Thank you for the invitation to appear before the committee.
I'm talking to you from the territory of the Coast and Straits Salish peoples, whom I want to acknowledge before I begin.
For over 20 years I've been studying identity development in adolescents and young adults. My work has come to focus on the relationship between identity development and well-being among first nations youth in British Columbia and Manitoba. More specifically, I've been studying how failures in identity development are associated with youth suicide. What we've been trying to understand is why suicide rates vary so widely across first nations communities, from rates of zero in some communities to rates many times higher than the provincial average in others.
We managed to collect data on every suicide that took place in British Columbia between 1987 and 2006. We calculated the suicide rate of nearly 200 first nations communities in British Columbia. What we found was that some communities seem to have solved the problem of youth suicide. In fact our first wave of data collection showed that more than half of the communities had no youth suicides. Others had rates that were below the provincial average, and a minority had rates that were far above the B.C. average.
Our research has been guided by the idea that communities that have enjoyed success in preserving their cultural traditions and in gaining control over their collective social and political future would be better able to provide an environment that protects their youth from the risk of suicide.
We developed a set of indicators to measure what we called “cultural continuity”, things we could assess and verify about each first nation in B.C. We measured whether communities had a building devoted to cultural purposes and events, or had managed to foster the use of their traditional language, or had managed to include their own culture in the school curriculum. We looked at the participation of women in local governance. We looked at the extent to which communities controlled basic civic services—police and fire services, health services, and education. We looked at the history of land claims negotiation and litigation and efforts toward self-government.
We found that the variation in suicide rates is not random. Communities that scored higher on these measures of cultural continuity had lower youth suicide rates.
It shouldn't come as a surprise that higher levels of community control and maintenance of culture are associated with better outcomes for youth, but you need hard data to prove that. That's what we've been doing in B.C., and now in Manitoba.
I could go on about my research, but I want to address the final two points in the invitation I received.
The first concerns the availability of statistics about suicide, and the second asks for comments on best practices for mental health care and suicide prevention.
Since data for first nations people or status Indians are held by the federal government, it was extraordinarily difficult for us to access the suicide data we needed for British Columbia. We benefited from cooperative relations between the B.C. Coroners Service, the Office of the Provincial Health Officer, and what was then Indian and Northern Affairs Canada. We face similar challenges in Manitoba.
Both of these projects I've done are special one-off projects. There's no ongoing surveillance of suicide at the level of individual communities. Even the communities don't know where they stand on the issue of suicide, or any other health outcome relative to other communities, or to the province or the country as a whole.
What I believe we need is a system that creates annual health report cards for each first nation community. Every community should get a report that shows where it ranks in terms of suicide, mental health, addictions, and other health outcomes relative to other first nations, the province, and the country as a whole.
I need to stress that these reports shouldn't be made public. There's nothing to be gained by identifying on the front page of every newspaper in Canada the community with the highest suicide rate in the country, but if communities have no access to their own data, how can they plan or create interventions?
These report cards could also be used to better deploy resources to communities that desperately need them and avoid wasting them on otherwise healthy communities. At the moment, no one can tell those communities apart.
My final comment concerns best practices.
Our research demonstrates what many first nations already understand, that programs aimed at reducing suicide need not target suicide. If we support culture, we support health.
Some first nations elders and newspaper editors warn against talking about suicide for fear of creating copycat suicides. As a researcher, I'm not sure that media reports of suicide, or suicide prevention programs, somehow plant the seed or somehow cause suicides. I am convinced that efforts to promote and support culture work to prevent suicide.
We have the data to prove that. We just we need to do a better job of getting that message across, and we need to do a better job of recording and reporting suicide data. Unless we know what's happening at the community level, we're left with no action plan. Knowing that the suicide rate, the diabetes rate, or the injury rate is higher in aboriginal people tells us nothing. We need to know and, more importantly, specific communities need to know where they stand and what they can do. At the moment, there's no way for any of us to know, and that needs to change.
Thank you for your time. That's all I have to say. I'm happy to take your questions.