A hidden refuge for troubled minds

Iqaluit has been home to Nunavut’s only mental health facility since Dec. 24, 2002, but chances are that even if you’re familiar with Iqaluit, you may not know where the Akausisarvik mental health facility is or exactly what it does.

For the dozen residents who live there, Akausisarvik — located in the Qimaavik women’s shelter’s former location overlooking the city on Apex Road — is an important place.

“We’re taken good care of here,” says one man, eager to communicate how he feels about his home.

Akausisarvik is designed to offer care for Nunavummiut who suffer from serious or moderate mental illnesses such as schizophrenia, manic depression or personality disorders.

Most of the men and women who live at Akausisarvik had previously been living in mental institutions in the South. Because of their mental problems, all but one have been rejected by their families.

“They are social outcasts. They’re stigmatized,” says Akausisarvik’s manager Shelley Cuthbert. “They have no place to go.”

Akausisarvik offers them a secure place to live, with ample food and round-the-clock supervision. Residents live in shared or single rooms, with male and female residents in separate sections of the home. They receive pocket money for cigarettes and personal items, and can go out into the community. Some venture out alone, others require a staff supervisor for outings.

“They go anywhere they want to go,” says Cuthbert.

In back of the building, there’s a dog that needs feeding every day, while inside the residence, there’s a computer and television for entertainment.

Therapy, says Cuthbert, is “informal,” and residents receive counselling when they are in the mood to talk, usually one-to-one with Cuthbert.

Residents are encouraged to learn and use appropriate behavior. A few gaping holes in the walls show violence is sometimes a problem. A quiet room is available when residents need a “time out.”

“They can be very unpredictable,” Cuthbert says. “[But] we try to look at the whole person.”

Four staffers plus Cuthbert work during the day. Three are on duty at night. They make sure residents receive their many medications at the proper hours and fill out extensive sheets describing how each resident does during the day.

“If you get along with the residents, it’s OK,” says Khalil, who cooks for the Akausarvik residents. “Some of them like to cook and some of them like to eat.”

Nearly all of the 22 staff have other jobs in addition to their 12-hour shifts at Akausisarvik. Nine are employed at the Baffin Correctional Centre. Khalil is a taxi driver.

None of the current staff at Akausisarvik are Inuit.

“It doesn’t matter what colour you are or what race you are to work,” says Cuthbert.

She says staffing issues — not the mental problems of residents — has been the largest test Akausisarvik has faced. The out-patient day program, in limbo for the moment, is a casualty of the facility’s rough first year with its staff.

Cuthbert admits working at Akausisarvik isn’t for everyone. Although most days are routine, some require skilled mental and physical responses.

“Burnout is the number one problem among mental health workers because the residents are so challenging, and there’s the odd time that you may get injured.”

Cuthbert says workers must also participate actively in their training as psychiatric nurse assistants, and in other areas, such as suicide intervention.

They must always show up on time for their shifts — something that didn’t happen until a few months ago, when staffing became more stable.

Although Akausisarvik wasn’t designed as a long-term solution for its residents, most won’t be leaving soon. That’s because there is no group home in Nunavut where they can move as a transitional step. Most residents, she says, couldn’t manage independent living and would risk becoming homeless.

As a result, resident turnover at Akausisarvik is small and there’s a waiting list for admission. Cuthbert says she could easily fill another 25-bed mental health facility.

“Though there are no Inuit staff, and English is the language of Akausisarvik,” Cuthbert says residents are far better off living in Nunavut than in the South.

“This is where their heart is,” she says.