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Inuit Approaches to Suicide Prevention
Suicide is among the 10 leading causes of death in Canada. Inuit suicide rates are more than 11 times higher than the Canadian rate, according to Health Canada. And 83% of these are people under 30 years of age.
Communities are working with Inuit organizations, governments and non-government organizations in the four Inuit Land Claim Regions, to increase supports for coping, promote resiliency and raise awareness, so Inuit know where to go for help and how to help when asked. This backgrounder describes some of these activities taking place in Inuit communities; some facts about Inuit in Canada; Inuit suicide rates, protective factors and causes of suicide; and provides some information for assistance and funding.
Inuit in Canada
There are approximately 55,000 Inuit living in Canada, according to recent estimates from Statistics Canada. The majority of Inuit (over 80%) live in 53 communities spread across two provinces and two territories. Over 90% of these communities are accessible by air only. Inuit communities are located in four Land Claim Regions:
- Nunatsiavut (Labrador)
- Nunavik (Northern Quebec)
- Nunavut Territory
- Inuvialuit Settlement Region (Northwest Territories)
- Inuit also live in southern Canada.
The Inuit population is the youngest in Canada, with 39% under the age of 15; in Canada, 19% are under age 15. Not only is the Inuit population very young, it is growing a rate of 12.1% in the years 1996-2001, compared to the rate of 3.9% for the entire population of Canada.1 The youth and the growth rate of the population impact on health issues, capacity and needs of Inuit when compared to other Aboriginal groups and the rest of Canada.
Suicide in Inuit communities2
According to 2001 Census data, the national Inuit suicide rate is 135 per 100,000 population, or more than 11 times higher than the overall Canadian rate of 12 per 100,000 population. It is not possible to cite a national suicide rate for Inuit as provincial death certificates do not identify ethnicity. Health Canada estimates the following suicide rates for Inuit regions from1999 to 2003:
- Nunavik – 181 per 100,000
- Nunatsiavut – 239 per 100,000
- Nunavut – 120 per 100,000
- Inuvialuit – 61 per 100,000
85% of Nunavut suicides are males, the majority in the 15-24 age range. In one Nunavut region, from 1999 to 2003, young Inuit men between the ages of 14 and 24 committed suicide at an annual average rate of 280 per 100,000. 3 These tragically high figures appear to be on the increase, and the average age is dropping. The number of suicide deaths in Nunavut and Nunavik has more than doubled in the past decade.4
While the suicide rate for Inuit women is lower than for Inuit men, it is far above the 2001 Canadian average of 4.9 per 100,000. The rate for Inuit women in Nunavut in 2001 was 24.6 per 100,000 and in Nunavik, 52.4 per 100,000.5
Protective Factors
The NAHO Ajunnginiq Centre’s 2006 report on suicide prevention drew on the traditional knowledge of Elders in each of the four Inuit regions. Inuit elders believe the coping and resilience skills and values they used in the past are just as necessary in today’s world, including patience; perseverance; love and caring; communication; awareness of self and others; confidentiality and respect for others; and personal responsibility to youth. They identified certain coping skills as especially important in Inuit culture:
- Paying attention to each other’s needs
- Focusing on helping others as a way of promoting connection and a sense of usefulness
- Doing something productive, active and healthy
- Talking things out
- Solving conflicts with others, and
- Accepting that life is not always easy but that tomorrow can be better
Another study underway is Qaujivallianiq inuusirijauvalauqtunik, an Inuit-specific, comprehensive, territory-wide follow-back study to collect and analyze 300 Inuit life stories, including 100 people who have never attempted suicide, 100 who have, and 100 who completed suicide. The purpose is to better identify risk factors and assist in developing more effective prevention approaches. The study was designed by a reference group, including the Embrace Life Council, RCMP, Nunavut Tunngavik Incorporated (the Inuit Land Claim organization), the National Inuit Youth Council, the Government of Nunavut and the clergy, with the McGill Group for Suicide Studies.
