Nunavut suicides a "public health emergency".

Nunavut’s government “shall immediately declare suicide a public health emergency,” and appoint a Cabinet minister responsible for suicide prevention, recommended a coroner’s jury in Iqaluit. The territorial government should appoint the new minister by its next sitting and add a secretariat with “the mandate and the resources to demonstrate the Government’s commitment to this crisis,” by April 2016, the six-member jury stated. The jury delivered its recommendations at the close of the Sept. 14–25 inquest into a record 45 suicides in Nunavut during 2013. The territory has not yet agreed to appointing a Cabinet minister or creating a Secretariat. Neither did it agree to a new action plan to implement a suicide prevention strategy that the inquiry’s expert witnesses praised as the “gold standard” in prevention. Instead, in its closing recommendations at the inquest, the government acknowledged the crisis and agreed to increase funding for two nonprofit organizations: a helpline and the Embrace Life suicide prevention council. The territory also promised — as it has before — to collect data on suicide attempts. It did not agree to create a system to follow up on people who have attempted suicide, or to adopt two of the jury’s other recommendations, which were to mandate school-based programs on improving coping skills and protecting against sexual abuse. Calling the inquest was Nunavut coroner Padma Suramala’s attempt to force action from Nunavut’s government, which had ignored her previous request for urgent help. The territory’s suicide rate is 9.8 times greater than elsewhere in Canada. This isn’t the first time the word “emergency” has been used to depict the crisis. On May 18, 2013, after responding to the suicide of a 13-year-old girl in Pangnirtung, Suramala pleaded with then-Health Minister Keith Peterson, then-Justice Minister Daniel Shewchuk and senior bureaucrats “to declare a state of emergency,” which could have resulted in additional federal funding or expertise. “We have reached a breaking point and our community is under crisis,” Suramala said in an email, obtained through an Access to Information request. Describing a sleepless night agonizing over “the impact of drugs, alcohol, violence and sexual abuse” on Nunavummiut, Suramala asked why a 13-year-old girl chose to die “before even experiencing her life?” But the government did not declare a state of emergency. An inquest was the best tool to expose the growing number of deaths, Suramala said. More than two years later, the inquest jury echoed Suramala’s assessment of the severity of the continuing crisis. The inquest heard from more than 30 witnesses, including government representatives, the architects of the territory’s suicide prevention plan and the families of an 11-year-old boy and a 25-year-old man who were among those who killed themselves in 2013. The jury has called, once again, for government action. “Calling a state of emergency will kick in more resources, more funding and dedicated people working on the issue,” Suramala told CMAJ. “I did what is my part. It’s now in the government’s hands, and it is in the public’s eyes.” — Laura Eggertson, Ottawa.