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Breaking Point: The Suicide Crisis in Indigenous Communities

Indigenous communities require adequate numbers of skilled health service providers to serve their community members. The Committee heard considerable evidence that there are insufficient numbers of health professionals working in Indigenous communities. In some communities, specific conditions can limit the capacity of service providers to work effectively with clients such as multiple suicides over a short period of time, high needs amongst clients and staff burnout. Citing the 1996 Report of the Royal Commission on Aboriginal Peoples, Michael DeGagné recalled that when the report was released there was an “urgent need to train 10,000 new community-based health workers.”[262] The Committee heard that many positions in communities remained unfilled or were filled only temporarily.[263]

Witnesses described that the shortages of health professionals in Nunavut are particularly pronounced. Adam Akpik observed that in 2006, Nunavut also had the “lowest ratio of physicians, the lowest ratio of registered nurses, and the lowest ratio of psychologists.”[264]

Kathy Kishiqueb noted that continuous staff turnover affects the continuity of health care and presents difficulties for First Nations, “Clients who have experienced trauma get tired of telling their stories over and over to new faces.”[265] Staff shortages affect the rate of burnout and youth in Kuujjuaq and Iqaluit noted social workers and mental health workers rarely stay in their positions longer than three months at a time.[266] As explained by Jakob Gearheard:

They fly in, they get traumatized, and they leave. If you’re a client … they’ll complain about the mental health worker who just flew in. They’ll say things like, “I went in there and I had to spend the first 30 minutes explaining to them Inuit history.”[267]

Witnesses described the importance of Indigenous-specific mental health supports, from people who can provide services in the local language and understand the community’s history and culture. However, there are very few Indigenous mental health specialists. Cornelia Wieman, a First Nation psychiatrist, described that due to low numbers of Indigenous psychiatrists, in her estimation there may be six in the country, “virtually all psychiatric care across this country to Aboriginal people is provided by non-Aboriginal psychiatrists.”[268]

The Committee heard that recruiting and retaining health professionals in Indigenous communities is challenging, often leading to shortages that affect the delivery of mental health services. Lisa Bourque Bearskin indicated it was difficult to retain health care professionals as staffing shortages contributed to the burnout of front-line nurses: “One nurse was in her community for three weeks providing 24-7 care. There’s no way we’re going to be able to retain that nurse. She’s going to be burnt out. There’s a huge lack of community support.”[269]

The Committee heard that increasing Indigenous peoples’ involvement in the delivery of health services is an important long-term solution to the shortages of health professionals. Local communities need to be supported through training to build their internal capacity to address issues regarding the retention of health care workers. As shared by Lisa Bourque Bearskin, “Indigenous nurses who have been trained, you'll see the retention is higher for them to stay in their communities. Our Indigenous nurses are staying and working within their own communities.”[270]

Authors: the Standing Committee on Indigenous and Northern Affairs

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