Nunavut suicide Inquest: GN delays can't be 'morally justified'

Psychologist Brian Mishara made an impassioned plea Friday for improved suicide prevention funding at a coroner's inquest into the high rate of suicide in Nunavut. 

Over the past week, a slew of experts, government officials, family members and RCMP officers have testified about the devastating effects of suicide on the community and what more they think should be done. 

"I get very upset when I hear government and others saying 'well, we have other priorities' and 'it's a long process,'" testified Mishara, the inquest's final expert witness.

"If my daughter was in danger, I'd spend every penny I have to save her life."  

Over the course of ten years, Mishara says his home province of Quebec made suicide prevention a political priority and "dramatically decreased" a rate of suicide that was, in 1999, the highest among Canada's provinces. 

While he said he is not promoting Quebec as a "success story," Mishara suggests it does show the difference it can make when a government promises change.

"This is not something that can be morally justified to put off." 

'You can change it. And you should change it.'

Mishara agreed with earlier expert witnesses who said Nunavut's suicide prevention strategy is "a very impressive document" — even a gold standard. 

But when it come to implementation, Mishara agreed with a recent review from an independent consultant. 

Those who are trying to save lives with a prevention strategy cannot be bogged down by government bureaucracy, he argued.

"My recommendation would be to have a person who is in charge of suicide prevention and who has the resources and the mandate." 

Mishara, who directs the Centre for Research and Intervention on Suicide and Euthanasia, championed various prevention techniques like including "social coping" skills in school curricula and implementing "systematic and proactive" follow-up for every person who attempts suicide in the territory. 

Drawing on his knowledge of mental health programs in Africa and around the world, Mishara also renewed calls to create more Inuit-specific guidelines.

"What I've heard is that 'according to the Mental Health Act I can't inform the family when someone comes to hospital,'" said Mishara. 

"The Mental Health Act is a Nunavut Mental Health Act and you can change it. And you should change it."

Earlier last week, elder Shuvinai Mike told the court her daughter had gone to the hospital several times before taking her own life, but she was never informed. 

Mike shared her frustration with privacy rules that kept the hospital from contacting her, saying family should always be involved. 

Mishara agrees. 

"If your [culture's] values are that saving people's lives are more important than respecting the ability to make an individual decision then you say 'Well, I'm sorry. Saving your life is more important than allowing you to make that decision yourself.'"

Coroner's office presses for commitments

When each of the three expert witnesses testified this week, they submitted a full list of recommendations for action on suicide prevention. 

The court has also reviewed the 42 recommendations from the review of the suicide prevention strategy.

So when the health department's Assistant Deputy Minister of Operations took the stand, a lawyer for the coroner's office pressed her to commit to a timeline for changes to be made. 

"The Government of Nunavut is committed to working on suicide prevention and the Nunavut suicide prevention evaluation report is going to be one of the factors into the work that's going to continue," testified Rosemary Keenainak.

She said the government is planning to look into these recommendations within the next few weeks, but she can't predict when any proposed changes will be seen by Nunavut's Legislative Assembly.

"We can make some recommendations at a bureaucratic level, but that has to be approved by cabinet," she said. "At my level, I can't approve a policy." 

That wasn't enough for Sheldon Toner, a Yellowknife-based lawyer representing Nunavut's coroner.

"I'm looking for the government's position, because I understand you're the most senior government official who will be at this inquest."

Toner asked that Keenainak answer why the government hasn't further implemented the territory's suicide prevention action plan. 

He also asked if she would commit to a series of recommendations from the inquest's first week of testimony — from improving grief counselling to compiling data for researchers on the number of people who attempt suicide. 

"I'm not an expert on mental health and addictions," she argued, mentioning at several points that she only knows so much about the history of the strategy, because she began in her position only two years ago. 

"I appreciate you weren't here for certain things, but you're here now," said Toner. "You're responsible now."

'Every kid's at risk'

The long week of testimony wrapped up with another emotional story from a Nunavut employee who regularly deals with Inuit youth. 

Pascale Baillargeon is currently a teacher at Iqaluit's Inuksuk High School, but worked in nearby Kimmirut, pop. 455, for many years. 

Baillargeon had only recently moved to Kimmirut to serve as one of two teachers at the community's first high school, when the community experienced a tragedy. 

"We had two [teenagers take their own lives] in June about a week apart and one later in the summer." 

Baillargeon had only taught one of those first two teenagers, but since "everybody knows everybody," she was deeply affected by the deaths. 

Baillargeon was asked if there were warning signs: "In retrospect, yes. At the time, no."

"I've come to believe every kid's at risk."

If you are feeling suicidal you can call the Kamatsiaqtut Help Line. It is anonymous and confidential: (867) 979-3333 or (800) 265-3333. You can also call the Kids Help Phone to speak to a counsellor: 1-800-668-6868.