The only full-time, provincially funded mental-health position in Attawapiskat First Nation has been vacant since last summer, in part because of a housing shortage that has long plagued the northern Ontario community now dealing with a spate of suicide attempts among children as young as eight years old.
The Weeneebayko Area Health Authority told The Globe and Mail on Tuesday no one applied for the position until the fall, but that candidate fell through when she learned she would not have access to the same housing as nursing staff, who live on hospital grounds in homes with up to three bedrooms. In early March, with the position still vacant and no other applicants from within the community or otherwise, the provincial authority approached that same candidate and told her it would, in fact, allow her to stay in the nurses' housing, even if it means a nurse might have to share his or her home when the community is at full staffing.
The new worker starts on April 18, nine days after 11 people – 10 of them youth – attempted suicide in Attawapiskat on Saturday alone. On Monday, a group of children, including an eight-year-old, were apprehended by the Nishnawbe-Aski Police Service and brought to the local hospital, where they were treated and assessed amid concerns they were part of a suicide pact and planning to end their lives that night. On Tuesday, several more people were brought to the hospital as part of the suicide crisis, according to Nishnawbe Aski Nation Deputy Grand Chief Anna Betty Achneepineskum, who is currently in Attawapiskat.
The mental-health crisis flaring up there and in other remote indigenous communities across the country is so grave that federal MPs opted to hold an emergency debate in the House of Commons on Tuesday night to discuss the issue. Attawapiskat's declaration of a state of emergency on Saturday marks the latest in a string of alarming situations in northern communities such as the fatal school shooting in La Loche, Sask., the rash of suicides among Manitoba's Pimicikamak Cree Nation and the house fire that killed nine family members in Ontario's Pikangikum First Nation, which has long grappled with a suicide epidemic.
On Tuesday, federal Health Minister Jane Philpott said in Ottawa that various levels of government are responding to the crisis. Eighteen additional mental-health workers have been deployed to the typically resource-strapped community. Weeneebayko, for its part, has sent in its professional practice director, three mental-health workers, a Cree-speaking social worker and a traditional healer. At the same time, four support workers who had been dealing with the tragedy as it unfolded in recent days were expected to fly out for some rest.
Indigenous Affairs Minister Carolyn Bennett noted to reporters on Parliament Hill that aboriginal youth are significantly more likely to die by suicide than their non-aboriginal counterparts. "We want these kids to feel good about their lives," she said. "This is not where we want to be."
And yet, this is the bleak reality in Attawapiskat: Some of the children apprehended by police Monday had to spend time in a holding cell, where they could be kept safe, until health workers could see them at the hospital; some of those children had recently been treated for suicide attempts – "repeats," as Health Canada assistant deputy minister Keith Conn put it Tuesday; many of the attempts over the past couple of months were overdoses by youth stealing prescription drugs, including blood thinners for diabetics; some children have spoken about being bullied; several youth have been airlifted out of the community to urban centres after threatening or attempting suicide, only to be sent back to Attawapiskat after a day or two.
Mr. Conn said his understanding is that at least some of the youth who were treated Monday had previously been sent away for psychiatric examination and then discharged back to the community – evidence, he and community leaders say, that the assessment process needs to be re-examined, especially with regard to the aftercare plan.
There must also be more aggressive efforts made to permanently hire mental-health workers to serve the community of Attawapiskat, including its students, Mr. Conn said. "You can imagine the school systems are going under a level of stress with bullying, for example," he said.
The federal government is responsible for providing health care to First Nations and Inuit communities across Canada. However, in the case of Attawapiskat and a handful of other communities around James Bay, Ottawa struck an agreement several years ago that turned the job of health-care delivery over to the provincially funded Weeneebayko authority.
Health Canada still provides health and wellness programming as well as funding for crisis intervention through the Nishnawbe Aski Nation, the territorial organization that represents Attawapiskat, which declared a state of emergency over a housing shortage in 2011.
Deborah Hill, Weeneebayko's chief nursing executive and vice-president of clinical services, told The Globe that the new mental-health worker in Attawapiskat is replacing a woman who held the job for about a decade and who was allowed to live in the nursing quarters as a "one off" exception to a policy dating back to when the authority was federal. While the position sat vacant, regional mental-health workers went into Attawapiskat for at least a week each month and offered "telemedicine" through video-conferencing, she said.
"WAHA, as an organization, deemed this valuable enough, and shuffled their resources to make it happen," Ms. Hill said. "That community deserves their own worker."