The topic of my essay is the suicide rate among young Indigenous people in the Arctic region of Canada, which encompasses Nunavut, Inuvialuit, Nunavik and Nunatsiavut. Suicide is one of the leading causes of death among youth worldwide. However, Indigenous populations consistently have a disturbingly higher rate of suicide per capita than average. The objective of this essay is to answer the following questions: What are the main reasons for young Inuit to commit suicide and what could the government do to resolve it? My thesis is that the high rate of suicide links to the social and economic challenges of the Inuit, which might increase the risk of substance abuse and in turn exacerbate pre-existing mental disorders. Other aspects, such as the harsh conditions in which they live, and the lack of adequate mental healthcare, also play an important role.
I conclude that the main reasons behind the high rate of suicide among young Indigenous populations are prolonged and untreated mental health issues, caused by childhood abuse, alcohol or drug dependence. Personality disorders, depressive disorders and inclination towards aggressive and impulsive behavior are the most common diagnoses of people who take their own lives. These pathologies root deeply in the historical development of the region and reflect the social and economic inequality with which the Inuit struggle.
Statement of Problem/Background
According to the World Health Organization (WHO), almost one million people take their own lives a year and thus it is one of the leading causes of non-violent death in the world (see Chachamovich and Tomlinson, 11). Inuit regions suffer from a much higher rate of suicide than the rest of Canada. While the national average is 11.3 suicides per 100 000 inhabitants, Inuvialuit is 60.4, Nunavik is 113.5, Nunavut is 116.7 and Nunatsiavut is a shocking 275.3 suicides per 100 000 inhabitants (see Inuit Statistical Profile, 18). However, the issue of suicide is not exclusive to the Canadian Indigenous peoples. We can see similar rates among Australian Aborigines, New Zealand Maori, and US Native Americans.
The psychological autopsy by Eduardo Chachamovich and his team discovered a high prevalence of psychiatric disorders among the Inuit, compared to the rest of the Canadian population. They combined the results from psychopathology with plausible effects of early life adversity, which are both risk factors for suicide. Chachamovich and his team concluded that suicidal behavior is mainly influenced by a major depressive disorder (a factor exhibited by 60.8% for subjects) and various personality disorders (borderline – 20.53% and antisocial – 15.17%, avoidant – 9.83%). Among other factors is the history of a person´s childhood (whether she/he was a victim of abusive or violet behavior), occupational status and substance abuse or dependence (alcohol – 44.1%, cannabis – 59.1%). These results correspond with findings from comparable studies regarding suicide among general and young populations.
Michael Kral from Wayne State University identified the key reasons behind suicidal behavior among the Inuit as depression and substance use. He traced these pathologies to the colonization era – a time which Kral calls “the most hurried and extreme event in Inuit History.” During those times, Indigenous peoples were forced to leave their lands, abandon their traditional way of life and stay in permanent settlements. The Inuit had to send their children to infamous residential schools, where they were subjected to harsh treatment in a foreign environment, with the ultimate goal of assimilating them into the mainstream society and annihilating their Inuit identity.
This radical change took a toll on the mental health of children and youth, who went through the system. Years of trauma, physical and emotional abuse, feelings of shame, neglect and abandonment in early life resulted in thousands of cases in mental health problems, in some ways resembling the post-traumatic stress disorder (PTSD). These symptoms among the survivors of the residential school system are thus known as “residential school syndrome”. After they left the schools, Indigenous people often struggled with alcohol and drug abuse, depressions and feelings of hopelessness, alienation and suicide behaviors. Elias et al. points out that in the research among Indigenous people who attended the schools, 48.1% reported a history of abuse, 26% admitted suicidal thoughts and 14% attempted suicide (see page 1561).
In the past, there were several attempts to analyze high suicide rates among the Inuit, usually from a medical standpoint, that tried to frame the issue as some sort of epidemic. These efforts proved only of limited use. Suicide prevention programs were flawed and exhibited lack of understanding for the reasons that Indigenous people resorted to suicide. More recently the government turned to a more complex model. It places emphasis on cooperation between the federal, provincial and local governments, while also engaging Indigenous communities, organizations and governments along with academics and researchers.
