embracing life: northern saskatchewan working together

Embracing Life:Northern Saskatchewan Working TogetherOctober 29 and 30, 2013Prince Albert

Dr. James Irvine1

IntroductionHow Embracing Life workshop was developedThe need for continued ACTION

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What is Embracing Life?Ongoing action for suicide prevention starting with a

2-day North-wide action based workshopA starting point to develop action items to address

suicide in every community in the northCommunity specific actions utilizing our strengths

and resources most effectivelyPlatform to provide input & plan action steps for

reducing suicides and self-harm by health promotion, suicide prevention, intervention and post-vention

Comprehensive & across organizations, governments and communities.

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Why is this Important?A call to action to reduce suicides and self-harm

We all have a role to play in suicide prevention – need for ownership, commitment and collaboration

Building on our strengths

Establishing North-wide supports

Moving forward from previous work

Suicide and self-harm are continuing issues in the north

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Deaths by suicide Canada 2000-2007; and North Sask 2000-2009

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Hospitalization for Self-Harm North Sask and Sask 2002-2010

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Hospitalizations for self-harm North Sask and Sask - 2002 to 2010

Death by suicide is the tip of the iceberg

What lies underneath?

The many faces of the same issues:

Deaths by suicideThe crisis: a symptom of underlying issues.

Self-harm, assaults, injuries Emergency department visits and hospitalizations

Mental health issuesUnresolved grief, previous traumatic events,

depression, substance / alcohol abuse, bullying

Social issuesPoverty, intergenerational trauma, cultural

loss

CPHO’s Report on the State of Public Health in Canada 2008, Addressing Health InequalitiesFrom: Dahlgren G, Whitehead M (1993)

Things that determine our health = health determinants

Canadian Supplement to UNICEF’s THE STATE OF THE WORLD’S CHILDREN 2009, Aboriginal children’s health: Leaving no child behind

The Balance

Protective factors Risk Factors

Risk factors versus protective factors

Risk Factors:• Mental illness – depression, anxiety, substance abuse• Previous attempts – especially with highly lethal means• Precipitant e.g. stressful life event, social humiliation or disgrace, • Impulsivity• Family history – family communication / parental monitoring• Environment characterized by abuse and/or loss • Family or friends’ histories of suicides or self-harming• Sexual identity• Intergenerational trauma• Poverty

Risk factors versus protective factors

Protective Factors:• Social supports• Sense of family cohesion• School connectiveness• Sports involvement• Community engagement in rebuilding or

maintaining their cultural continuity

Risk Factors

Individual influencesSocial risk factorsCultural & systemic risk factors

Risk Factors:

1) Individual influences: one’s own psychological state, personality, mental / emotional health– Low self-esteem, depression, impulsivity, sexual

orientation, substance abuse2) Social: school, peers, community, parents, etc

– Suicide by a friend or family member, sexual victimization, family violence, neglectful and unsupportive parents, social isolation

3) Communities, Culture and Continuity– Cultural identity, colonization, intergenerational trauma

Suicide Continuum of Care

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• Minimizes the impact of a suicide on survivors; important for prevention

• Policies and programs that

enhance healing, mental, spiritual, social, & physical

well-being

• Provides coping and problem-solving for

increased resiliency, reduced risk

conditions

• Early recognition, direct contact with the person involved, access to assessment and care

Post-Vention

PreventionInter-vention

Deaths from heart attacks is decreasing in Canada the efforts of many people

• Members of the public knowing the signs and knowing CPR• Emergency responders, primary care providers• Specialists• Life behaviour influencers – healthy eating, physical

activity, education on smoking reduction, medical prevention management

• Policy makers – e.g. regulations on smoking, food, etc to make healthier environments

Promotion Prevention Intervention Rehabilitation

Suicide and Self-harm

• Awareness of signs and symptoms• Knowledge of what to do if you know of someone• Human services providers, schools, workplaces,

communities• Where to seek help – crisis lines 811, • Screening through primary care sites for risks• Access to counseling and supports• Access to care• Post-event counseling and supports

Promotion Prevention Intervention Postvention

Whose Responsibility Is It To Reduce Suicide and Self-Harm?

WE ARE ALL RESPONSIBLE!!!

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Multiple actions at multiple levels - long-term – community driven

Promotion PreventionInter-

ventionPost-

vention

Community

Regional

Northwide

Provincial & National

What has happened?NHSP – A Suicide Prevention Resource:

Exploring Strategies for Northern Saskatchewan 2009

Northern Suicide Prevention Forum 2009

Suicide Prevention, Intervention and Post-Vention Training

Health Line 811 22

What is currently happening?First Nations and Inuit Health Branch, SK

Region Strategic Review Metis Nation – Saskatchewan Northern Youth

Suicide Prevention National Aboriginal Youth Suicide Prevention

StrategyProvincial Mental Health and Addictions

Action Plan

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What is currently happening?Saskatchewan Suicide Protocols for

Saskatchewan Health Care ProvidersSuicide Prevention Policy for regional

health authorities by March 31, 2014Pre-Workshop Activities

MatricesTraining and Resource ListLiterature Review

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How Will Embracing Life Be Effective?

Building on work that has been done previously Background information collectedBest practices, programs, gaps, resources, trainingPresentations meant to provide thorough

information for participantsOpportunity for ALL participants to provide

feedback & input on: priorities, action items, gapsBreak out sessions planned to obtain input from

front line staff, community members, Elders, youth, agencies, organizations, etc.

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How do we best come together and move forward for mental well-being?

What approaches are required? Traditional approaches; conventional mental health; youth development; others.

Thank you for attending, for your participation, your voice, your desire for change for a brighter future for our youth.

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Embracing Life CommitteeSo far, composed of

representatives from:

First Nations University of CanadaFederation of Saskatchewan Indian Nations

Health CanadaKeewatin Yatthé Health Region

Mamawetan Churchill River Health RegionMinistry of Government Relations

Ministry of JusticeNew North SANC Services Inc.

Northern Human Services PartnershipNorthern Inter-Tribal Health Authority

Northern Lights School DivisionPopulation Health Unit

Prince Albert Grand Council 27

Thank You!