Nunavut should declare state of emergency over suicide crisis

On May 18, 2013, after responding to the suicide of a 13-year-old girl in Pangnirtung, Nunavut's chief coroner pleaded for help from the territory's minister of health and senior bureaucrats.

"It is time to declare a state of emergency," Padma Suramala wrote in an email sent to Health Minister Keith Peterson, Justice Minister Daniel Shewchuk and others. After working for 13 months straight, and dealing with nine suicides in the previous month, and five that month alone, the coroner described herself as devastated and disheartened.

Before she wrote the email, she spent a sleepless night agonizing over what brought a 13-year-old to the decision to die "before even experiencing her life."  

"We have reached a breaking point and our community is under crisis," Suramala wrote in the email, obtained through an access to information request. "I leave it in your best hands to make the decision of calling [a] state of emergency … and bring awareness of available resources to Nunavummiut."

Nothing happened.

On Friday, a jury at the inquest Suramala called into the record number of deaths by suicide in 2013 agreed with the coroner's assessment of the severity of the crisis.  

• Nunavut's suicide crisis prompts pleas for action
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After hearing from more than 30 witnesses, including the families of two Nunavummiut who took their own lives, the six-member jury urged the territory to declare suicide in Nunavut a public health emergency.

Nunavut should also appoint a minister responsible for suicide prevention at the next legislative sitting, and create a secretariat with the resources "to demonstrate the government's commitment to this crisis" by April 2016, the jurors recommended.

The recommendations are long overdue. The question is why territorial leaders have not already treated suicide the way they would a lethal, virulent infection — like Severe Acute Respiratory Syndrome (SARS), or H1N1 — and why they haven't reached out for help from the federal government and the rest of Canada.  

In 2003, during the SARS crisis, centred largely within Toronto, 44 people died. That's one fewer than the 45 who completed suicide in Nunavut in 2013 alone. Since the territory was created in 1999, 479 Inuit have killed themselves. The collateral damage that suicide inflicts means every one of the territory's 36,000 residents has been devastated by the trauma — including the candidates for the three major parties in this federal election.

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During both H1N1 and SARS, the federal and provincial governments poured experts and resources into containing the viruses. While suicide is not an airborne infection, it does, many researchers have argued, have a contagious effect. Nunavut, where suicide is so normalized some people think it impossible to prevent, exemplifies that contagion.

Startling suicide numbers

Inquest testimony from health, education and family services officials made it abundantly clear the Nunavut government has not, so far, been able to bring to bear the financial or human resources required to reduce a suicide rate 10 times that of the national average. Those statistics are startling enough — but in the case of Inuit boys 15 to 19, the suicide rate is 40 times higher than those of their peers in the rest of Canada.

Many Nunavummiut work hard to prevent suicide, despite the trauma, grief and loss that overwhelm them.

Throwing money at this complex problem is not the sole answer. It would indicate a level of commitment and priority that so far seems lacking from territorial and federal leaders.

In May of 2013, when Suramala wrote her email, current Conservative candidate Leona Aglukkaq was the federal minister of health and a key cabinet minister. Had they wanted to, it should have been easy for the recipients of Suramala's email to reach out to Aglukkaq. She could not help but be aware of the depth of the crisis affecting her constituents — and her family and friends.   

Canada has an Emergency Management Act, and an Emergency Management Framework. If any province or territory requires "resources beyond their capacity to cope in an emergency or disaster," Ottawa responds rapidly, the framework states. It also makes clear there is a federal role in the prevention of emergencies.

The inquest laid bare the territory's lack of capacity to cope with suicide. But to trigger federal help, a territory has to ask.

It's hard to conceive of a greater disaster than Nunavut's suicide rates and the underlying risk factors. The inquest exposed all of these — from the effects of historical trauma and its symptoms to the high rates of child sexual abuse, alcohol and drug use, poverty, high school dropout rates, and the cultural losses brought about by residential schools and forced relocations.

Suicide prevention should be an urgent issue, during this election campaign and beyond. To his credit, NDP candidate Jack Anawak has called for action. But at an economic forum held in Iqaluit while the inquest was underway, none of the candidates — including Aglukkaq — addressed the staggeringly high socio-economic costs of suicide.

Nunavummiut can make suicide prevention an election issue now. They must push their governments to contain this public health emergency. If the territorial leaders can't — or won't — ask for help, then Ottawa and public health officials must offer, before more lives are lost.