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    River of Life Online

    The River of Life course discusses strategies designed to strengthen the protective factors of youth at risk. The material focuses on providing participants who work with youth the knowledge to respond to youth at risk of suicide. River of Life has been developed with extensive consultation with Indigenous people.  The Advisory committee included Elders from Métis and First Nation communities, as well as members from the community who work with Indigenous youth. Participants taking this course have three months to complete the course from the time they log into the course. Participants have taken anywhere from a week to four weeks to complete the course. [expand title="READ MORE" swaptitle="LESS" trigpos="below"] Learning Objectives Explain the current context of youth suicide within Indigenous communities Describe the impact of key historical events that have disrupted cultural continuity and continue to negatively impact Indigenous youth Identify and define factors that either protect or put Indigenous youth at risk of suicide Recognize the warning signs or invitation suggesting that an Indigenous youth might be at risk of suicide Recall the legal responsibilities when working with Indigenous youth at risk of suicide Define the three levels of suicide response: Prevention, Intervention, and Postvention. Audience Ages 18+ This workshop provides information and offers practical approaches for those working with Indigenous youth ages fifteen to twenty-four. The precipitating factors of suicide are different in Indigenous communities than in the general population. Certificate Participants will receive a certificate of completion after completing the online course. [/expand]


    We must all advocate for Indigenous rights

    Many Indigenous communities in Canada experience very high suicide rates, especially among young people. In some communities, youth die by suicide 5 times more often than youth from the general population and that number rises to 11 times more if the youth is Inuit. Why are we losing so many young Indigenous individuals to suicide? The effects of colonization and social and economic inequity in Indigenous communities are at the root, as they can lead to feelings of hopelessness and behaviours which can put individuals at risk for suicide. Members of Indigenous communities are often closely related and share the same social predicaments; therefore, the impact of a single suicide is often felt by the entire community. There is also a greater risk of individuals killing themselves in response to the suicide, as they may feel depressed and hopeless after the loss of a loved one, and see suicide as an option, a “normal” way to cope with these feelings. Not all Indigenous communities have high rates of suicide, though. Indigenous leaders and community members are taking great steps to prevent suicide and in communities where control over services is autonomous, and where culture is honoured and taught, suicide rates are very low if not non-existent. Non-Indigenous Canadians can effect positive change, too. Many Canadians are unaware of the detrimental effects that colonization had and continues to have on Indigenous people and we need champions for Indigenous rights who can inform others and further the process of healing and reconciliation. Last week, the world lost one such non-Indigenous champion in Gord Downie. Downie brought great awareness to the injustices and historical trauma suffered by Indigenous people. His multimedia project Secret Path is a riveting declaration of his support for Indigenous justice and reconciliation. It chronicles the life and tragic end of Charlie Wenjack, who was sent - like so many other Indigenous children - to a residential school.  Charlie escaped from the brutal school, but tragically died trying to return on foot to his far-away home in Northern Ontario. Near the end of the final Tragically Hip concert in August of 2016, Downie drew attention to PM Justin Trudeau who was there that night, and stated that “(Trudeau’s) leadership will take us where we need to go.”  Downie acknowledged that it may take a “hundred years” to rectify the wrongs done to First Nations people; “people who we have been trained to ignore for all of our lives.”  This message reached not only the thousands of people in the concert audience, but also the several million others watching on TV. The massive number of tributes expressed on radio, television, online, and in print about Gord Downie’s death by brain cancer last week says it all: he was well-loved and will be sorely missed. His support of Indigenous causes reached a lot of people. When the Assembly of First Nation’s Chief Perry Bellegarde heard the sad news that Downie had died he offered this tribute: “I honour the life and work of Gord Downie, a dedicated and accomplished artist who used his profile to advance reconciliation and build support for First Nations peoples. I will always be moved by the powerful moment last December at our Assembly when we honoured Gord for his work, and gave him the Lakota name Wicapi Omani - Walks Among the Stars.” [caption id="attachment_67799" align="aligncenter" width="640"] Gord Downie performing live.[/caption] We hope that the leaders of our country, led by PM Justin Trudeau, will continue to work towards reconciliation with Indigenous people and ensuring their rights. We share our country’s grief at the loss of Gord Downie and believe that if his words and actions educate and motivate even a fraction of his fan base - who might otherwise remain unaware or apathetic to Canada’s true history - then his efforts will have made a difference. Find out more about Indigenous suicide prevention in our resources and workshops. 