The Nunavut Suicide Prevention Strategy
One such example is the 2010 Nunavut Suicide Prevention Strategy, which brought together The Government of Nunavut, Nunavut Tunngavik Inc., the Embrace Life Council and the Royal Canadian Mounted Police. Its goal is working together to prevent suicide in Nunavut. The strategy consists of eight commitments, which are designed to tackle the issue of suicide among Inuit youth. It seeks to promote suicide prevention by launching public campaigns against psychical and sexual assault. These campaigns spread awareness among teachers and parents and provide them with training on how to engage troubled kids or teenagers, so they can identify suicidal behavior early (see page 18). Another goal is to improve the opportunities for youth to grow and develop themselves, but also to cope with their negative emotions, such as anger management sessions, counseling and special sports training camps (see page 20).
The plan also seeks to strengthen mental health services by increasing and improving medical facilities in Inuit regions, so they can provide full range of services from maternal care to counseling, diagnosis, treatment and even clinical care. The goal is to improve accessibility of mental health care with regard to cultural appropriateness. The Government of Nunavut already pledged to revise its Mental Health Strategy and to review the Mental Health Act (see page 17 and 20). An important part also lies in obtaining detailed knowledge about the problem of Indigenous suicide. The partners of the Nunavut Suicide Prevention Strategy committed themselves to support further research and information in this area, sharing among themselves but also with the Inuit representatives on local levels to better understand the issue and to cultivate better-addressed policies (see page 19 and 20).
Even though there is a consensus among the politicians and scholars over the necessity to tackle the problem of suicide, there are only a few programs designed to help troubled youth. The current programs, such as the Nunavut Suicide Prevention Strategy, or the National Aboriginal Youth Suicide Prevention Strategy (NAYSPS), launched in 2005 by Health Canada as a 5-year program with a budget totaling $65 million, subsequently extended and received additional $43 million, are showing promising results. However, they are still struggling with the lack of funds, required to cover such vast territory with highly dispersed population. Other possible shortcoming of these programs is the lack of participation of local communities in the drafting process and data analysis, which limits the evaluating capabilities of governing bodies and hampers proper performance measurement of the programs.
- Promoting Opportunities
For any person in life, it is important to have something to live for, some goal and ambition. The government should strive to create more job and development opportunities in the Northern regions. Inviting investors who would create jobs and education opportunities in the region ravaged with unemployment (14.8% in 2018) would give the youth a chance for a better life and would foster the growth of the whole communities.
- Promoting Mental Health
The most important aspect in suicide prevention is metal health. To achieve this, the government can expand campaigns to promote the initiatives on raising mental health awareness and facilitating the access to mental health care in Indigenous communities. One such proposal would be more extensive and intensive use of e-health, which could increase the quality and availability of the mental health care in remote areas. The network would facilitate information sharing and perhaps help local doctors to correctly diagnose a mental illness. Software would be also more effective in preventive care and in analyzing patient’s data and thus more capable of identifying risky patients, who in turn could receive help before their mental state deteriorates. There is evidence that e-health helps to increase the quality of care in other fields, so it would be logical to extend it to the mental health care.
- Promoting Cooperation
We need to be cautious applying the western-style of psychological or medical approaches to Indigenous people. We must consider regional and tribal specifics and take into an account community-wide trauma, such as colonization, relocation and forced assimilation if we are going to devise a policy or an approach that might prove helpful and deter the Inuit from committing suicide. Therefore, it is important to engage Indigenous communities even more than today. The Nunavut Suicide Prevention Strategy may serve as a model of an effective way to prevent more people from taking their lives. The government might consider a broader initiative, which would bring together Indigenous peoples, government officials and experts from medical and sociological fields.
I argue that the Canadian government should consider all three proposals mentioned previously and devise an effective combination of said approaches with a consideration of budgetary and infrastructural aspects. It is my belief that the issue of high suicide rate among the Indigenous peoples is too complex for one actor or one approach to solve. Therefore, I advocate for a creation of a broad coalition that would include government officials from the federal, state and local level, representatives of the Indigenous peoples, academics and experts from relevant fields and business representatives. Only then there is a hope of devising an equally complex strategy, capable of tackling the socioeconomical problems that are having a disruptive effect on the Indigenous communities ultimately leading to the high suicide rate with respect to their heritage and traditional culture.
Brasfield, Charles, (2001) „Residential School Syndrome“, British Columbia Medical Journal, 43:2, p. 78-81, online at: https://www.bcmj.org/articles/residential-school-syndrome (accessed: 05/23/2019).
