Auditor calls for improvement in northern Saskatchewan suicide prevention

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WATCH: Saskatchewan's auditor calls for improvements to suicide approach – Dec 5, 2019

Northwest Saskatchewan consistently has a higher suicide rate than the rest of the province, according to the Saskatchewan Coroner’s Office.

Saskatchewan’s auditor is recommending eight areas where health care providers in the north can better address patients at risk of suicide.

Judy Ferguson found that health care providers in northwest Saskatchewan generally don’t receive “sufficient training on caring for suicidal patients, and training varies significantly.”

READ MORE: Saskatchewan First Nation calls for long-term solution to youth suicide crisis

Ferguson noted staff at Battlefords Union Hospital received online training for mental health and suicide screening. However, the staff at other emergency departments visited by the auditor’s office did not receive this training.

Communities visited in the review include North Battleford, Lloydminster, Meadow Lake and La Loche.

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Recently, three young people in the northwestern community of Makwa Sahgaiehcan First Nation​ died by suicide. The youngest was a 10-year-old girl.

At-risk patients typically access health services through emergency rooms or mental health outpatient departments.

The auditor found that in three of the 23 examined files, ER staff did not provide high suicide risk patients with a psychiatric consultation prior to being discharged. Additionally, ER staff did not refer patients to mental health outpatient services for follow-up appointments.

Ferguson said proactive follow-up care helps promote continuity of care and can reduce the rate of patients who have attempted suicide from re-attempting.

Rural and Remote Minister Warren Kaeding said the province is taking steps to enhance suicide prevention resources in the north and across the province.

“We’re looking right now at doing an inter-jurisdictional scan, and that’s scanning all the provinces and territories, to look at what they have incorporated into their initiatives, policies and certainly not precluding the [Federation of Sovereign Indigenous Nations]’ strategy as well,” Kaeding said.
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This scan is an ongoing process with no fixed end date, according to Kaeding.

Opposition Leader Ryan Meili took issue with falling back to the scan of suicide strategies.

“Action is exactly what we’re asking for and it’s what we’re not seeing. We saw the premier get up last week and say we’re checking to see if there are gaps. There are clearly gaps. The rate of suicide in northern communities is much higher than the rest of the province,” Meili said.

Prior to talking to reporters, Kaeding said he looked at the 25-page report “briefly” to understand some of the key recommendations. He was waiting on his staff to prepare a briefing on the remainder of the report.

“Certainly the officials who are working on the ground and those are the ones that we need to make sure fully understand and work with the recommendations in there,” Kaeding said when asked why he hadn’t read the full report.

“My role is to then follow up with officials and make sure that we’ve got all the tools.”

Kaeding later said he would read the report himself, in detail, and ask officials to put forward their thoughts as well.

READ MORE: ‘I’m scared, I can’t sleep’: northern Saskatchewan communities call for help

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The auditor also found issues with the Saskatchewan Health Authority (SHA) not having a formal process to follow up with patients who poorly utilize services provided via scheduled telehealth appointments. Missed telehealth appointment rates are close to 50 per cent most years, according to the report.

Many small northern communities rely on telehealth for psychiatric appointments as there are staffing shortages of these health care providers in small centers.

For patients in smaller communities, the need to access mental health services in larger centres is common. For instance, the report says 51 per cent of patients treated in North Battleford’s mental health inpatient services were from outside the Battlefords in 2018-19.

Kaeding said he accepts all of the recommendations put forward by the auditor, saying there are few surprises as these are ongoing issues in healthcare.

“We need to continue to put resources toward this and engage with our northern communities and our First Nations stakeholders, as well as all our healthcare professionals in the north to make sure we understand and work toward strategies that are going to be effective into the longterm,” Kaeding said.

The northwestern suicide rate in 2018 was 28.7 per 100,000 people. The provincial rate in the same time frame was 18.7. This is above the Canadian average of roughly 11 suicides per 100,000 people.

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The report says the suicide rate in the northwest is highest among children, youths and young adults. For men, the suicide rate is highest among those aged 20- to 29-years-old. For girls, the suicide rate is highest among 10- to 19-year-olds.

SHA response

Richard Petite, SHA’s executive director for primary health care for the northwest, said the authority accepts and plans to implement all recommendations.

Some of the inconsistencies between hospitals, he said, are a result of 12 health regions amalgamating into a single health authority two years.

“Different processes have been implemented in different areas, and now we’re looking at standardizing and being consistent,” Petite said.

When it comes to suicide training, Petite said mental health therapist and addictions workers enter the workforce trained. All staff’s suicide training needs will be assessed and delivered by next summer, Petite said.

Currently, the SHA is providing six mental health workers on a daily basis for Makwa Sahgaiehcan First Nation. Roughly 90 to 100 suicide risk assessments have been completed.

Click to play video 'Makwa Sahgaiehcan chief criticizes government response to suicide crisis' Makwa Sahgaiehcan chief criticizes government response to suicide crisis
Makwa Sahgaiehcan chief criticizes government response to suicide crisis – Nov 27, 2019

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

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The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.