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"There's no doubt in my mind," Ontario Health Minister Eric Hoskins said last week of the First Nations community of Pikangikum, "that it's a community in crisis."

With all due respect to Dr. Hoskins, it would require willful blindness to arrive at any other conclusion.

Pikangikum, a remote Ojibwa community of about 2,800 in northwestern Ontario, has been in a state of crisis for decades.

Read more: Ontario boosts resources to remote First Nation facing suicide crisis

In 2000, a British sociologist calculated that it had the world's highest suicide rate, at 213 suicides per 100,000 people.

In 2012, Maclean's magazine famously dubbed it "the suicide capital of the world," after the rate reached 250 per 100,000 people. Many more have died by suicide since then, the latest being four youths this month, including two 12-year-olds.

Dr. Hoskins responded to the most recent deaths by announcing that the Ontario government will send 20 mental-health workers to the community, to reinforce the eight already there. Ottawa is considering sending the Armed Forces to put up tents or other temporary facilities in which to hold the counselling sessions.

The community will soon have one mental-health worker for every 100 residents, and it may still not be enough. Because, while counselling can save lives, it can't do anything about the underlying causes of Pikangikum's distress.

What is needed is a frank understanding of the situation. Thankfully, one was recently provided by a member of the Ontario Court of Justice who has travelled to the community once a month for 24 years, first as a lawyer and then as a judge.

"I have seen first-hand the steady and rapid increase in the size of the community, the explosion in violent crime and the deterioration of living conditions," Justice David Gibson wrote in a criminal-case decision he handed down in January of this year.

Judge Gibson was ruling on the sentencing of two Pikangikum men who pleaded guilty to charges stemming from their part in a riot that broke out in 2015, after an OPP officer used a taser on a unco-operative local man during a traffic stop.

"Seventy-five per cent of the community is under 25 years old," he wrote. "The entire population lives in 375 homes. A single diesel generator supplies electricity to the community and 80 per cent of the homes lack running water and sewage. Unemployment is 75 per cent. Alcoholism and solvent abuse is rampant, with estimates that up to 500 young people regularly sniff gasoline."

He quoted the Ontario Chief Coroner, who investigated the suicide rate in Pikangikum in 2011 and reported that, "A lack of an integrated health-care system, poor education by provincial standards and a largely absent community infrastructure are uniquely positioned against the backdrop of colonialism, racism and social exclusion…."

The judge was daringly frank in acknowledging the influences that turned a tiny trapping outpost of about 100 people in 1955 into the state-dependent community of 2,800 that it is today.

The arrival of a Hudson Bay Trading post in 1959, from which federal subsidies were dispensed, and a reliance on welfare payments that increased with the number of children in a family, were factors in the town's settlement and growth, he wrote.

But he also rightly blames Christian missionaries who urged residents to abandon old traditions, and the sexual abuse suffered by young Pikangikum children at residential schools, for the breakdown of the family unit. The dearth of basic services compounded an imposed dysfunction. And so did the utter lack of jobs.

So what can be done? You can send every mental-health expert in Canada to Pikangikum, and you can build a new school, as was done last year, but that can only do so much.

The question that needs asking is, how do you reconcile the right of Indigenous people to live on their ancestral lands with the undeniable fact that, in some remote, fly-in communities, there is no viable economy to support them?

Pikangikum may be the most extreme example of this conundrum, at least in Ontario. Other communities in the Nishnawbe Aski Nation (NAN), a loose organization of First Nations communities in Northern Ontario, have social problems too, including high suicide rates. But most are much smaller in size. And many have better, if still struggling, local economies.

On Monday, Ontario, Ottawa and NAN officials signed an agreement to give NAN communities control over health-care services. That will help, as could Ontario's 2013 decision to grant Pikangikum a license to develop the ancestral boreal forest that surrounds it. If the community can find a way to exploit the timber resources and create jobs, that might make all the difference.

Barring that, though, change will be hard to bring. The people who live there are resilient. They want to fix the home they love, and Ottawa and Ontario must do more to help. But no community can flourish when almost every one of its residents can't find work.

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