On Sunday, the tiny community of Attawapiskat joined the ranks of several First Nations reserves across Canada that have declared states of emergency this year in response to a wave of suicides and attempted suicides.
Within hours, a crisis team was being flown in to assist the overwhelmed local health workers who had dealt with 11 people trying to end their lives in a single night. But according to experts, that represents a band-aid solution at best for a community that has seen 100 people attempt suicide since August.
“You can send a whole pile of councillors in there, but in the long-term that doesn’t work,” said Dr. Rod McCormick, a First Nations mental health expert and one of just half-a-dozen psychologists in Canada who are also of Aboriginal background.
“We need some more innovative alternatives to what we have now.”
McCormick suggested that the key, at least in the short-term as governments work to improve overall quality of life on reserves, could be strengthening resiliency among individual band members. That means working to shore up a person’s self-esteem, he said, and giving them better tools for connecting with others, or for identifying and expressing emotions.
A one-week training course to teach these basic coping skills could go a long way, said McCormick.
To try and equip every First Nations community across the country with permanent, culturally trained mental-health professionals is simply impossible, he added.
Dr. Allison Crawford, a psychiatrist at Toronto’s Centre for Addiction and Mental Health who has worked in several Nunavut communities, pointed out that fly-in crisis teams must first establish trust and connection with patients before they can begin helping them.
“We think about intervening at the end, when there is most acute risk,” she said. “When someone has shown up in crisis or distress, or they’re intoxicated, or there are a lot of (suicide) attempts in a community … but we have to think earlier along that pathway.”
Crawford said it may be useful to look at Aboriginal communities that have not struggled as much with suicide, or which have overcome the problem, for hints about best practices. In the end, she said, it will take structural improvements to things like education, health and infrastructure to really start fixing the problem.
The need for innovation is pressing. Aboriginal suicide rates, especially among young people, have remained stubbornly high for years.
According to Health Canada, suicide and self-inflicted injuries are the leading causes of death for First Nations youth and adults up to 44 years of age.
Aboriginal youth commit suicide about five to six times more frequently than non-Aboriginal youth, and it is not a problem limited to reserves. A study released by Statistics Canada in January revealed that in the broader Aboriginal population, more than one in five First Nations, Métis and Inuit adults living off-reserve report having suicidal thoughts.
The root causes are no mystery. Anxiety disorders, drug use, lack of self-worth, alcoholism, familial issues and poor physical health are all contributing factors when it comes to suicidal thoughts, according to the study from Statistics Canada. When all Aboriginal groups and males and females were combined, the study noted, personal experience or experience within the family with the residential school system was also significantly associated with thoughts of ending one’s life.
On reserve, lack of basic amenities and services, overcrowded housing and isolation contribute even further to mental health problems.
WATCH: Attawapiskat Chief Bruce Shisheesh says support workers in the community are ‘overworked’
‘Clusters’ of suicides
The situation in Attawapiskat and other communities may be dire enough to require a state of emergency, but there is little evidence to suggest that there is a suicide epidemic on every First Nations reserve.
In Ontario, for example, research cited in the Canadian Medical Association Journal found that Aboriginal suicides (not including attempts) are indeed increasing, rising from 11 suicides in 1991 to 31 in 2013, but they tend to occur in clusters. Forty-two per cent of the First Nations suicides in Ontario over the last decade have occurred in just seven communities.
Assembly of First Nations National Chief Perry Bellegarde called last weekend’s events in Attawapiskat part of a “national tragedy,” and said he’s encouraged by the federal government’s commitment to change. But he also echoed McCormick’s views on needing a better, more preventative approach in the short-term.
“This issue has been around for years,” Bellegarde said. “We’re always really reacting, and there is not a hell of a lot of proactivity that’s going on … that’s where we’ve really got to pick up our socks.”
With files from Andrew Russell.