    Walk With Me

    This workshop is intended for Indigenous caregivers working in Indigenous communities. The Walk With Me workshop draws heavily on Indigenous culture and tradition as it seeks to take participants through the cycle of suicide grief. Indigenous communities are frequently struck with a series of suicide deaths in a short period of time, each of these deaths adding to the already present burden of grief and loss. Bringing community members together for a day of hope and healing builds understanding and strength. This workshop takes the participants on a journey from the past, to the present and looks to the future; it creates a context for people to examine where they are in the grief cycle and how they can move forward to hope. [expand title="READ MORE" swaptitle="LESS" trigpos="below"] It is recommended that participants of this workshop also attend the 2-day ASIST workshop for skills-based suicide intervention training. Workshop Topics: Stories of Indigenous experiences Talking openly about suicide Suicide bereavement model How we heal Developing grief work strategies Self-care Audience Ages 18+ This workshop provides information and practical approaches for understanding and dealing with our own grief and to better understand others’ grief. It is NOT a replacement for grief counselling nor does it train participants to become counsellors. It is recommended that participants wait a period of time after losing a loved one to suicide before attending this workshop. Information provided is appropriate for beginner and intermediate social work practice. Certificate All participants will receive a participation certificate upon completing 7 hours of instruction. Special Accommodations Please contact the Centre for Suicide Prevention if you need specific accommodations. [/expand]


    Indigenous Suicide Prevention

    First Nations (status and non-status peoples), the Inuit and Métis are collectively referred to as Indigenous people. Indigenous people in Canada have some of the highest suicide rates in the world, but this is not true for all Indigenous peoples. There are also many communities that have very low rates of suicide. Historically, suicide was a very rare occurrence amongst First Nations and Inuit (Kirmayer, 2007). It was only after contact with Europeans and the subsequent effects of colonialism that suicide became prevalent. Statistics In the 2006 Census, a total of 1,172,790 people in Canada identified themselves as Indigenous people. A National Household Survey in 2011 showed that 1,400,685 people in Canada identified themselves as Indigenous persons. This represents 4.3% of the national population. The 2011 statistics show an Indigenous population increase of 20.1% between 2006 and 2011, compared with 5.2% for the non-Indigenous population (Statistics Canada, 2013). Suicide and self-inflicted injuries are the leading causes of death for First Nations youth and adults up to 44 years of age (Public Health Agency of Canada, 2016). Approximately 46% of all Indigenous children are under 25 years of age (Statistics Canada, 2012). The suicide rate for First Nations male youth (age 15-24) is 126 per 100,000 compared to 24 per 100,000 for non-Indigenous male youth. For First Nations females, the suicide rate is 35 per 100,000 compared to 5 per 100,000 for non-Indigenous females (Health Canada, 2010). Suicide rates for Inuit youth are among the highest in the world, at 11 times the national average. Legacies of Colonization The effects of colonization and governmental policies of forced assimilation continue to cause acculturative stress and marginalization amongst the Indigenous population.  These effects can be passed on from one generation to the next; this is referred to as intergenerational trauma. They can ultimately manifest in behaviours which may place individuals at risk for suicide (see risk factors below). Some of the effects of colonization include: Residential schools experiences Forced adoptions and foster care Forced relocation from one community to another Denial of existence as people (as in the case of the Métis Nation) (Kirmayer, 2007) Consequences of these legacies include: an eradication of culture, an erosion of traditional values and a loss of traditional family stability (Elias, 2012). Acculturative stress often occurs when an individual is trying to adjust to a new culture. This stress can manifest through the victim’s feelings of marginality, depression, anxiety, and identity confusion (Leach, 2006). Suicide Contagion & Clusters (excerpt from iE10: Suicide Contagion and Clusters) Many members of Native reserves are closely related and share the same social predicaments. The impact of a single suicide is often felt by the entire community. Because of the closeness of the residents, there is a greater risk of a contagion effect leading to a cluster of suicides (Kirmayer, 2007). These can also manifest as “echo” clusters which refer to clusters that occur over an extended time period after the original cluster (Masecar, 2009). A single death by suicide can resonate for months to come, with individuals taking their own lives in imitation of a prior suicide. It is important to note, however, that not all Indigenous communities have experienced suicide clusters or have regular incidents of suicide.  