„Canada’s Residential Schools: The Inuit and Northern Experience: The Final Report of the Truth and Reconciliation Commission of Canada“, (2015) Truth and Reconciliation Commission of Canada, McGill-Queen’s University Press, Vol. 2, http://www.jstor.org/stable/j.ctt19rm9tm (accessed: 05/24/2019).
Chachamovich, Eduardo and Monica Tomlinson, (2013) „Learning From Lives That Have Been Lived: NUNAVUT SUICIDE FOLLOW-BACK STUDY 2005‐2010“, Douglas Mental Health University Institute, Montreal, Quebec Canada 56p, SIEC No: 20130932, online at: https://www.suicideinfo.ca/resource/siecno-20130932/ (accessed: 04/28/2019).
Chachamovich et al., (2015) „Suicide Among Inuit: Results From a Large, Epidemiologically Representative Follow-Back Study in Nunavut“, Canadian Journal of Psychiatry, 60:6, DOI: 10.1177/070674371506000605, online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501584/ (accessed: 04/27/2019).
Elias et al., (2012) „Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada’s residential school system“ Social Science & Medicine, 74:10, p. 1560-9, DOI: 10.1016/j.socscimed.2012.01.026, online at: https://www.sciencedirect.com/science/article/pii/S0277953612001426?via%3Dihub (accessed: 05/07/2019).
Hicks, Jack (2007) „The social determinants of elevated rates of suicide among Inuit youth“, Indigenous Affairs, vol. 4, ISSN: 1024-3283, online at: https://www.iwgia.org/images/publications/IA_4_07.pdf#page=30 (accessed: 05/08/2019).
„Inuit Statistical Profile 2018”, (2018) Inuit Tapiriit Kanatami, ISBN: 978-1-989179-00-0, online at: https://www.itk.ca/wp-content/uploads/2018/08/Inuit-Statistical-Profile.pdf (accessed: 04/28/2019).
Kral, et al., (2009) „Canadian Inuit community engagement in suicide prevention“, International Journal of Circumpolar Health, 68:3, p. 292-308, DOI: 10.3402/ijch.v68i3.18330, online at: https://doi.org/10.3402/ijch.v68i3.18330 (accessed: 04/27/2019).
Kral Michael J., (2016) „Suicide and Suicide Prevention among Inuit in Canada“, Canadian Journal of Psychiatry, 61:11, p. 688–695, DOI: 10.1177/0706743716661329, online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066555/ (accessed: 04/28/2019).
„Nunavut Quick Facts“, Nunavut Bureau of Statistics, online at: http://www.stats.gov.nu.ca/en/home.aspx (accessed: 05/07/2019).
„Nunavut Suicide Prevention Strategy“, (2010) ed. by Health and Social Service, online at: https://www.gov.nu.ca/sites/default/files/files/NSPS_final_English_Oct%202010(1).pdf (accessed: 05/08/2019).
Pollock et al., (2018) „Global incidence of suicide among Indigenous peoples: a systematic review“, BMC Medicine, 16:145, online at: https://doi.org/10.1186/s12916-018-1115-6 (accessed: 04/27/2019).
Pollock, Nathaniel J., (2018) „Tracking progress in suicide prevention in Indigenous communities: a challenge for public health surveillance in Canada“, BMC Public Health, 18:1320, online at: https://doi.org/10.1186/s12889-018-6224-9 (accessed: 05/24/2019).
Redvers et al., (2015) „A scoping review of Indigenous suicide prevention in circumpolar regions“, International Journal of Circumpolar Health, 74:1, DOI: 10.3402/ijch.v74.27509, online at: https://doi.org/10.3402/ijch.v74.27509 (accessed: 04/28/2019).Shain, Benjamin, (2016)
„Suicide and Suicide Attempts in Adolescents“, Pediatrics, 138:1, online at: https://pediatrics.aappublications.org/ content/138/1/e20161420 (accessed: 05/22/2019) Turecki, Gustavo and David A. Brandt, (2016) „Suicide and suicidal behaviour“, The Lancet, 387:10024, DOI: 10.1016/S0140-6736(15)00234-2 (accessed: 05/22/2019).
Webster, Paul, (2017) „Northwest Territories leads Canada in electronic medical record coverage“, CMAJ, 189:47, DOI: 10.1503/cmaj.109-5511, online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703686/ (accessed: 05/07/2019).