Attawapiskat: Suicide isn’t a ‘big mystery’ – lessons from successful suicide prevention strategies

Natan Obed watched members of Parliament debate suicide in Indigenous communities for hours, and was frustrated by what he heard.

“It’s obvious that there are people who care,” said the president of Inuit Tapiriit Kanatami (ITK), a national organization representing Inuit. But he didn’t hear concrete solutions or the political will to methodically tackle the problem, he said.

“As the debate unfolded in the House of Commons, you just hear over and over again, the solutions that our members of Parliament are coming up with have nothing to do with the foundation and the environment and the life course of all of these people at high risk of suicide.”

READ MORE: Indigenous affairs minister gets earful on visit to Attawapiskat

The suicide rate in Nunavut was 63.5 per 100,000 people in 2012, according to Statistics Canada – much higher than Canada overall at 10.4.

And since the suicide rate among Inuit has been elevated since the 1970s, pretty much everyone has been personally affected by suicide, including him. “Many of my teammates, some of the kids that I’ve coached, my very close cousin. I have so many different people that I can think of. Just when you ask the question, that floods me with memories of those that aren’t with me, with our community anymore.”

“Each one of us from the time we’re teenagers are saturated with suicide, suicide attempts and the effects of completed suicides on our lives – whether they are friend or our family members, they leave an indelible mark on who we are. This sort of reality is something I don’t think many people, many Canadians realize.”

This is why he wants to hear about solutions and come up with a clear plan to fight suicides in Inuit and other Indigenous communities. One good place to start, he thinks, is looking at what has worked in other communities.

“It isn’t necessarily that suicide interacts with this culture or our society in a fundamentally different way than it would affect any society,” he said. “The overarching idea of why suicide happens and how to prevent suicide is fundamentally universal. We’re dealing with risk factors for suicide and we also want to ensure that we have resilience factors that protect against suicide.”

Suicide prevention in Quebec

He points to Quebec as an example of success.

The suicide rate in Quebec rose every year beginning in the 1960s up until 1999 – right as the province introduced a comprehensive strategy to combat suicide. It’s fallen nearly every year ever since.

“The youth suicide rate for example, ten years later, was half of what it was in 1998,” according to Brian Mishara, director of the Centre for Research and Intervention on Suicide and Euthanasia at the Université du Québec à Montréal, and one of the people who drafted the strategy.

“It’s an impressive turnaround. The only unique explanation for this change at that point in time is that at that time Quebec initiated a series of actions in suicide prevention.”

The Quebec government did things like create a 24-hour crisis telephone line and developed suicide prevention training programs. A three-day training program for doctors, mental health professionals and social workers was taken by 30,000 people, he said. Another program helped to train people in workplaces, educational institutions and elsewhere to identify people at risk and refer them to help. There was also better follow-up with people after suicide attempts.

All of these programs helped to address suicide risks and combined, they helped. “Suicide is multi-determined. There’s no simple cause. And there’s no single simple solution, but you can do many things, each of which will contribute to decreasing the suicide rate,” he said.

“Suicide is preventable.”

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“Suicide prevention involves really looking at all of the risk factors that are present and doing everything possible to diminish those risk factors,” he said. And Indigenous communities have a combination of high risk factors, and fewer of the resilience resources that can help people cope.

READ MORE: Indigenous leaders offer solutions to suicide epidemics

Some of the risk factors in Inuit communities include high rates of physical and sexual abuse, food insecurity, overcrowded homes, poor educational attainment and few mental health services, said Obed.

“This isn’t some big mystery,” said Mishara. “You take young people and you put them in a situation where they have almost no hope of getting a job and earning a livelihood and having a meaningful life in the same sense as people aspire to everywhere in the world.”

The good news is, the problems are fixable. “It’s just a matter of starting to address them. As soon as improvements are made, hope increases within a community.”

Dedicating resources

Obed said he is often asked how to prevent suicide. “The question that I’m really being asked is ‘Without the necessary resources that just about any society would need to prevent suicide, how do you propose we prevent suicide for Inuit?’”

“It’s almost like asking for magic.”

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The government treats Indigenous suicide differently, he said, partly because it’s not a political vote-winner, and also because Indigenous people are still struggling for equality and investments in Indigenous communities are often seen as wasted money.

“If the government of Canada wanted to treat Indigenous suicide the way it treats any other crisis in public health or in health care in general, then we would be well on our way toward solving this.”

The government should work with Indigenous communities to adapt solutions that have worked elsewhere, he said.

One good place to start would be meeting “basic human needs” like drinking water and better housing, said Mishara.

Obed said ITK is working on a suicide prevention strategy to be released this summer. Eventually, he would like to see strategies to improve education, housing and health care as well as investments to help identify those at risk and help people who have attempted suicide.

“This is a point in time where we can make a difference, but we can only make a difference if we start having a mature conversation about this as a public health crisis and not as an Indigenous suicide issue,” he said. “Once we start labelling it and thinking of it in the way we would think about any other health issue, only then can I think people will start to realize that we can do something and this isn’t something that is just our problem.”