In communities where there is a strong sense of culture, community ownership, and other protective factors, it is believed that there are much lower rates of suicide and sometimes none at all (Kirmayer, 2007). Unfortunately, on some reserves where these protective factors have not been strongly developed, the situation can sometimes be severe. The wounds of historical social and economic upheaval caused by colonization, residential schools, and the “sixties scoop” (and into the seventies where children were taken off the reserves and fostered to mostly Caucasian families) continue to fester in many areas today. This is often called “acculturative stress” and inhibits the growth of a healthy environment. The young will be increasingly vulnerable as Indigenous are the fastest growing ethnic group in Canada. Protective Factors There are certain social conditions which can help create a positive and healthy environment for both a community and its individual members. Chandler and Lalonde (1998) have identified six protective factors which they found in Indigenous communities that had low rates of suicide. These are identified as “cultural continuity” and include: Self-government Land control Control over education Command Police and Fire services Health services Control of cultural activities (Chandler, 2005; CSP, 2003) They also found lower rates of suicide in communities where the indigenous language was widely spoken (Chandler, 2005). A study of various bands in British Columbia indicated that those bands with higher levels of language knowledge (more than 50%) had fewer suicides than those bands with lower levels. [caption id="attachment_765" align="alignnone" width="900"] Image by United Nations[/caption] Risk Factors The following are risk factors which can place an individual at risk for suicide: Depression and other mental illnesses Alcohol and drug dependency Hopelessness Low self-esteem Sexual abuse and violence Parental loss Homelessness (Elias, 2012) The Urban Indigenous Experience Indigenous people who live in cities and towns are an often overlooked segment of our overall urban population. 54% of First Nations (both status and non-status), Inuit and Metis now live in cities and towns (Place, 2012). Many Indigenous people who spend their time living between reserves and cities regard themselves as “boundary spanners” (Letkemann, 2004). For some, this separation from the home community can often heighten feelings of cultural isolation and cause further family instability. Others, however, may adapt to urban life easily. Urban Indigenous people face challenges to their cultural identity which include discrimination and racism, exclusion from opportunities for self-determination and difficulty finding culturally appropriate services. A loss of connection with the land, contact with Elders, and engagement in spiritual ceremonies may contribute to the effects of marginalization and isolation. One consequence for those who live in cities is possible homelessness - Indigenous people are greatly overrepresented in the urban homeless population.  Another is disproportionate incarceration: although they comprise only 3% of the Canadian population, Indigenous people make up 22% of those sentenced to custody in the provincial or federal correctional systems (Environics, 2010). Prevention Suicide affects the youth in Indigenous communities more than any other demographic. Suicide occurs roughly 5 to 6 times more often among Indigenous youth than non-Indigenous youth in Canada. Community and Spirituality Suicide prevention is best undertaken by community members, friends and family who understand the social context of the community. Strategies must be formulated in response to local cultural meanings and practices (Wexler, 2012). Some prevention strategies include: Community-based approaches Gatekeeper training School-based suicide prevention programs Means of suicide restriction Peer support programs (Kirmayer, 2007) Community Wellness Strategies: prevention should be the responsibility of the entire community (CSP, 2003). Spirituality has been recognized by many as a key part of wholeness. In western approaches to mental health, the Indigenous concept of well-being and spiritual wellness is largely absent. Spirituality is a key part of wholeness. [caption id="attachment_45983" align="alignnone" width="1024"] Image by Leo Vaha[/caption] Traditional healing practices place healers and community members at the heart of the healing process, and Western practitioners supplement by acting as secondary helpers. This is a more culturally sensitive approach that can be integrated into a diverse range of Canadian Indigenous communities (Wortzman, 2009). An example of a community-based approach utilizing cultural and spiritual methods as healing practices can be found in Alkalki Lake, British Columbia. Dances, ceremonies, and spiritual practices, such as pow-wows, sweetgrass ceremonies, sweat lodges, and drumming circles were used by traditional healers to try and treat the substance-abuse issues of some of its members. The guiding philosophy of this treatment program was: “Culture is treatment, and all healing is spiritual”.  The community reduced its alcoholism rate from 95% to 5% in ten years (McCormick, 2000). [caption id="attachment_45982" align="alignnone" width="1024"] Image by Kris Krug[/caption] References Centre for Suicide Prevention. (2003). Suicide among Canada’s Indigenous peoples. Alert #52. Chandler, M. and Lalonde, C. (2008). Cultural Continuity as a protective factor against suicide in First Nations youth. Horizons, 10(1):68-72. Elias, B., et al. (2012).Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada’s residential school system. Social Science & Medicine. 