Breaking the cycle: How northern Saskatchewan is rallying to end suicide

It was a case in point nobody wanted to make. At a meeting calling for urgent action on suicides in northern Saskatchewan on Wednesday, one of the guests had to cancel to help an 11-year-old girl who had overdosed in a nearby community.

The meeting in Buffalo Narrows was a call to action spurred on by recent deaths in La Loche, Turnor Lake and Île-à-la-Crosse, all more than 400 kilometres north of Saskatoon.

Holly Toulejour, a social worker from the Dene High School in La Loche, called the community meeting to push for a state of emergency in the north.

It was an act of desperation to draw attention to a suicide problem she says has long been present in her community, only now she believes it is getting worse.

'Do we need to have six people kill themselves in a row before people realize, like, 'OK, this is not right?'"- Holly Toulejour

Having watched the response over the years, Toulejour is fed up with talk about strategies and policies. She's also frustrated by the tendency to boost community resources after a tragedy, saying the services always drop off.

"What is it going to take for people to realize that there's a sense of urgency?" she asked.

"Like, do we need to have another suicide, do we need to have six people kill themselves in a row before people realize, like, 'OK, this is not right?'"

Growing up in La Loche, Toulejour said young people had a feeling that their community was "less than."

Toulejour herself struggled with depression and as a young woman attemped suicide.

"I know how it feels like to think 'OK, the world would be a better place without me and who cares,'" said Toulejour.

"That was 17 years ago when I felt that way but there are still people who are feeling that way."

System needs overhaul: Northern doctor

In October and November last year, six girls aged between 10 and 14 took their own lives in northern Saskatchewan.

Their deaths were labelled a crisis. Premier Brad Wall visited the region with two cabinet ministers and additional mental health workers were sent to the area.

Those workers have since returned to their home regions.

Dr. Stephen Britton is a doctor at the Île-à-la-Crosse Hospital, which also services other communities covered by the Keewatin-Yatthe Regional Health Authority.

Suicides are preventable, they are not automatic.- Dr. Stephen Britton

He said the system needs an overhaul because it is failing people in the north.  

According to Britton, there were nine "self-harm events" recorded at the Île-à-la-Crosse emergency room last week, and another 10 were recorded on a different week in August.

Overall, he said 100 self-harm events were recorded at the ER between January and August.

A 22-year-old woman killed herself in Ile-a-la-Crosse last week. He said she should not have died.

"Suicides are preventable, they are not automatic. This is not normal for this to happen," said Britton.

He raised the issue of having crisis services that end after business hours, saying people in crisis often end up being seen at the emergency room by doctors like himself.

Vicious cycle

Those that need beds at a psychiatric ward are not always able to get them and are sometimes forced to return to the community and wait to see a counsellor a few days later, he said.

Britton said the communities are also caught in a cycle of grieving that is almost constant because of the high number of suicides and their impact across the communities.

Candice Evans-Waite, who brought a group of young people to the meeting to make signs with positive messages, said she wants to see more education for young people because they are hearing about suicides through social media.

She too wants an immediate response, similar to the state of emergency that was called in Attawapiskat last year.

"I would hope that some action is taken and not just spoken because that happens far too often, where it sounds really good then it dies a slow death and we never hear or see the end result," she said.

"The end result would be more happy and healthy families."

Île-à-la-Crosse Mayor Duane Favel said there has been more planning than action in the response to northern suicides in recent years.

But he said the solution would have to be more than just government intervention.

"We always know that nobody is going to parachute into the community and save us from all the issues and the challenges that we have in northern Saskatchewan," said Favel. 

"We know enough as northern people and community members that we need to empower ourselves and believe in our strengths and our abilities to take care of ourselves and I think that's where that push is coming from."

FSIN vice-chief Heather Bear lost her 19-year-old daughter to suicide.

The young woman had been drinking at a local bar before her death and Bear believes drinking establishments should carry more responsibility when it comes to reducing community drug and alcohol problems.

With limited job opportunities, Bear said there was a lot of pressure on young families living in northern villages and reserves.  

"You look at the poverty that exists within our communities — there's so many that fall through the gaps there, that go unnoticed, just because of the everyday struggle and challenge sometimes to keep good nutrition or food on the table," said Bear.

"I know there's many young parents right now that have had parents die of suicide. It's a cycle."

'Always' in a state of emergency: FSIN Vice-Chief

She said the communities have "always been in a state of emergency" and governments owe it to children living with the impacts of residential schools to invest in more support services.

But she said the solutions and strategies have to come within Indigenous communities if they are to work.

"You know, the provincial and federal governments, they've had their chance and we're not growing — give it back to the people. I know we love our people. That's what's going to make the change.

"Federal and provincial strategies — they've been continually trying to ram their strategies down our throats and they're not working, obviously."

The Federation of Sovereign Indigenous Nations has been working on a dedicated suicide-prevention strategy since last year.

But what do you do with a strategy if you're already unable to fund new programs?

Bear said the new strategy was about creating an Indigenous-led approach that can then be used to push the government to invest in better solutions.

Buffalo Narrows Mayor Bobby Woods believes any approach needs to focus on young people.

He said there were noticeably few youth at Wednesday's meeting, highlighting a gap in youth involvement that he sees as a major problem.

Involving future leaders

Rayden Noltcho, a 16-year-old from Buffalo River Dene Nation, was among the young people at the meeting.

He said it was the first time there had been a community meeting to address suicide in his region since he was old enough to attend, adding that he thought it was a good idea.

"This is very empowering to our people because for our ancestors, they used to gather and talk about things in circles and go to sweats all the time and do stuff like this and pray," said Rayden Noltcho.

Noltcho thinks a brief sharing session at the start of the school day would help young people feel more supported for the rest of their day.

Meghan Morin, 12, was part of a group of young people making signs with slogans like "our lives matter" before the meeting.

She and other young people at the meeting explained that cyberbullying was something they were seeing amongst their classmates.

"You can block that person, get away from that person, but maybe they can have friends to bring more people to cyberbully that one person and they just quit on social media," said Morin.  

Toulejour believes language and culture programs are key to building resilience and strength among young people in northern communities.

She is working with a community in B.C. where suicide rates dropped dramatically after the introduction of traditional programs.

"It's not a fancy solution, it's really traditional so returning to those traditional ways, but for a lot of us, we have to relearn those things so that's not easy," said Toulejour.

"And this is not going to be an easy process, it's a long timeline but I feel like we do have people here who are committed."

A state of emergency has not been called as a result of the meeting. 

Ministry supports

The Ministry of Health currently funds Saskatoon-based psychiatrist Dr. Sara Dungavell to visit La Loche, La Ronge and Stony Rapids to provide in-person services three days per month.

The province said she will also run follow-up clinics through remote technology when a new psychiatry service line is implemented in the next few months.

It provides funding for northern child psychiatry services one day a month to La Ronge through the Saskatoon Health Region, which also runs follow-up clinics.

In 2017-18, it said it had provided funding for the creation of culturally appropriate initiatives and to build on local programs, and for a mental health first aid course for professionals who come into contact with youth who struggle with mental health and addictions.