Indigenous and Northern Affairs Committee on June 7th, 2016

[Natan Obed]

First and foremost, I do not believe that it is respectful for the government to prescribe solutions for indigenous peoples when it comes to suicide.

As for many of the reasons that our communities are the way they are, it's because colonization and programs and policies of the Canadian government have created historic and intergenerational trauma. To now say, without true partnership with indigenous Canadians and representatives of indigenous Canadians, that the Canadian government will do this to prevent suicide is another form of speaking on our behalf and is not actually partnering in an Inuit-to-crown or nation-to-nation way.

The second part of this is that social equity is necessary. We have so much to do to be able to ensure that all Canadians have equity, and within the Inuit community there are very specific simple, straightforward measures that we can take to do that. As Canadians, we should all believe that we are.... We demand equity within Canada.

[Georgina Jolibois, NDP, Desnethé—Missinippi—Churchill River, SK]

Thank you.

What message can we give to our youth?

[Natan Obed]

Thank you. That is a wonderful question.

Youth are often expected to come up with solutions in a vacuum within this issue, and I know that youth carry a tremendous burden already. There are expectations from their families, from their communities, and within themselves about who they are as indigenous people and, in my case, about who they are as Inuit. Often, I believe, we don't do enough to ensure that they have the necessary ingredients to succeed.

There are so many of our youth who have succeeded despite the systems that are undermining their potential and their ability to be strong and proud Inuit. I commend our Inuit youth for all they are doing and for all that they have said they want for society, but I also say that we need to demand a better future, and Inuit youth need to stand up and say, in very clear ways, that the realities they have lived through are not acceptable and that we can all do better to improve the lives of Inuit youth.

[The Chair, Liberal, Andy Fillmore]

Thank you.

Our next question is from Don Rusnak, please.

[Don Rusnak, Liberal, Thunder Bay—Rainy River, ON]

Thank you for coming to the committee today. It's nice to see you again, Mr. Obed, and nice to meet you for the first time, Mr. Hicks.

Since we began this study, I've been hearing from a lot of people that suicide is simply a symptom in indigenous communities of all the problems that exist. Some people have been telling me that we need to work on a two-stage solution to the problem, with the first stage being getting in there with health workers and dealing with the problem in communities immediately, while the long-term solution is economic self-determination and creating the environment for the communities and the people within them to prosper.

What would you have this committee recommend to all our ministries, but most importantly to the Minister of Indigenous Affairs, to immediately help and then to prevent this from continuing in the long term?

[Natan Obed]

In the development of the national Inuit suicide prevention strategy, we have worked with Health Canada, and hopefully on day one, on July 27, there will be commitments from the Government of Canada to work with Inuit on the first steps toward suicide prevention. Across the government there are responsibilities. This is not just a health issue. This is an issue that has many different aspects.

I also want to respond to the discussion about self-determination.

Our objective is self-determination. The link between our rate of suicide and relative self-determination or self-determination within a governance model is something that I would say does not have an evidence base within the Inuit reality. Perhaps in other jurisdictions there is a clear correlation between self-government or self-determination and the suicide rate, but for Inuit....Greenland has been self-determining for some time. Its rate is elevated and is similar to the Canadian rate.

I believe that self-determination demands self-government and free, prior, and informed consent and a number of different concepts that this government is struggling with in trying to understand what it actually means for the relationship. We should go full steam ahead on all of those discussions. However, to tie self-determination directly to suicide prevention, I believe, is a stretch. Perhaps with greater research and greater understanding of this issue, there will be more concrete ties, but there are many holes in what we know about evidence on this, which is why we have tried, in the development of our strategy, to have a foundation of evidence rather than a broad grasping of different things that may sound plausible.

[The Chair, Liberal, Andy Fillmore]

You have three minutes.

[Don Rusnak, Liberal, Thunder Bay—Rainy River, ON]

The immediate solution, as I believe you said before, is to treat it as a public health policy and to have a strategy, working with the Inuit and working with organizations in the areas that you represent, to have culturally based and culturally sensitive workshops or programs for Inuit. Has that been attempted by any previous government? Has it been attempted in recent memory? If it has, what have the successes been?

[Natan Obed]

At the federal level, the only program I am aware of that has been introduced was the national aboriginal youth suicide prevention strategy. That was approximately 10 to 15 years ago, and there was an Inuit-specific framework associated with it. It largely funded community-based programming and was not specifically focused, in many cases, to counselling or intervention in suicide prevention.

What we need to do first is a better job of intervening for those who are at risk, and of identifying those at risk, ensuring that they have the care, the mental health services, and the supports they need.

With regard to postvention for those who have gone through trauma, virtually nothing has been done for Inuit who have experienced trauma in relation to suicide or who have attempted suicide but then not received any sort of follow-up.

