Day by day at Nunavut's suicide inquest

Padma Suramala, Nunavut's chief coroner, called an inquest to investigate why 45 Nunavummiut took their lives in 2013, the highest rate of suicide in the territory's history. CBC North reporter Elyse Skura followed the inquest all week. Here's a summary of what she heard.

Monday

The inquest began with a day of emotional testimony from two families who lost loved ones to suicide. 

Bernadette Uttak's grandson, Antonio 'Rex' Uttak, took his own life on Aug. 10, 2013, just weeks after turning 11 years old. 

Three relatives and the RCMP officer who investigated the death agreed Rex was a happy boy. None had any explanation as to why he decided to end his life. At the time, the Uttak family was living in overcrowded housing, and Rex was coping with the murder of his older sister.

"I'm lifeless," Bernadette Uttak testified in Inuktitut. "A lot of time there is no help from even my own children and I told my older son at one point not to worry if I just fall over and die one day."

Joanasie Akumalik broke down on the stand as he testified about the death by suicide of his son Clyde, or 'Aapi,' in 2013.

Akumalik says Aapi was a normal young Inuk man, but he was shy, had never finished high school and didn't have a job in Iqaluit.

But Aapi had been sexually abused, and was drinking "quite a bit, probably four months prior to his suicide," said Akumalik. "Why did it happen? What was the cause? To me, I'll never know." 

Tuesday

Jack Hicks, a suicide researcher who spent many years in Nunavut, testified that the territory's suicide rate is 9.8 times the national average. 

Hicks called Nunavut's situation a regional crisis, which has its roots in an early wave of trauma caused by residential schools, the dog slaughter, resettlement and other historical injustices.

"Nunavummiut are soaked in unresolved grief," testified Hicks, suggesting that counselling and support for families after they lose a loved one to suicide should become a key priority. 

Both Hicks and Natan Obed, Nunavut Tunngavik Inc.'s director of social and cultural development, said Nunavut's suicide prevention strategy has stalled due to a lack of funding. Hicks said the territorial government's bureaucracy has also stonewalled progress on the file.

Despite the best intentions of the strategy's four partners, the Government of Nunavut, Nunavut Tunngavik Inc., the RCMP and the Embrace Life Council, the timeline for actions has not been followed.

"It isn't a lack of will per se, but it is a failure to complete," Obed said.

Wednesday

Witnesses testified that Nunavut desperately needs culturally-appropriate suicide prevention programs.

"It should feel safe to come for health care," said Dr. Allison Crawford, a psychiatrist who has worked in several Nunavut communities. 

She says many Inuit don't like to seek treatment as part of the formal health care system, because of historical trauma. "It's a real limitation that I think everyone recognizes."

Crawford also said Nunavut needs to confront its high rate of childhood abuse.

Shuvinai Mike, director of Inuit Qaujimajatuqangit (traditional knowledge) with Nunavut's Department of Culture and Heritage, shed light on the need to understand Inuit culture in her testimony on Wednesday afternoon.

"Whoever is leading the strategy, I think we need to work together," she testified. "We need for them to utilize our elders."

Mike lost her own daughter to suicide, and said she would have intervened if she had known her daughter had been repeatedly hospitalized.

Thursday

A Government of Nunavut bureaucrat defended the territory's progress on suicide prevention work on Thursday at a coroner's inquest in Iqaluit into the high rate of suicides. 

Lynn Ryan MacKenzie, the health department's territorial director of mental health and addictions, says the solution suggested by earlier witnesses — putting a high-level government employee who can make decisions on behalf of multiple departments at the table — is untenable.

"I think it's unrealistic to think one person could be given that responsibility," MacKenzie said. "That's not how the government is structured."

MacKenzie said the government has made progress in providing mental health services.

Victoria Madsen, the director of mental health for Iqaluit, also testified about capacity issues in the mental health system and the challenge of recruiting and retaining staff. 

"We need more qualified and experienced counsellors," said Madsen. "That is a challenge."

She identified two other challenges her department is facing: hiring counsellors who specialize in youth and substance abuse issues, and finding Inuktitut-speaking staff.

Friday

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

"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. 

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

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. 

"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."

When each of the three expert witnesses testified last week, they supported a list of 42 recommendations for action on suicide prevention made by an independent study. 

Rosemary Keenainak, the health department's Assistant Deputy Minister of Operations, said the government takes the recommendations seriously, but could not predict when any proposed changes will be seen by Nunavut's Legislative Assembly.

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.