Mental health diploma course a small step in right direction

SARA MINOGUE

Nunavut’s first ever diploma program to train mental health workers got started at Nunavut Arctic College in Iqaluit this past Wednesday.

Two years from now, those students could become the first to take mental health care out of Nunavut’s major centers and into the communities.

“This program is a very big step towards the care of the mentally ill in Nunavut, and it will make a tremendous difference in how care is delivered in Nunavut,” said Shelley Cuthbert, a founder of the Akausisarvik mental health centre in Iqaluit and a member of the committee that adapted the program from a similar course offered in Edmonton.

Students will spend two years learning about mental health, with an emphasis on “the whole person.”

In the end, they will be trained to offer counseling for things like sexual abuse, drug and alcohol abuse, domestic violence, depression, suicide and other mental health problems. They will design treatment plans, conduct basic mental health assessments and oversee patients on medication.

The course includes two six-week practicums. The first takes place in Iqaluit, either at the Baffin Correctional Centre, Young Offenders, Akausisarvik, Baffin Regional Hospital, the mental health clinic, or the wellness centre.

The second practicum takes place with a psychiatric nurse in a different community.

Planning for the program started almost two years ago, when the Government of Nunavut’s Department of Justice began meeting with a psychologist to see what could be done for people with mental health problems who are returning to their communities.

Right now, the justice system regularly deals with people who are mentally ill for whom treatment is not available. Mental health services are concentrated in regional centres, where even there, they are in short supply.

“It would be wonderful if we could get [a mental health worker] in every community,” said Irene Swoboda who has worked as a psychiatric nurse in Arctic Bay for the last three years, and joined the course committee last year.

Psychiatric nurses have only come into the Baffin within the last three years. Swoboda sees a “large need” for more.

She has so far seen 450 to 500 patients in Arctic Bay, Pond Inlet, Resolute Bay and Grise Fiord. She has treated people as young as four years old.

Often, the only counseling she can offer are telephone conversations every other week, in English. A much better scenario, she said, would be to refer clients to a mental health worker in the community.

“Most people are expressing very, very deep and heartfelt emotions,” Swoboda said. “It’s always better to do that in your own language.”

Swoboda uses the suicide rate as an indicator of the need for services. In 2003, Nunavut lost 37 to suicide. By December of this year, the number was 22.

“A lot of people suicide in reaction to a crisis,” Swoboda said, such as a girlfriend leaving.

The first 24 hours after such an event are crucial.

“If there was somebody in the communities that was accessible, this would be of large benefit.”

In the meantime, far too many people are being sent out of territory for services.

Swoboda recalls one day when five of her clients were sent to the Selkirk Mental Hospital in Selkirk, Man.

“Imagine hearing voices and seeing things that aren’t there and being shipped down south to a white community and try and communicate with people in English, in an environment that is radically different than anything you’ve ever seen before.”

Severe cases would likely still have to be sent out of territory for intense treatment, but with new mental health workers, the goal would be to identify these cases sooner, and offer treatment earlier.

The new mental health workers will add some continuity to services, liaising with wellness counselors, psychiatric nurses, and visiting psychiatrists or doctors.

They will also do community education and prevention — something that overloaded psychiatric nurses don’t get enough time to do, or only do as a follow-up to a suicide.

Communities want this information, said Swoboda. She recalls workshops in Pond Inlet where seats were packed. She’s prepared half-hour talks on depression that have kept people’s attention for three and a half hours.

The course is challenging, thorough, and tailor-made for Nunavut. Students can expect to find a rewarding career.

“If you want a career that makes a difference in people’s lives, this is it,” said Swoboda.

“You never know how many lives you’ve saved.”

For now, the Department of Health and Social Services is funding the course.

Eventually, the program could become a core-funded course. The committee has discussed extending the course to regional campuses or to distance education in the future.