously understood, and therefore not been incorporated.”
A 2015 review published in the International Journal for Circumpolar Health has found that while suicide prevention and intervention programs in the Arctic abound, few peer-reviewed studies evaluate intervention programs.
Some programs, however, do show potential. In the Northwest Arctic Borough in Alaska, the Teck John Baker Youth Leaders program, now in its sixth year, is making a radical difference in the indigenous suicide rate. The program identifies youth leaders in schools and trains them to help their peers feel less isolated.
Like Nunavut, suicide rates among Alaska natives, particularly in the 15–25 age bracket, are among the highest in the U.S. In 2008, the year before the Teck John Baker program launched, the northwestern borough in Alaska saw eight suicides; the following year, the number dropped to five. In every subsequent year, the number has dropped to zero.
Okalik said he is looking at suicide prevention programs in the circumpolar region to be models for Nunavut’s strategy. “We’re not alone in tackling this issue,” he said. “We’re trying to learn as much as we can from others on how they are tackling this.”
For Okalik, “any reduction in suicides is good.” The territory’s next steps could set a precedent not just for the rest of Canada, but for the circumpolar region as a whole.
- A scoping review of Indigenous suicide prevention in circumpolar regions
- The Canadian Association for Suicide Prevention has issued a strategy called The Blueprint
- The U.S. National Strategy for Suicide Prevention
- Norway’s National Plan for Suicide Prevention and its follow-up project for 2000-2002
Top image: Snowy owl painted on a wall in Iqaluit, Nunavut. The Arctic territory is in the midst of evaluating and implementing a list of recommendations that stemmed from a recent coroner’s inquest into suicides in Nunavut. (Flickr/Mike Beauregard)