Nations need a strategic plan to deal with suicide, says doctor

The Cowichan Tribes on Vancouver Island declared a State of Emergency last month due to the high number of suicides, suicide attempts and threats carried out by band members.

But while Ottawa and British Columbia have promised immediate support, the community says long-term resources and strategic planning are needed to stop the ongoing crisis.

“We are calling on the minister of Health for British Columbia, the federal minister of Aboriginal Affairs and Northern Development and the federal minister of Health to work with us on an urgent basis, in the spirit of reconciliation and cooperation, to address suicide prevention and work together with Cowichan Tribes to turn our community around,” Chief Harvey Alphonse said in a statement about the emergency his community was facing.

“Together we can create an environment where our community embraces life,” he said.

The declaration sheds light on the reality that incidences of suicide by First Nations youth in British Columbia is approximately three times higher than that of non-Aboriginal youth. The declaration also draws attention to the fact that suicide alerts or threats in First Nation communities have more than doubled in recent years.

“After completing an analysis of our health statistics for the last 10 years, including suicide alerts received by the Ts’ewulhtun Health Centre, our records show that the 52 alerts received already this year demonstrate a significant increase,” Alphonse said. “Cowichan has lost two employees to suicide in recent months. We are losing our most valuable resources–our children and our caregivers,” he noted.

Of the nearly 4,000 registered Cowichan Tribe members from the Cowichan Valley, approximately half live on the reserve.

Jennifer Jones, Cowichan Tribes acting Health Director at the Ts’ewulhtun Health Centre, saif the band experiences an average of eight suicide deaths in the community each year.

She says youth between the ages of 19 and 25 are among the highest number of suicide fatalities in the First Nation community.

Also, while males often dominate the suicide demographic the band is seeing a recent spike in the number of women taking their lives.

Furthermore, Jones said that between 2007 and 2011 the number of suicide alerts in the community had risen 254 per cent. In one year alone the band had been notified of nearly 260 alerts.

It is the high number of alerts and the need for prevention and intervention prior to tragedy that needs to be addressed, Jones said.

“Even though we are calling it a state of emergency, it’s also about our people contemplating suicide,” Jones explained.

Jones said she would like governments to provide immediate and long-term ongoing mental health support services for a community she claims has limited resources.

“Our counsellors are already overworked,” she said, adding that the band has a total of nine support aids—three for youth, five drug and alcohol counsellors and one mental health counsellor.

“We’re all trying to work together and look at the different ways we can provide medical and cultural resources as we look forward,” she added. “[But] I’m hoping for long-term solutions rather than short-term ones. Instead of being reactive we want to provide preventative measures,” Jones explained.

But Mary Polak, minister of Aboriginal Relations and Reconciliation, told Windspeaker that BC will first work with the Cowichan Tribes to explore ways in which the province can offer immediate emergency aid.

Polak agreed that a long-range plan to address the high rates of suicide in First Nation communities is needed, however, she added that a future suicide prevention strategy must incorporate First Nations culture and values in its policy framework.

Federal Health Minister Leona Aglukkag and John Duncan, minister of Aboriginal Affairs and Northern Development, also offered their support to the First Nation as regional government officials were deployed to meet with the band last month.

“Health Canada is deeply sorry for the loss experienced by the members of the Cowichan community,” a ministry spokesperson stated. “The government of Canada recognizes that suicide among Aboriginal people, and Aboriginal youth in particular, is an urgent matter [and] Health Canada is committed to working collaboratively with the First Nations community and our federal partners, as well as provincial and other partners on initiatives that are improving the wellbeing of First Nations communities and individuals, including the Cowichan tribes.”

The spokesperson also pointed out that during the 2010 budget plans, $75 million in funds were allocated to renew the National Youth Suicide Prevention strategy until 2015. The strategy was set to expire in 2010.
Also, Health Canada said that it has committed $3.7 million in health transfers for 2012-2013, which includes more than $145,000 in funding to Cowichan First Nation for mental health programming, including suicide prevention.

The Vancouver Island Health Authority [VIHA], which provides a range of healthcare services to residents of Vancouver Island, has too extended support.

“We know that they’re going through a difficult time and we want to work with them and support them and offer them the supports that we have,” said Ian Knipe, director of VIHA’s Aboriginal Health Program.

Knipe said that along with looking into providing additional mental health resources to the band, VIHA says it could offer training for community members wanting to help in crisis prevention, intervention and management.

Knipe further stated that a partnership accord signed last month between VIHA and the Vancouver Island Regional Health Caucus of the First Nations Health Council has a mandate to create a more integrated, culturally appropriate, safe and effective health system for Island First Nations and all Island residents. The signing took place in a cultural ceremony during the fifth annual provincial Gathering Wisdom for a Shared Journey forum May 14.

Meanwhile, the Cowichan Tribes say they plan to take matters into their own hands and are working toward formulating a strategic community plan entitled “Embracing Life at Cowichan Tribes.” The band is asking Ottawa and B.C. to provide resources needed to create the plan.

“Cowichan Tribes wants to implement a program that holistically addresses all the determinants of health impacting First Nations in Canada, including the intergenerational effects of residential school abuse and diminished resources for mental health care,” explained Maureen Tommy, Cowichan Tribes General Manager.
Dr. Evan Adams, deputy provincial health officer with responsibility for Aboriginal health, agreed that First Nations in B.C. need to formulate a comprehensive, province-wide, community-driven health plan. But he said Aboriginal communities mustn’t rely solely on government approval and funds to strategize a plan.
“It doesn’t have to be [led] by a government official and it’s not a huge drain of resources,” Adams said of drafting a future plan. “A strategy needs to be written by a pen and someone needs to hold that pen,” he urged.

“What I need for the plan is it to be shared around. One comprehensive plan adapted to fit each First Nation community,” he explained. Adams also said that while a plan must consider the social determinants of health—poor housing, inadequate nutrition, poverty, addiction, and intergenerational residential school traumas—it must also acknowledge powerful influences such as peer pressure and the pain of relationship heartbreak in its formulation if it is expected to help people, especially youth-at risk for suicide.

“We can’t keep not having a [suicide prevention] plan,” asserted Adams. “We need to get organized.”

“People need cultural, community and familial support. We must plan to protect our community members, teach resilience and break the silence around suicide,” he said.