Nunavut officials defend their suicide prevention, mental health efforts

This study, released June 5, shows that child abuse, pot smoking, and mental disorders rank among the biggest risk factors for suicide in Nunavut. (SOURCE: LEARNING FROM LIVES THAT HAVE BEEN LIVED)

This graph, from the study “Learning From Lives That Have Been Lived,” shows that many of the people in Nunavut who died by suicide between 2003 and 2006 suffered maltreatment in childhood. (SOURCE: LEARNING FROM LIVES THAT HAVE BEEN LIVED

Following the release June 5 of a major study showing that widespread child abuse, substance abuse and mental distress in Nunavut create big risk factors for suicide deaths, it’s still not clear if Government of Nunavut officials have the capacity to tackle those issues.

GN officials, at an Iqaluit press conference, fended off questions June 5 on the gap between the large number of Nunavut residents who need help and the limited help that’s actually available.

“The question about, is there a big gap between who is being cared for and the need, we can’t answer that definitively, but we are in fact very much engaged in reaching out to people with mental health issues and support them when they have been identified as a risk…” Monita O’Connor, an assistant deputy minister of health, told reporters.

Nunavut’s suicide prevention action plan states that by 2011-12, the GN health and social services department — which has now been split into two entities — was committed to do a “gap analysis” for territorial mental health services.

“Gap analysis” is civil service jargon for work aimed at figuring out the services that people need compared with the services they’re actually getting.

It’s not clear if the GN has done this work. But O’Connor did say the GN’s mental health activities have “doubled” over the past decade.

“Since 2003 to 2006, there has been an extension of mental health resources across the territory. It’s probably more than doubled, mental health outreach work as well, and psychiatric staff,” she said.

But at least one participant in the creation of the Nunavut suicide prevention action plan admits the action plan is not yet implemented.

“I would say that as of today we haven’t achieved what we set out to do in the action plan regarding the improved mental health continuum but we are working on it,” said Natan Obed, the director of social and cultural development at Nunavut Tunngavik Inc.

Earlier this month, residents of Pangnirtung told Nunatsiaq News the community is not getting enough help to cope with a cluster of suicides and suicide attempts that afflicted their community, where three people died by suicide in less than a month.

“We need to take a different approach. What we’re doing now is clearly not working,” said the Pangnirtung resident, who spoke on conditions of anonymity.

O’Connor said, however, that the GN is hiring more specialized staff to work on mental health.

“Last year [we hired] three additional psychiatric nurses in the north Baffin, including Pang and they have additional staff…,” O’Connor said.

She also said the GN helps communities by reaching out to them.

“We recognize these needs in chronic serious mental health, personality disorders, the correlation with alcohol and drug abuse and the risk for suicide. We realize it and the staff are being trained to support people and not only wait for the crisis but to reach out to the communities,” she said.

The study, which reconstructed the life stories of 120 people who died by suicide between 2003 and 2006, found that many of those people suffered maltreatment in childhood.

“The focus on child sexual abuse and physical abuse is something that we would probably need to do more on,” Obed said.

Again, it’s not clear that GN officials have the political support needed to tackle child abuse in the territory.

This past March, MLAs voted to delay a proposed new law called Bill 40, which would create an independent child and youth advocacy office in Nunavut.

This occurred in spite of a damning report from the Auditor General of Canada that revealed numerous failures in the territory’s child protection system.

Dr. Eduardo Chachamovich, a assistant professor of psychiatry at McGill University and one of the leaders of the Nunavut suicide study, cautioned that there is no “one single cause for suicide.”

But he did say, as his study found, that child abuse combined with other factors creates big risks for suicide later in life.

“What it can reaffirm is that this is a process that starts at some point early in life and the outcome is going to be a suicide several years later,” he said.

And he said that though the causes of suicide are complex, some the issues that a suicide prevention strategy should tackle are obvious.

“I don’t think you could possibly have a suicide prevention strategy without tackling the mental health problems, substance abuse and childhood adversities,” Chachamovich said.

Jenny Tierney, the executive director of the Embrace Life Council, said her group plans to do more work with communities this year.

She said her group has already handed out copies of a “community resource card” that provides information about where people can get help, and plans more consulting work.

“We’re looking to do outreach with the communities and specifically find out from them what they need and find those resources for them,” she said.

And Embrace Life also wants to do an information campaign for youth on cannabis abuse.

Cathy Towtongie, the president of NTI, pointed out that Nunavut’s young people are trying to cope with difficult cultural conflicts.

“We’re dealing with a person that has to be bicultural, bilingual and they have to sort out behavioural mechanisms to survive in today’s society…,” she said.

“Where one culture starts to take dominance over another culture, these individual Inuit, when they are depressed, they have no basis for balancing what is good in their culture and what they can take from the other culture.”