Nunavik doctors ponder mental health issues

Karen Kettler, who works with Nunavik’s Cirqiniq social circus program, drum dances during a recent workshop for doctors in Kuujjuaq. (PHOTO COURTESY OF THE NUNAVIK REGIONAL BOARD OF HEALTH AND SOCIAL SERVICES)

Doctors who work in Nunavik had a rare opportunity to usher in the season of warmer weather and light in Kuujjuaq, where they recently attended a meeting to understand more about mental illness, the darker side of life in the region.

Many of the 27 doctors working either on a full or part-time basis in the region, who may go months without any contact with each other, met in Kuujjuaq March 22 to March 24.

Their get-together — the first ever regional gathering of Nunavik doctors, organized by the region’s family medicine department, la Département régionale de medicine générale, was far from a social event.

Sessions included complex issues such as personality disorders, suicide, detoxification and post-traumatic stress.

Yet the focus was more on solutions than problems, said Dr. François Prévost, the head of the regional family health department for Nunavik, who has worked in Nunavik for 16 years.

During the two-and-a-half day session, called “New landmarks in mental health,” participants looked at ways to improve mental health in Nunavik.

That big challenge means that “as a tool, we must be sharp,” Prévost said about doctors who practice in Nunavik.

Nunavik faces an alarming rate of psychiatric problems: the highest suicide rate in the world, early psychosis, chronic depression, marked personality disorder, widespread substance abuse, sexual abuse, incidents of explosive violence, post-traumatic stress and transgenerational trauma.

And the region has few mental health resources, Prévost said, although every day in their practice, doctors deal with mental health issues among their patients.

There’s not even a psychologist for the entire Hudson Bay coast, he said.

Despite the lack of mental health services and high needs, Prévost said those at the weekend meeting wanted to look for solutions that don’t require huge amounts of money.

These solutions include how to develop more compassion and sensitivity, integrate more Inuit perspectives into their practice and support each other, because practicing medicine in Nunavik can be stressful.

“We must change our judgments, our scope,” Prévost said.

Among the questions considered during the meeting: “how can we improve prevention efforts and ensure greater success in psychiatric care in the context of an isolated region? Within a transcultural context? What do we know of the Inuit vision of their own health, their preferences in terms of recommended solutions?”

But the meeting was in no way intended to put the responsibility to deliver mental health care services on to the backs on family doctors, Prévost said.

And that’s something he hopes Quebec’s new health minister, Réjean Hébert, will take action on when he visits Nunavik April 2 to April 4.

However, while Nunavik waits for Quebec to put money into expansion of health services and infrastructure in the region (where the 25-year-old Inuulitsivik hospital in Puvirnituq and the even older Tulattavik hospital in Kuujjuaq both need replacing), doctors can start a parallel process of discussing how to expand and improve their understanding of mental health, Prévost said.

To that end, the meeting also featured sessions on “how creativity and storytelling contribute to well being,” and on Nunavik’s Cirqiniq social circus program.