High rate of suicide declared emergency
Coroner's inquest ends with forceful recommendations from jury to government and other parties
Michele LeTourneau
Northern News Services
Monday, September 28, 2015
IQALUIT
A six-person jury at the chief coroner's inquest stunned those in the courtroom Sept. 25 when it led the delivery of its recommendations by forcefully calling on the government of Nunavut to declare the high rate of suicide a public health emergency.
The jury, made up of Inuit and non-Inuit, presented its recommendations in Inuktitut and English to an emotionally tense and absolutely silent crowded courtroom, which included chief coroner Padma Suramala, Health and Justice Minister Paul Okalik, Joanasie Akumalik of Iqaluit, who lost his 24-year-old son to suicide in 2013, along with lawyers, media and members of the public.
It was the unprecedented high number of deaths in 2013 - 45 - which spurred Suramala to call for the establishment of the discretionary inquest.
Overwhelmed by the incomprehensible numbers of preventable deaths she attended, the grief and trauma she witnessed in families and communities, the general inaction of government and a failure to implement the Nunavut Suicide Prevention Strategy, Suramala acted by calling for an inquest in January 2014.
Over nine days, Sept. 14 to 25, the realities of the tragedy that has plagued the territory were exposed.
In response, the jury not only called for a public health emergency to be declared, but also recommended the GN appoint a minister responsible and accountable for suicide prevention and to create a secretariat responsible for suicide prevention with the mandate and resources necessary, and the requirement to report to the minister within set timelines. The next sitting of the legislative assembly begins Oct. 21.
"This will be completed by April 1, 2016," stated the jury.
These are but three urgent recommendations with tight deadlines the jury presented to presiding coroner Garth Eggenberger after listening to nine days of heartbreaking testimony from more than two dozen witnesses speaking to the at least 486 suicides which have occurred in Nunavut since 1999.
That number does not include a young man's death by suicide in Hall Beach Sept. 20, even as the inquest was taking place.
Inuit suicide numbers matched the national average in the 1960s but has since grown to 10 times more than the average number of suicide deaths in the rest of Canada.
Later, when everyone had left the Nunavut Court of Justice in Iqaluit where the inquest was held, Suramala wept.
Inquest recommendations are not legally binding. Suramala said she knows this, but intends, as her office allows her, to keep the pressure on all the entities that will receive recommendation aimed specifically at them. These include the GN as a whole, the Department of Education, the Department of Health, the Department of Family Services, the Department of Culture and Heritage, the Nunavut Housing Corporation, the Government of Canada and the RCMP.
Eggenberger, speaking quietly after the jury left the courtroom, said "we all are responsible," echoing politician Jack Anawak's testimony earlier in the week, when he said, "We have a deep ongoing responsibility to care, to be our brother's and our sister's keeper, to do due diligence and act in a consistently ethical manner."
The jury recommended the adoption of 41 of 42 recommendations in an independent evaluation of the Nunavut Suicide Prevention Strategy, adoption of several recommendations from the Qikiqtani Truth Commission report and the adoption of a call to action by the Truth and Reconciliation Commission's report.
The jury called for the GN to immediately launch a public awareness campaign to de-normalize suicide.
It also recommended the GN pilot Clyde River's Illisaqsiviq model in other communities, that the Department of Health establish a formal followup protocol for individuals who have attempted suicide, and that the Mental Health Act be changed to ensure families be contacted and immediately involved after a suicide attempt, regardless of the age of the person who has attempted suicide.
Okalik, speaking to reporters after the close of the inquest, did not immediately make a commitment related to the recommendations.
However, when questioned about a more formalized inclusion of elders in suicide prevention, Okalik paused. With tears in his eyes, his voice breaking, he said, "I wouldn't be here without them. That's how important they are."
Brian Mishara, an international expert on suicide prevention who testified at the inquest, was not immediately able to say whether a high rate of suicide has ever been declared a public health emergency.
But, he said, "When you consider the rates, the incidence, proportion of the population affected each year, the death rate is higher than other problems that have been declared public health emergencies in the past."
Declaring a public health emergency is intended to muster resources required to respond to a health crisis.
"But there are no obligations, other than responsibility to the public to deal with the crisis," said Mishara. "It always comes back to political will and the extent of public pressure to act."