74(10), 1560-1569. Environics Institute. (2010). Urban Indigenous peoples study: Main report. Toronto, ON.: Environics Institue. Retrieved from http://uaps.ca/wp-content/uploads/2010/03/UAPS-Main-Report_Dec.pdf Hallett, D., Chandler, M. and Lalonde, C. (2007). Indigenous language knowledge and youth suicide. Cognitive Development, 22(1):392-399. Health Canada. (2010). Acting on what we know: Preventing youth suicide in First Nations. Retrieved from http://www.hc-sc.gc.ca/fniah-spnia/pubs/promotion/_suicide/prev_youth-jeunes/index-eng.php#tphp Kirmayer, L., et al. (2007). Suicide among Indigenous people in Canada.Ottawa, ON.: Indigenous Healing Foundation. Leach, M. (2006). Cultural diversity and suicide: Ethinic, religious, gender and sexual orientation perspectives. New York: Hawthorn Press. Letkemann, P. (2004). First Nations Urban Migration and the Importance of “Urban Nomads” in Canadian Plains Cities: A Perspective from the Streets. Canadian Journal of Urban Research, 13(1):241-256. McCormick, R. (2000). Indigenous traditions in the treatment of substance abuse. Canadian Journal of Counselling, 34(1):25-32. Olson, R. (2013). iE10: Suicide contagion and clusters. iE:infoExchange. Place, Jessica. (2012). The health of Indigenous people living in urban areas. Prince George, B.C.: National Collaborating Centre for Indigenous Health. Retrieved from http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/53/Urban_Indigenous_Health_EN_web.pdf Public Health Agency of Canada. (2016). Suicide prevention framework. Retrieved from https://www.canada.ca/en/public-health/services/publications/healthy-living/suicide-prevention-framework.html Statistics Canada. (2012). Aboriginal Peoples: Fact sheet of Canada. Retrieved from https://www150.statcan.gc.ca/n1/pub/89-656-x/89-656-x2015001-eng.htm#a3 Statistics Canada.(2013). Indigenous Peoples in Canada: First Nations People, Métis and Inuit. National Household Survey, 2011. Retrieved from http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99-011-x2011001-eng.pdf Wexler, L. and Gone, J.(2012).Culturally responsive suicide prevention in indigenous communities: Unexamined assumptions and new possibilities. American Journal of Public Health. 102(5), 800-806. Wortzman, R. (2009). Mental health promotion as a prevention and healing tool for issues of youth suicide in Canadian Indigenous communities. First Peoples Child & Family Review. 4(1):20-27. Related Links Miyupimaatisiiuwin Wellness Curriculum (MWC) MWC is a Canadian school-based suicide prevention program developed in 2000 to promote a wide range of healthy lifestyle choices to counteract the long-term incidence of suicide, as well as substance abuse and violence. It focuses on “wellness” and targets children from kindergarten to Grade 8. This holistic program emphasizes Indigenous culture and was developed with the Cree community to encourage active participation of the family and community. River of Life: Online Course about Indigenous Youth Suicide The River of Life course discusses strategies designed to strengthen the protective factors of Indigenous youth at risk. The material focuses on providing participants who work with Indigenous youth the knowledge to respond to those at risk of suicide.


    Trauma and suicide in Indigenous people

    This toolkit is one of a suite of three focused on trauma. The full suite includes: Trauma and suicide, Trauma and suicide in children and Trauma and suicide in Indigenous people.  Trauma is very common among people in Canada, and the Indigenous people in Canada (First Nations, Metis and the Inuit) have nearly 4 times the risk of severe trauma than the non-Indigenous population (Haskell & Randall, 2009). Colonialism is responsible for much of the trauma experienced by Indigenous people all over the world, and its effects continue to this day (Linklater, 2014; Haskell & Randell, 2009). Most people receiving treatment for mental health issues have had some form of trauma (Rosenberg, 2011). Trauma places people at higher risk for additional mental health issues such as depression and addiction. People who have experienced trauma are also at greater risk for suicide. What is Trauma? Trauma is “a horrific event beyond the scope of normal human experience” (Greenwald, 2007). Some examples of traumatic experiences include: motor vehicle collision; rape; losing a loved one; and childhood abuse, neglect. Some of the many traumatic experiences caused by colonialism include: forced settlement of nomadic tribes; forced relocation from traditional settlements; and removal of children from their homes into residential schools, non-Indigenous foster homes or orphanages in the “sixties scoop”. Historical Trauma The traditional ways of living that fostered resiliency in Indigenous communities were almost completely abolished by colonialism: not only did acts of colonialism cause trauma in Indigenous people, but it also affected their means of coping with and healing from trauma. This is why historical trauma is so enduring and continues to negatively affect generation after generation of Indigenous people today (Linklater, 2014; Haskell & Randell, 2009). Effects of historical trauma: depression and mental illness, sometimes leading to suicide; feelings of hopelessness; addiction as a result of coping by drinking or doing drugs (substance abuse); and sexual and physical abuse including domestic violence. What are Indigenous healing practices? Indigenous healing practices are often based on natural law and the medicine wheel. Natural law is the widespread Indigenous belief in the interconnectedness of nature, animals and man. There are 7 natural laws that provide guidance to human beings derived from the animals that personify them: Love (eagle), respect (buffalo), courage (bear), honesty (sasquatch), wisdom (beaver), humility (wolf) and truth (turtle) (Bouchard & Martin, 2009;  Piitoaysis Family School, n.d.). The medicine wheel recognizes four aspects of the individual: the physical, the mental, the spiritual, and the emotional. All of these are taken into account when looking at a person's overall health. These aspects are interconnected and, when balanced, an individual is whole and healthy (McCormick, 1996). The coordinate indicators (north, east, south and west) symbolize the individual's connection with Mother Nature, which is also vital to their health and well-being (Margot, L. & McKenzie, M., 2006). The medicine wheel approach is different from typical western healing practices because it is holistic and considers all aspects of the individual equally, whereas western medicine tends to focus on the individual's physical health in isolation. Some examples of healing practices include: sweat