When Sean Hopkins reads about a suicide in Whitehorse, he braces for the worst. “It’s highly possible that I know or have even looked after that person,” he said.
Canadians in the territories are nearly three times more likely to be hospitalized for intentionally cutting, poisoning, or harming themselves compared to those in the provinces, according to an analysis of national health data.
Hopkins has worked as a mental health counsellor in Whitehorse for the past 18 years. He’s no longer surprised by the number of self-injury hospitalizations, but he can see the effect on the community.
“It’s a difficult reality and there’s a kind of intimacy here because we’re such a small population,” he said.
Nearly all of the Yukon’s mental health services are located in Whitehorse, leaving nearly 14,000 people who live outside the city with “a poverty of services”, according to Hopkins. He said a lack of mental health supports in remote communities across the territories could help explain the high rates of self-injury.
The analysis looked at data from the Canadian Institute for Health Information (CIHI). CIHI tracks self-injury hospitalizations that are deemed intentional, reflecting suicidal behaviour.
Northwest Territories suffered the highest rate of self-injury hospitalizations in 2015-2016, with 194 hospitalizations per 100,000 people. Manitoba recorded the lowest rate at 54 per 100,000.
Despite years of experience, Hopkins struggles to understand why the numbers remain so high in the territories.
“Is it isolation? Is it hopelessness? Is it the legacy of residential schools? We don’t actually know,” he said.
Mary Bartram is a health policy expert at Carleton University. If the country is serious about reducing numbers in the North, governments need to deal with issues such as housing shortages and food insecurity, she said.
Nunavut often has the highest rate of self-injury and is plagued with housing shortages. More than half of the population depends on social housing, yet the Nunavut Housing Corporation needs 3,500 new units.
Households in Nunavut are also nearly four times more likely to suffer from food insecurity compared to the provinces, according to a study by the Canadian Institute for Health Research. Food insecurity is defined as insufficient access to nutritious and affordable food.
Bartram said a chronic lack of social workers in Northern communities has led to higher rates of self-injury. 37 per cent of the social worker positions in Nunavut remain unfilled on a month-to-month basis, according to an Auditor-General report from 2011.
Stress levels among care workers who remain in the territories is a “very real issue”, Hopkins said. Many of his patients are paramedics and social workers, people who are intimately familiar with the number of self-injury and suicide victims in the Yukon.
“These are people who have experienced vicarious trauma from constantly, constantly dealing with these things,” Hopkins said. “It’s difficult to get any respite from that.”
Bartram and Hopkins both said conversations about self-injury in the North must also recognize Canada’s history of colonialism.
Indigenous peoples make up more than 50 per cent of the territorial population. Bartram said the legacy of residential schools and forced relocations contribute to a suicide rate that is five times higher among Indigenous youth compared to non-Indigenous youth.
Any effort to lower the rate of self-injury must “stress the importance of supporting Indigenous peoples, communities and governments to set their own priorities and implement them,” Bartram said.
$36 million in new funding for mental health for the territories has already started to flow, but the federal government has yet to disclose exactly where it’s going. Bartram called on the government to make those decisions public, to ensure the country is closing the gap in mental health outcomes between the provinces and territories.