Causes of Inuit suicide
Some common factors exist in Aboriginal suicides6; however, some factors are specific to Inuit:
- Lack of coping skills (relationship break-ups frequently trigger suicides by Inuit youth);
- Barriers or lack of access to mental health treatment;
- Loss of control over land and living conditions;
- Socio-economic factors in the community7 (non-medical determinants) including:
- high poverty rates; in 2001, the average personal Inuit income was only 66% of the average Canadian’s personal income, although food may cost from 2 to 3 times more than in Southern Canada
- housing problems: in 2001, 20% of Inuit households were crowded, compared to less than 2% of non-Aboriginal Canadians
- low levels of education and literacy; only ½ of Inuit have completed high school
- lack of employment: in 2006 only 37% of Inuit were satisfied with job opportunities in their communities; in 2001, unemployment rates for Inuit men were nearly 30% higher than for other Canadian men
- Inadequate sanitation and water quality; in one region, over 40% of Inuit consider their drinking water unsafe year-round
- Intergenerational trauma resulting from historical events, for example:
- forced relocations to permanent settlements which ended nomadic life and in some cases, separated extended families completely
- sled-dog slaughters impaired Inuit hunters’ abilities to provide for their families and obliged them to remain in settlements
- enforced boarding school attendance or lengthy treatment for tuberculosis or other illnesses in hospitals in southern Canada, caused damage to family relationships through separation and language loss
- Loss and/or changes to values, beliefs and lifestyle from various causes; for example, climate change leaves Inuit hunters unable to trust their traditional methods of predicting weather and animal migration patterns;
- Individual history (e.g. experiencing traumatic events such as the early loss of a parent; sexual abuse; experiencing or witnessing violence, etc.);
- Alcohol is frequently cited as a major factor in Aboriginal suicides. However, the Nunavut coroner’s report for 1999-2003 and the coroner’s data cited in the Health Canada Northwest Territories study for 1994-1996 both report that in the approximately 80 per cent of suicide deaths in which toxicology testing was possible, alcohol was not a factor in approximately 70 per cent of cases;
- Family or caretaker history of suicide, or suicide “clusters”, where a number of suicides occur over a short time period.
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3. Origins of Suicide: Individual Vulnerability and Resilience.............................................................33
Psychiatric Disorders........................................................................................................................................34
Previous Suicidal Ideation and Attempts.......................................................................................................36
Alcohol and Substance Use.......................................................................................................................38
Gambling.....................................................................................................................................................40
Developmental Factors.....................................................................................................................................40
Temperament and Personality Traits......................................................................................................41
Fetal Alcohol Effects..................................................................................................................................41
Parenting and Child Rearing.....................................................................................................................41
Childhood Separation, Loss, and Family Disruption...........................................................................42
Childhood Physical and Sexual Abuse....................................................................................................43
Hopelessness, Problem Solving, and Reasons for Living.............................................................................44
Sexual Orientation............................................................................................................................................46
Interpersonal Factors........................................................................................................................................47
Physical Environment......................................................................................................................................48
Resilience............................................................................................................................................................49
Table of Contents
iv
The Interaction of Risk and Protective Factors.............................................................................................51
Summary............................................................................................................................................................54
4. Origins of Suicide: Social Suffering and Survival..............................................................................55
Social Structure and Economy........................................................................................................................55
Poverty and Unemployment....................................................................................................................56
Reserves, Settlements, and Urban Settings.............................................................................................57
Incarceration...............................................................................................................................................57
Family and Religion...................................................................................................................................57
Social Disorganization and Traditionalism............................................................................................58
Cultural-Historical Factors.............................................................................................................................59
Culture Change, Modernization, and Acculturation....................................................................................61
Acculturation..............................................................................................................................................61
Education....................................................................................................................................................64
Forced Assimilation...................................................................................................................................65
The Impact of the Residential School System...............................................................................................65
Sexual Abuse in Residential Schools.......................................................................................................67
Communities Without Children.............................................................................................................68
Intergenerational Effects of Residential Schooling................................................................................69
Linking Residential Schools to Suicide...................................................................................................70
The Child Welfare System and Systematic Out-Adoption.........................................................................72
The Extension of Child Welfare to Aboriginal Communities.............................................................73
Impact of the “Sixties Scoop”.....................................................................................................................75
Cultural Continuity, Community Wellness, and Collective Identity.........................................................76
Summary............................................................................................................................................................78
5. What Works in Suicide Prevention?.....................
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