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Risk of suicide 40 times higher for Inuit boys

September 10, 2013

Sixteen-year-old Jimmy Joanasie seemed fine to his mother the day he went into his room and hung himself.

It was Apr. 25, 2006.

Jimmy, a friendly, outgoing athlete who played floor hockey and basketball, and practised Tae Kwon Do, had left an extended family gathering with his mother, Anna Lucy Joanasie, and his sisters just 20 minutes earlier. His youngest sister, then 13, opened his bedroom door in their home in Iqaluit, Nunavut, to find him hanging.

“I have no idea why he hanged himself. Still today I don’t know why,” says Joanasie, an interpreter and medical transport aide. “He was my best friend, and he was my helper.”

Young Inuit men are at the highest risk of suicide of any population group in the world — many of them simply don’t survive their teenage years. From 1999 to 2011, Inuit males aged 15–19 killed themselves at a rate of just over 500 per 100 000, according to statistics compiled from coroners’ records by Jack Hicks, a researcher and PhD candidate studying Inuit suicide. That’s about 40 times greater than the rate for non-Inuit males in the same age group (12.6 per 100 000 for Canadian males aged 15–29 in 2009). Overall, Nunavut Inuit take their lives at a rate nine times the Canadian average.

The family members left behind, like Jimmy’s mother, struggle to understand why. They also cope with a stigma attached to their parenting skills, she says.

“Some people point at us…as bad parents. Lots of people say ‘That’s why you lost your son,”’ Joanasie says. “I say, ‘I’m a good parent.”’

A follow-back study, or psychological autopsy, released in June into the suicides of 120 Inuit people who took their lives between 2003 and 2006 provides some clues about the risk factors among the Inuit. They include high rates of childhood sexual and physical abuse, depression, and alcohol and marijuana use, according to interviews the researchers conducted with surviving family members and friends. Other Inuit who committed suicide had recently experienced triggering factors such as the breakup of a romantic relationship or were facing court charges.

Some Inuit men who have survived suicidal periods point to family circumstances, including poverty and substance abuse, as critical factors. They also report the prevalence of suicide around them as making it seem almost reasonable.

Junior Kopak was 14 when one of his closest school friends hanged himself in his grandmother’s bathroom. Four years later, Kopak’s girlfriend hanged herself in her room.

Kopak also considered suicide during his high school years. His parents were unemployed and depended on welfare and the National Child Tax Benefit to feed the family, but his father’s drug use often meant that Kopak and his brothers and sisters were hungry.

“We would be eating lunch at home, and when they were finished I would ask them if they were full. If they said ‘No,’ I would give them my plate, so that they wouldn’t be hungry,” Kopak says. “Sometimes I would think killing myself would be easier than living life.”

His love for his little sisters kept Kopak from killing himself, he says. He didn’t want them to think suicide was an acceptable response to pain.

It might seem unusual to most Canadians that a 21-year-old like Kopak could have experienced the level of trauma he copes with, from the suicides of those close to him and his own difficult childhood. For Nunavummiut, however, it is almost unremarkable, as Nunavut Health Minister Keith Peterson pointed out in a speech earlier this year at a fundraising dinner in Iqaluit for Embrace Life, Nunavut’s suicide-prevention organization.

“It is heartbreaking that the issue has become so commonplace in our community that it has almost become normalized,” Peterson says. “Anywhere else in Canada it would be a national tragedy.”

The prevalence of suicide is the reason Nunavut’s Suicide Prevention Strategy Working Group called for Applied Suicide Intervention Skills Training (ASIST) to be taught widely to caregivers and community members across the territory — something the Government of Nunavut has promised but is having trouble delivering.

Peterson took the course himself a few years ago, calling it “eye-opening.”

“The more we can identify the early warning signs, the more we can intervene and perhaps save a life,” he says.

Since 2009, when Nunavut launched “Uqaqatigiiluk!” or “Talk About It!” a specially adapted version of ASIST, more than 600 people across the territory have taken the workshop. Although anecdotes abound, there are no statistics about how many lives caregivers trained in ASIST have already saved. But critical gaps exist in the frequency with which the Government of Nunavut has organized and offered the training, including in school settings.

Meanwhile, parents like Joanasie are left to pick up the pieces of their lives. Recently, she adopted a baby boy, Paul James, to help repair the hole in her heart.

“I’m healing very slowly, because my heart was torn into a thousand pieces when we got the news that [Jimmy] didn’t make it,” Joanasie says.

Editor’s note: This is the fourth of a series on suicide in Nunavut, Canada; the other stories can be read at cmaj.ca. Laura Eggertson received a 2012 Michener–Deacon Fellowship for Investigative Journalism award, which supported her travel and the research into this series of articles about suicide by Inuit and First Nations youth.

DOI:10.1503/cmaj.109-4594
— Laura Eggertson, Iqaluit, Nunavut
NT5