There are some very specific immediate things we can do that help fix the situation in the very short term. However, the larger issue, the upstream public health investments that Canadians have talked about in a very nuanced way for other public health issues, must happen in relation to our communities. The environment of risk for suicide specifically, as it is created through a person's life and then as it is created in a societal sense, needs to be addressed.

There are often people in our communities who question why a particular individual died. Usually they start off the conversation by saying that the person came from a loving home and they graduated from high school. Often we don't get to the next part of the conversation, which is that the person was in a society that has risk factors for suicide. No matter who you are, no matter what individual situation you have, you are connecting with risk. Even the idea that exposure to suicide is actually a risk factor for suicide needs to be better understood and appreciated in the way we look at this issue within our communities.

[The Chair, Liberal, Andy Fillmore]

Thank you.

We have to keep moving along. Perhaps Mr. Hicks can slide in a response during other questions.

We are now into the five-minute round of questions. Time is moving quickly, so I would invite members to try to come to their question as quickly as they can, without too much preamble.

The next five-minute question is from Harold Albrecht, please.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Thank you.

Thank you very much to both of you for being here. The incredible grasp you have on this is very humbling for me, I'll tell you.

I had the opportunity to look through the outline of the “Resiliency Within” paper you've done. I certainly applaud many of the initiatives here. I could go through the eight chapters and list many of them. I think it's a great program.

In regard to this, has there been any consultation with the Public Health Agency of Canada in the development of the federal framework for suicide prevention, which is to be implemented sometime later this year? The Public Health Agency of Canada was charged with the responsibility of implementing Bill C-300, the federal framework. I'm wondering what kind of collaboration happened between the Government of Canada and the Government of Nunavut in terms of developing your program.

Certainly I wouldn't want to imply that the framework should supersede or even be over it. In fact, that's one of the reasons we chose the word “framework” rather than “strategy”. We wanted something that was available to be contextualized in different communities across Canada, but I think there should have been, and I'm hoping there was, some degree of consultation with the Inuit community.

[Natan Obed]

I'll speak specifically for Inuit Tapiriit Kanatami. We have been engaged in those discussions with the Public Health Agency—

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

You have been.

[Natan Obed]

—but all the way through those discussions, we have advocated for an Inuit-specific approach that the Public Health Agency and Health Canada can also adopt, in partnership with us, to work on suicide prevention. The ways in which risk is distributed in our communities are so different from the Canadian population that it demands a very Inuit-specific approach.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Yes. I couldn't agree more. I'm not implying that the framework should in any way supersede what you're doing there. Again, I applaud what you've done here.

I find this paper you handed out to be very helpful. You have cultural continuity, community cohesion, family strength, and so on as protective factors. One thing that may be missing, or maybe we simply haven't stated, is an area I'm very passionate about, and that is the spiritual component of who we are as humans. I know there has been a lot of research done on that.

You may be familiar with this book on clinical research for suicide prevention. One of the comments the author makes as it relates specifically to indigenous communities was, I thought, very insightful. I'll quickly read it: “Similarly, actively participating in spiritual practices on a regular basis was found to buffer against suicide.” He's specifically speaking to indigenous youth suicide in Canada in this regard.

I'm wondering what aspect of the spiritual community, whether it's the indigenous faith community or other faith communities.... You mentioned the faith communities in your opening remarks, which I was pleased to hear. In terms of prevention, intervention, and even postvention, could you comment on what responsibility the faith community has in that regard?

That's for either one of you.

[Jack Hicks]

In our work in Nunavut, we recognize that the people who deal with the phone calls at two o'clock in the morning, be it a mental health crisis or a suicide or mentions of suicide, are often members of the faith community. They are just solid people, and they exist in every community.

One of our goals was to ask those people what training they would like. There are issues around how seriously the fly-in health workers treat those people. I mean, they don't claim to be social workers or nurses, but they are really solid community residents. Certainly in Nunavut I value those people tremendously. When we do our work, they're quite often the first people we talk to in the communities. The working group has always had a representative rotating among the different faiths.

There's no question that a strong spiritual grounding in any society is a protective factor, but not everybody has that.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

I'm not implying that it's the magic solution. I wasn't implying that. I just I think it's unfortunate if, as mental health care workers or political people, we leave one tool out of the tool box. It's not the only tool, but it's one of many that I think we should be utilizing.

Do I have any time left?

[The Chair, Liberal, Andy Fillmore]

You have 10 seconds.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Okay, 10 seconds will be great.

Mr. Hicks, could you identify whether your ASIST training is the same as safeTALK training? Is that the same thing?

[Jack Hicks]

SafeTALK is from the same organization. It doesn't teach intervention skills. They have a suite of programs.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

It's about observation.

[Jack Hicks]

The idea is teach you something about suicidal behaviour, and, in the event that you notice something, you know who the ASIST-trained people you can connect with are.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Thank you. Thanks for your patience.

[Jack Hicks]

It was developed in Canada, in Alberta, I would point out.

[The Chair, Liberal, Andy Fillmore]

Very good.

Mike Bossio, go ahead, please.