Promising practices in Arctic communities

Since the 1960s, there has been an increased rate of suicide among Arctic Indigenous peoples.. In Greenland alone, suicide rates among Inuit men and women have remained around 100 per 100,000 since the 1970s¹. The increased prevalence for suicide rates is indicative of several underlying factors including the communities’ exposure to socio-cultural changes, political marginalization and changing gender roles^2-3. Historically, Indigenous Peoples in circumpolar regions had very low rates of suicide deaths. Tragically, suicide rates in the Arctic are now among the highest in the world. Youth are especially at risk. Yet it is Indigenous Peoples, collaborating with government agencies and health care providers, who have been working passionately and diligently towards suicide prevention for decades across the Arctic. 

Through international gatherings, we learned about programs that had been designed by Arctic communities. The following practices show us successful examples of community designed initiatives that address underlying factors associated with suicide in Arctic communities. 

1. The Makimautiksat Youth Wellness and Empowerment Camp was launched in 2011 in five Nunavut communities following a year and half long consultation with youth, parents, community members and teachers. Developed in partnership with the Qaujigiartiit Health Research Centre in Iqaluit, this evidence-based and culturally relevant summer camp for 9-12 years-old Inuit youth focuses on fostering wellness, positive Inuit identity, community building and skills building. The program can be delivered in English and/or Inuktitut.

2. Another program in Nain, Nunatsiavut (Labrador, Canada), called Aullak Sangillivalianginnatuk (Going Off, Going Strong), sees hunters and fishers teaching high-risk youth about harvesting and preparing traditional food. This cost-effective outreach program has successfully developed a unified approach to complex and overlapping community challenges, including suicide prevention, mental health promotion, cultural connections and food security.

3. The Youth Leaders Program was launched in 2008 to reduce youth substance abuse and its consequences for the students living in a remote region of Northern Alaska, United States, where the teen suicide rate was seven times higher between 2008 and 2012 than the state average. The program is designed to empower youth to take personal responsibility for a positive school climate, and to contribute to the wellness of their community. Specifically, Youth Leaders attend an annual retreat with workshops that focus on topics of: Iñupiaq values, drugs and their longterm effects, violence, suicide prevention, anti-bullying, sexual assault,  stages of grief, and speaking up. Youth Leaders also participate in trust exercises and team-building activities in which they learn how to identify and talk with someone who shows signs of depression or suicidal thoughts as well as how to follow a protocol to conduct a behavioral intervention with another student who was exhibiting negative behaviors. Once back home, Youth Leaders are expected to lead through example by finding ways to improve their school climate and organizing and hosting recreational activities for students and their families.

4. In late 1987 and early 1988 the community of Krasjok, Norway, lost 18 Sámi youth to suicides.  These tragic deaths became a catalyst for the formation of the Sámi Psychiatric Youth Team by the Sámi Norwegian Advisory Unit on Mental Health and Substance Abuse (SANKS). The program takes a culturally sensitive approach to treating suicidal behavior and substance abuse in Sámi communities. Each four-member team (a psychologist, social worker, nurse, and medical doctor) works with adolescents and young adults between 15 and 30 years of age, and the team became a permanent fixture in the clinic in 1990, with dedicated funding from the Norwegian government. The team treats between 80-120 clients per year from five Sámi communities in northern Norway, and provides services in the Sámi language and in Norwegian. The program also supports training opportunities in the community including ASIST (Applied Suicide Intervention Skills Training) and local programs, such as “Openness and Intimacy” in Tana community and “Finnmark – a suicide safer county.”

5. More recently, the 2016 release of the National Inuit Suicide Prevention Strategy (NISPS) and the 2017 Plan for Suicide Prevention (PSP) among the Sámi people, highlight the urgency that Arctic indigenous communities place on suicide prevention. The NISPS highlights six priority areas that include creating social equity; creating cultural continuity; nurturing healthy Inuit children from birth; access to mental wellness services; healing unresolved trauma and grief; and mobilizing Inuit knowledge for resilience and suicide prevention. The PSP is a project under SANKS in cooperation with the international Sámi Council. It contains prevention strategies based on the current evidence base of suicide and suicidal behavior among Sámi people as well as the knowledge of Sámi grassroots organizations and Sámi mental health professionals. These strategies are designed to supplement the suicide prevention work already conducted in Finland, Norway, and Sweden, and they also point to specific challenges and needs of the Sámi people that are not yet addressed in existing suicide prevention efforts.

References:

1. Oliver LN, Peters PA, Kohen DE (2012) Mortality rates among children and teenagers living in Inuit Nunangat, 1994 to 2008. Ottawa: Statistics Canada.
2. Sumarokov YA, Brenn T, Kudryavtsev AV, Nilssen O (2014) Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics. International journal of circumpolar health: 1;73(1):24308.
3. Wexler L (2009) Identifying colonial discourses in Inupiat young people's narratives as a way to understand the no future of Inupiat youth suicide. American Indian and Alaska native mental health research (Online): 1;16(1):1.

Photo Credit : Sámi Norwegian National Advisory Unit on Mental Health and Substance Use