lodges; smudging; and healing circles. Effective healing practices: are informed by Indigenous peoples themselves; are culturally relevant; strengthen bonds with Indigenous traditions and heritage; and foster resilience, which helps those exposed to trauma survive, resist and cope with its destructive effects (Haskell & Randell, 2009). Indigenous healthcare practitioners and helpers in the healing movement draw on: ceremonies; traditional knowledge; and cultural practices (Linklater, 2014). Collaborative Practices: “Two-eyed seeing” The best health outcomes of Indigenous peoples are achieved when they provide leadership in addressing their own trauma and mental health. However, collaboration between mental health providers, who offer more mainstream approaches, and affected communities is also crucial. Learning to see from one eye with the strengths of Indigenous knowledges and ways of knowing, and from the other eye with the strengths of Western knowledges and ways of knowing… and using both these eyes together, for the benefit of all” Eskasoni Mi’kmaq Elder Albert Marshall (Hogue & Bartlett, 2014, pp. 30-31). Trauma-Informed Care and Indigenous healing practices Trauma-Informed Care (TIC) is a determined effort to implement a better approach to treating people that takes into account the impact that previous traumatic experiences have had on an individual’s overall mental health. What is wrong with you?” has shifted to “What has happened to you?” (Rosenberg, 2011). Most Indigenous communities base their healing practices on the belief that connection with nature and community is vital to the overall health of an individual, while TIC stresses the well-being of the individual. Despite this difference, both traditional Indigenous healing practices and TIC share common elements. Both: understand that a traumatized person’s behaviour is a normal response to trauma; embrace a strengths-based approach (as opposed to a deficiency-based approach which focuses on the flaws in the “character” of the trauma survivor); respect the individual and their culture and treat them with dignity (Haskell & Randell, 2009); are holistic in acknowledging the physical, psychological, emotional and spiritual aspects of one’s overall health; and believe there is no “cookie-cutter” path for one’s health and no single “correct” way or approach (Linklater, 2014). In order to effectively treat traumatized people who are Indigenous, people working with them: need to be trained to deliver a trauma-informed approach in an Indigenous context; and must be aware of the interplay of traumatic historical events and social conditions that impact both the community and the individual (Haskell & Randell, 2009; Linklater, 2014). Cultural safety and competence have been identified as key components in providing services to Indigenous people. Without them there are greater chances of inaccurate or inappropriate assessments, inadequate treatment, and risk of re-traumatization (Twigg & Hengen, 2009). Read more about TIC in iE13: Trauma-Informed Care: Trauma, substance abuse and suicide prevention Trauma-Informed Indigenous programs Biidaaban Healing Lodge Pic River Nation, Ontario Round Lake Treatment Centre Vernon, British Columbia Tsow-Tun Le Lum Society Lantzville, British Columbia Urban Native Youth Association (UNYA) Vancouver, British Columbia Restorative justice and historical trauma Restorative justice attempts to repair the harms done to people and relationships through wrongdoing. It tries to restore those damaged relationships and ensure that everyone involved is treated with equal concern, respect and dignity. It is not a return to the past but the creation of a better future (Llewelyn, 2008). People are interconnected and when wrongs are perpetuated it affects not only the victim and offender but the fabric of society. Restorative justice owes much to the insights of Indigenous conceptions of justice. It is a restoration of balance and harmony like that represented by the medicine wheel (Llewellyn, 2008). The Truth and Reconciliation Commission in Canada is one such example of an organization dedicated to restorative justice. References Bath, H. (2008). The three pillars of trauma-informed care. Reclaiming Children and Youth, 17(3),17-21. Bouchard, D. & Martin, J. (2009). The seven sacred teaching of White Buffalo Calf Woman. Retrieved from http://www.btgwinnipeg.ca/uploads/5/2/4/1/52412159/the_seven_sacred_teachings_.pdf Greenwald, R. (2007). EMDR: Within a phase model of trauma-informed treatment. New York: Routledge. Haskell, L. & Randall, M. (2009). Disrupted attachments: A social context complex trauma framework and the lives of Aboriginal peoples in Canada. Journal of Aboriginal Health, 5(3), 48-99. Hogue, M. & Bartlett, C. (2014). Two-eyed seeing: Creating a new liminal space in education. Canada Education, 56(3), 30-31. Linklater, R. (2014). Decolonising trauma work: Indigenous practitioners share stories and strategies. Toronto, ON.: Fernwood Books Ltd. Llewellyn, J. (2008). Bridging the gap between truth and reconciliation: Restorative justice and the Indian residential school Truth and Reconciliation Commission. In Castellano, B., Archibald, L., & DeGagne, M. (Eds.), From truth to reconciliation: Transforming the legacy of residential schools (pp. 183-201). Ottawa, ON.: Aboriginal Healing Foundation. Margot, L. & McKenzie, M. (2006). The wellness wheel: An aboriginal contribution to social work. Paper presented at First North American Conference on Spirituality and Social Work,  Waterloo, Canada. Retrieved from http://tapwewin.pbworks.com/w/file/fetch/52896768/LoiselleMcKenzie.pdf McCormick, R. (1996). Culturally appropriate means and ends of counselling as described by the First Nations people in British Columbia. International Journal for the Advancement of Counselling, 18,163-172. Piitoyais Family School.( n.d.). The seven sacred teachings. Retrieved from http://schools.cbe.ab.ca/b244/seven.htm Rosenberg, L. (2011). Addressing trauma in mental health and substance use treatment. The Journal of Behavioral Health Services & Research, 38(4), 428-431. Twigg, R. & Hengen, T. (2009). Going back to the roots: Using the medicine wheel in the healing process. First Peoples Child & Family Review, 4(1), 10-19. Veriest, L. (2006). Allying with the medicine wheel: Social work practice with Aboriginal peoples. Critical Social Work, 7(1). Retrieved from http://www1.uwindsor.ca/criticalsocialwork/allying-with-the-medicine-wheel-social-work-practice-with-aboriginal-peoples


