IQALUIT
Hundreds of people in Nunavut have taken suicide prevention training but more trainers are needed to teach the course to people not employed by the territorial government, according to a recent evaluation.

The Applied Suicide Intervention Skills Training (ASIST) course offers everyone in the territory over the age of 16 the opportunity to become part of dealing with the tragedy of suicide before it happens.

As the minister newly appointed to oversee the suicide prevention file, Health Minister Paul Okalik has the responsibility for delivery of the ASIST course.

Commonly known as "suicide first aid," the training is provided in a two-day workshop format. It's called Uqaqatigiiluk! or Talk About It! in Nunavut, where the program was adapted to be relevant to Nunavummiut, and has been available since May 2013.

"At workshops, participants talk about suicide, they look to recognize certain things that may be indicators, they talk about safety and interventions skills," said Maureen Doherty, who took on the position of director of health and wellness programs at Nunavut Arctic College in August.

With this training, the intent is to keep people who are thinking about suicide "safe for now."

Nunavut Arctic College president Peter Ma was deputy minister of health in 2010 when the Nunavut Suicide Prevention Strategy and its action plan were approved.

Commitment 4.1 is to deliver Uqaqatigiiluk! to all interested Nunavummiut. Nunavut Arctic College took on the responsibility for teaching the workshop in 2013.

"Funding is provided by the Department of Health to Nunavut Arctic College to deliver ASIST on an annual basis. This decision was made in my tenure at the Department of Health because the college has the requisite infrastructure in most communities (i.e. Community Learning Centres) to provide the training," said Ma, who has taken the training.

Doherty said, "We have contracted the co-ordination of the program to a very experienced person, Isabelle Dingemans. She is a master trainer."

Dingemans has been deploying ASIST since 2013.

Currently, there are seven ASIST trainers in Nunavut, said Dingemans, who operates on an annual budget of $170,000.

During the first year, 2013-2014, the ASIST course was taught 31 times in 22 Nunavut communities. The workshop was not offered in Resolute, Gjoa Haven, Kugaaruk and Sanikiluaq. There are currently 1,633 people in the territory who have taken the ASIST workshop.

From the initial workshop, participants can choose to continue and become trainers themselves, Doherty said.

More trainers, she said, "would greatly increase our capacity to deliver the program within Nunavut."

She said. "It's very important to increase our capacity and have more trainers. We are looking to doing that in the spring."

But on the most basic level, the ASIST program is not reaching enough Nunavummiut, according to an evaluation of the suicide prevention strategy unveiled at September's inquest into the high rate of suicide.

"While the course can be delivered in Inuktitut, there are few certified Inuktitut speakers that are either master trainers or certified trainers and, as a result, most training is provided in English or with simultaneous translation," the evaluation states.

The evaluation also notes, "There has been variable support for ASIST particularly among school principals, with some making ASIST training mandatory for school staff (and utilizing professional development days for this purpose) while others have refused to have their staff participate. This is despite the fact the Nunavut Teachers' Federation and District Education Authorities have endorsed ASIST as a positive suicide prevention-related training intervention."

Even within the territorial government, some departments have opted out of making ASIST training available to staff, "and have instead provided for delivery of Mental Health First Aid (MHFA), which has a broader scope and takes less time to complete (three hours). MHFA is generally recognized as not having a strong suicide prevention focus, which is the intent of ASIST," the evaluation stated.

Finally, a recurring theme at the inquest was that suicide prevention must be embraced by everyone, including at the community level.

The evaluation noted, "ASIST has not fully penetrated the broader Nunavut society - it has been primarily delivered to GN staff and other groups, (such as Arctic College students). Information on ASIST is not readily available to Nunavummiut. There is nothing on the GN website about this training program and there is minimal promotion through other media."

ASIST training is something all Nunavummiut can do, said Premier Peter Taptuna when he announced in the legislative assembly Oct. 23 that "government liaison officers from every community in the territory will come together on Dec. 9 in Rankin Inlet to take this important two-day workshop."

Taptuna also addressed the population at large.

"I encourage more Nunavummiut to take the ASIST program and learn to intervene and help prevent the immediate risk of suicide. Every single Nunavummiuq has been affected by suicide, and we need to collectively stand together and put an end to this crisis together," said Taptuna.