Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, September 28, 2015

Suicide Run Amok

"I think the word 'contagion' scares people, because people do start to be worried about young people in their family catching suicide -- or it to be an epidemic in that way -- but suicide doesn't work that way."
"But that we do have evidence of is exposure. Where, if you are a young person and you know someone that has ended their life by suicide, there is an elevated risk that you will, in turn, end your life by suicide."
"The government [of Nunavut] deserves to be shamed for this [not funding anti-suicide strategy]."
"Child sexual abuse is another huge problem. But nobody is willing to talk about it."
Dr. Allison Crawford, psychiatrist, Nunavut

"I had never been exposed to suicide before that [1977 suicide of his two older brothers]. To me, that seemed to be the beginning, and it was usually young men committing suicide."
"Look, we have the highest suicide rate in Canada. Our leadership should be shouting about it from the hilltops."
"Let's make suicide prevention our number one issue."
Jack Anawak, 64, Repulse Bay, Nunavut

"The rates of major psychiatric illness found in this study were higher than in the general Canadian population. The rates of major depressive disorder among Inuit in our study were higher than the national average."
"There's no one single cause for suicide. What the study showed is that suicide is the outcome of a process that starts much earlier."
"Protective factors are also very, very important and they're also part of the picture. Our study is not able to give precise answers because the data we collected could not identify the causes. But there's definitely a pattern there."
"I don't think we could implement a suicide prevention strategy without tackling the mental health problems and substance abuse and childhood adversity."
"This is a process that starts at some point early in life, which in a way tells us there's different windows of opportunity to intervene on suicide prevention."
Eduardo Chachamovich, lead author, report on Nunavut suicide study, 2013
The sun over Iqaluit at noon in December. An inquest into Nunavut's devastating suicide rate has laid bare the territory's lack of capacity to cope, but to trigger federal help, a territory has to ask, writes Laura Eggertson.
The sun over Iqaluit at noon in December.  (Jeanette Gevikoglu) 

The territory of Nunavut's coroner, Padma Suramala, decided to initiate an inquiry/inquest into the prevalence of suicides among aboriginal Canadians, and specifically the high rate of the expression of hopelessness leading to suicide in the far North of Canada. Statistics show that since 1999, 479 Inuit have taken their own lives. The methods used range from hanging themselves, shooting themselves, overdosing, and stabbing themselves.

That number of Inuit children attempting suicide aged 11 to 14, represents 50 times the national average, out of a population of roughly 28,000. A young boy of 15 and older is almost ten times likelier to commit suicide than someone living in the south. In 2013, 45 suicides took place, a dozen of whom were women while 33 were men mostly in the age range of fifteen to twenty-five. The oldest committing suicide that year was 72 years of age, the youngest 13.

The soul-searing emotions of depression, substance abuse, emotions of utter hopelessness and despair can occur to vulnerable people anywhere, and they do, and they are responsible for taking lives everywhere, but the sheer volume of suicides taking place in Canada's far north speak of a far more fundamental issue that drains people's will to live. Researchers speak of the connection of child sexual abuse with later suicidal impulses among the young. Offenders in Nunavut are charged with sexual violations against children and youth at 10 times the national rate.

Research conducted not only in Canada's north but also among troubled youth in Alaska and Greenland reflect similarities. What all three places where Inuit live have in common is the transition in lifestyle, when beginning in the 1950s a social experiment took place with grave consequences seen today. In the 1950s, 60s and 70s, the federal government decided to change a society of hunters and gatherers into an urbane collective; people living in isolated settlements, becoming accustomed to shopping for their food.

As an example, Jack Anawak speaks of the rapid social transformation responsible for confusing traditional roles. He himself grew up with the tradition of hunting and trapping. He already had a family of his own by age 17, with all the responsibilities that normally accompany such a familial status. The food his wife and children relied upon was food he was responsible for providing, and not through a trip to the local grocery; he set traplines and he hunted.

When the social transformation took place, he witnessed the deterioration in purpose that struck his brothers, leading them to suicide in 1977. Additionally in that same generation many young Inuit were sent to residential schools, taken from their families and exposed to a modern lifestyle for the purpose of wrenching them away from a traditional Inuit lifestyle, where they lost memory of their heritage, their language, and were taught instead practical European lifestyle skills.

It isn't that the high suicide rate is being ignored. Years earlier the government of Nunavut, along with the Nunavut land claims organization, a suicide prevention group and the RCMP studied how they might best develop a suicide prevention strategy. In 2010 the completed strategy was announced, consisting of better access to improved mental health services along with suicide-intervention training for responders, including police, teachers, community leaders and parents.

Government departments were supposed to mobilize to "transform the way suicide prevention happens in Nunavut". But adequate funds were never set aside specifically for that purpose, and the plan was never fully implemented. If financial assistance was required to augment whatever the Nunavut government was prepared to allocate, there is a mechanism whereby, if requested, the federal government is prepared to help.

Canada has an Emergency Management Act, and an Emergency Management Framework. Ottawa is prepared to respond to any request for assistance, and to do so swiftly. The federal government has committed to a federal role in suicide prevention or any other emergencies that must be addressed. Requiring "resources beyond their capacity to cope in an emergency or disaster" is a recognized responsibility of the federal government. But it will act only if and when aid is requested of it.

So while the inquest mapped out the situation prevailing, in the process revealing the territory's inability to cope with the epidemic of suicide, federal assistance has not to date been requested, though it obviously should be. There is an atmosphere of malaise that is acknowledged but not much appears to be done to combat it, and that is the issue of sexual violence aimed primarily at women and children, although men too suffer such abuse in the territory.

Some 52 percent of women and 22 percent of men reported sexual abuse in childhood of the most severe nature; according to data from the Inuit Health Survey of 2007-2008. Cases of children presenting with sexually transmitted infections, along with other evidence of sexual abuse are identified by psychiatric nurses and psychiatrists, according to Dr. Allison Crawford, director of the Northern Psychiatric Outreach Program for the Centre for Addiction and Mental Health, Toronto.

"The degree of childhood abuse is something that I think is talked about even less than suicide. It's still present and prevalent in communities", she testified at the inquest. "We have a new case that's come to the attention of mental health at least monthly, and sometimes more frequently. Social services do become involved automatically, and often the RCMP will become involved. But often the outcome — there are very few consequences."

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