    Canada's Indigenous Communities and Suicide

    infoExchange is an original resource that examines topics relating to suicide in a way that encourages conversation, written in an editorial style. Click here to check out additional resources on Indigenous people and suicide prevention.  The reasons that any individual dies by suicide are multiple and complex. There are a host of psychological and biological factors that may influence someone to take his or her own life. Typically, there are many social and cultural factors that contribute to death by suicide as well (Lenaars, 2006). These particular complexities can be especially apparent in some Indigenous communities. Historical aspects that continue to affect Native Canadians socially and culturally to this day make suicide prevention efforts a continuing struggle. This situation is further complicated when acknowledgement is made of just how enormous and diverse this "community" actually is. Indigenous people in Canada include First Nations, Inuit, and Métis. Each of these distinct groups consist of unique peoples as well but they are all collectively referred to as "Indigenous." First Nations people are further divided into Status and Non-status Indians. This faction also consists of people who live on reserves and those who choose to move their residence to larger cities. In some cases First Nations members choose to reside both on-reserve and off, and migrate back and forth. Within each of these unique populations, rates of suicide differ. Some communities have few or no suicides, while others like some Inuit settlements in our nation's north — have the highest suicide rates in the world. So why are some Indigenous groups so much more at risk for suicide than other Canadian communities? Impact of Colonialism The historical events of colonialism, which continue to affect Indigenous peoples today, cannot be overstated. Various policies of forced assimilation have assaulted and suppressed Indigenous culture for as long as Canada has existed as a nation. An informative and witty account of this history by Indigenous writer, Thomas King, which I highly recommend, was published in 2012. The introduction of the reservation era in the 19th century, the residential school experience of the 20th century and the forced adoption policies of the 1960s and 1970s (also known as the "sixties scoop") are just three of the more egregious injustices perpetrated by the Canadian government. The eradication of culture and loss of language, erosion of traditional values, and the disintegration of traditional family structure are all long-term results of these policies. They have passed down through the decades like colonial heirlooms. This effect is often referred to as intergenerational trauma, and it has left many communities once proud cultural traditions buried deep and nearly smothered from years of shame and persecution. Some traditions, for example the speaking of distinct languages in certain areas, have been irretrievably lost forever (Kirmayer, 2007; Elias, 2012). The historical events of colonialism, which continue to affect Indigenous peoples today, cannot be overstated. [caption id="attachment_765" align="alignnone" width="900"] Image by United Nations[/caption] This was, and remains, dislocation on a grand scale: diverse groups of Indigenous peoples estranged from their land, culture, and heritage. This dislocation has historically created a psychological and social breakdown in many communities, causing feelings of marginalization, isolation, and hopelessness. Psychologist Bruce Alexander posits a theory of dislocation which states that those who are marginalized and "dislocated" will be more prone to states of despair and serious afflictions such as addiction. Additionally, states of "severe, prolonged dislocation regularly lead to suicide". And this dislocation need not only be geographical in nature — it can also result from the suppression of one culture by a dominating one. Obviously, this is applicable to any displaced or alienated group of people. Oppressed and marginalized peoples, be they in New Zealand, the United States, or here in Canada, will react in predictable ways. High rates of depression and mental illness, feelings of hopelessness, high incidence of substance abuse, sexual abuse and violence, are just a few of the behavioural predictors that result from oppression. Ultimately, the manifestations of such a dispiriting environment may also result in suicide (Alexander, 2008; Elias, 2012). And these rates of suicide can often be astoundingly high. It is important to note that before the 19th century suicide was extremely rare in North American Native communities. The culture shock that ensued with the arrival of the European explorers coupled with the institutionalized racism inherent in the Canadian government's policies, resulted in a steady increase of suicide in the 20th century which has continued until the present day. Suicides are especially high among the youth in some communities. Almost half (48%) of all Indigenous people in Canada today are under 24 years of age, and this age group is growing at a very rapid rate. Youth are in a seeming state of limbo as they "(Fail) to acquire and value Indigenous values and identity, while also failing to identify with the cultural values of the larger society" (Kirmayer, 2007). Even worse, among some youth, suicide has almost become a "normalized" response to a hopeless existence. The dire circumstances that surround these young people can further be exacerbated if the community formally chooses not to address the situation. In some areas the stigma of suicide is so strong that there is no word for it in the native language, and there is a pronounced reluctance and unspoken rule that the word "suicide" is not spoken (Olson, 2012). An added threat of suicidal contagion occurs on some Indigenous reserves because of the closeness of the residents and their shared social predicaments (Kirmayer, 2007). These clusters have the potential to "snowball" into what the mainstream media often describes and refers to as "epidemics'.' These crises are not confined to Indigenous reserves. As First Nations, Inuit, and Métis populations become larger in cities, suicidal behaviours are increasingly becoming an urban concern as well. 55% of the Indigenous populations already live in towns and cities, and it is a safe prediction these numbers will continue to increase in the future. It is important to note that this is not a new trend, and that not all Indigenous people are recent migrants; many have been residents for years, and many settled communities of Indigenous people can be found in all of Canada's major cities. However, our concern lies in the fact that these increases in urban populations are mostly due to new arrivals and that these migrants are generally young (Environics, 2010; Place, 2012). As First Nations, Inuit, and Métis populations become larger in cities, suicidal behaviours are increasingly becoming an urban concern as well. Displaced Indigenous youth might often find themselves in the city without vital cultural supports, and, additionally, they may experience prejudice and racism. The opportunities for employment may be few and, ultimately, this alienating environment can take its toll (Place, 2012). The lure of alcohol and other addictive substances can prove to be very strong, and there has been continuous wide-spread publicity about the fact that incidences of homelessness and incarceration are disproportionately high within this young group. For example, although they comprise only 3% of the Canadian population, Indigenous people make up 22% of individuals sentenced to custody in provincial or federal correctional systems (Environics, 2010). Culture as Cure The good news is that there are positive signs emerging that changing the prevalence of suicide for many of our country's affected Indigenous youth is possible. For example, The Urban Aboriginal Peoples Study (UAPS) suggests that a growing number of youth are starting to find more support in urban settings. Results of this study indicate that this is because there is more social integration and greater involvement in Indigenous cultural and political groups in urban centers. They further report that there were greater and more positive feelings of Indigenous pride among young people currently living in cities. Publications such as the magazine New Tribe acknowledge the accomplishments made by urban Indigenous people. Culture is treatment, and all healing is spiritual [caption id="attachment_764" align="alignnone" width="1024"] Image by Kris Krug[/caption] These efforts to provide reconnection to cultural heritage and pride in Indigenous culture are vital tools in this perpetual battle to combat feelings of hopelessness in those who feel that their lives are not important. Mental Health and Wellness The traditional western approach to both physical and mental health and wellness does not usually take into account spiritual elements, let alone Native spirituality. Spiritual matters have, however, always been at the bedrock of holistic Indigenous traditions, and healers continue to be integral figures who contribute to the overall health of the communities in which they practice. Any community-based or school-based programs designed to prevent suicide among Indigenous youth should have a spiritual emphasis. A renowned example of a community-based approach — although not specifically a suicide prevention program — utilizing cultural and spiritual methods as healing practices, can be found in Alkalki Lake, British Columbia. Dances, ceremonies, and spiritual practices, such as powwows, sweetgrass ceremonies, sweat lodges, and drumming circles were used by traditional healers to try and treat the substance-abuse issues of some of its members. The guiding philosophy of this treatment program is "Culture is treatment, and all healing is spiritual”. A study conducted during the program indicated that the community reduced its alcoholism rate from 95% to 5% over a ten year implementation period (McCormick, 2000). A program that has been lauded for its success is the Leadership Resiliency Program. This is a school and community-based program for high school students (14-19 years of age), that works to enhance the youths' internal strengths and resiliency, while preventing involvement in substance use and violence. Supporting cultural traditions has proven to be a powerful catalyst in restoring meaning and purpose to entire communities, and many youth who are deemed hopelessly adrift may find hope via this support. Identifying oneself with a proud heritage can go a long way to creating and maintaining strong feelings of self-worth and a positive self-identity. Our own efforts at the Centre for Suicide Prevention have been to develop, along with Indigenous leaders, an online suicide prevention program called River of Life. We are currently developing other workshops specific to Indigenous culture. These are created with direct input from leaders of Indigenous communities. There is also an Indigenous resource toolkit that is complementary to the preceding article. References Alexander, B. (2008). The globalization of addiction: A study in the poverty of the spirit. Oxford, UK: Oxford University Press. Chandler, M. and Lalonde, C. (2008). Cultural Continuity as a protective factor against suicide in First Nations youth. Horizons, 10 (I): 68-72. Elias, B., et al. (2012). Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada's residential school system. Social Science & Medicine, 74 (10): 1560-1569. Environics Institute. (2010). Urban Aboriginal peoples study: Main report. Toronto, ON.: Environics Institue. Retrieved from http://www.uaps.ca/wp-content/uploads/2010/04/UAPS-FULL-REPORT.pdf  Kirmayer, L., et al. (2007). Suicide among Aboriginal people in Canada. Ottawa, ON.: Aboriginal Healing Foundation. King, T. (2012). The Inconvenient Indian: A curious account of Native people in North America. Toronto, ON.: Doubleday Canada. Lenaars, A. (2006). Suicide among indigenous peoples: Introduction and call to action. Archives of Suicide Research, 10 (2): 103-115. McCormick, R. (2000). Aboriginal traditions in the treatment of substance abuse. Canadian Journal of Counselling, 34 (1): 25-32. Olson, R. (2012). iE7:Suicide prevention and cultural sensitivity. iE: infoExchange. Place, Jessica. (2012). The health of Aboriginal people living in urban areas. Prince George, B.C.: National Collaborating Centre for Aboriginal Health. Retrieved from http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/53/Urban_Aboriginal_Health_EN_web.pdf   


    Weekly News Roundup – July 17-23, 2017

    Every day we scan news headlines and social media for items of interest to the field of suicide prevention. Here's what we found last week: Linkin Park US tour cancelled after suicide of Chester Bennington - Reuters July 20, 2017 Chester Bennington, 41, lead singer of rock band Linkin Park, died by suicide last week. Bennington struggled with mental health throughout his life, and suffered from drug and alcohol abuse. Ottawa musicians plan benefit show in wake of high profile suicides - CBC  July 21, 2017 'My mind is a bad neighbourhood' - Chester Bennington's moving message about mental health - NME July 21, 2017 Chester Bennington's death is a reminder that mental health is a lifelong struggle - ATTN July 20, 2017 California Today: Stopping jumpers at California's bridges - New York Times July 20, 2017 Work on the suicide barriers being installed on the Golden Gate Bridge started in April, and officials are studying whether barriers should be installed on many other California bridges, such as the Coronado Bridge and the Colorado Street Bridge, as it has been shown that people who are prevented from killing themselves in the middle of a suicidal crisis often live long and full lives. CSP Librarian Robert Olson wrote about the importance of bridge barriers in suicide prevention in the article: 'Jumping' and suicide prevention. Indigenous suicide crisis: hundreds ask for counselling after Pikangikum First Nation sees 2 suicides - HuffPost July 18, 2017 Last Tuesday mental health workers arrived in Pikangikum First Nation to deal with the suicide crisis there, after 2 youth died by suicide. "There have been literally hundreds of people in this one community alone that have come forward asking for counselling," said Health Minister Jane Philpott. "We are needing ... to supply ... safe spaces for people to receive counselling, looking at accommodations for health workers who are going into the community." Ontario boosts resources to remote First Nation facing suicide crisis - Globe and Mail July 23, 2017 Canada committed to improving mental health in Indigenous communities: Philpott - Toronto Star July 18, 2017 Health Minister Jane Philpott writes in this editorial piece for the Toronto Star that the government is working to improve mental health in Indigenous communities, allocating $118.2 million over 5 years, which added to the $69 million allocated in 2016. Philpott highlights the need for social equality, especially in areas such as education, employment, housing, and community infrastructure. "We must acknowledge the tremendous amount of preventable suffering, trauma and loss of life in the past. But the future is before us, with the obligation to do better, to do right. The path to health and wellness for Indigenous peoples requires reconciliation, justice and equity. Nothing less," says Philpott. Learn more about how trauma affects Indigenous people in Canada with our resource toolkit on the subject. Ontario First Nation 'in shock' after two more young people take their own lives - Globe and Mail July 18, 2017 Pikangikum First Nation has lost four young people in the past three weeks. Anna Betty Achneepineskum, deputy grand chief of the Nishnawbe Aski Nation, of which Pikangikum is a member community, said that "We're always responding to crises, and all of the resources that we have are all committed to that part of it, so we really don't have the resources to develop some proactive and prevention measures." Suicide crisis meeting to address reducing bureaucracy faced by Indigenous leaders, federal health minister says - Toronto Star July 17, 2017 Next week, Health Minister Jane Philpott, the office of Ontario Health Minister Eric Hoskins, and Indigenous leaders from Northern Ontario will meet to discuss how communities can more quickly access funds meant to help them in times of crisis, funds which are now being held up by bureaucracy and not distributed in a timely manner. Some northern Ontario communities have recently been faced with suicide crisis. “We need to move beyond crisis management and see some permanent structures put in place to help us address youth mental health,” said Alvin Fiddler, Nishnawbe Aski Nation Grand Chief said. “We need to see some sort of permanent secretariat to address these issues, with input from the federal and provincial levels." 'These are our children:' Sexual abuse and suicide rate among Indigenous youth - CBC July 20, 2017 Subscribe to this weekly mailing list Archive