PROMISING PRACTICES
A Podcast about Mental Health and Addictions

Episode 10: Nunavut

Episode 10: Healing (NU)

May 27, 2021 – Learn about healing programs being offered to the people of Nunavut. You will hear about the approaches Nunavut is taking to reduce the stigma often associated with seeking mental health and addictions supports, as well as innovative ways to support those in need, especially among the youth.

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Loretta O’Connor: Welcome back to the Promising Practices podcast. This is episode number 10 of our 13-episode series on mental health and addictions.

This podcast series is an initiative of Canada’s Premiers.  The aim is to share promising practices that are underway in each province and territory.  In each episode, we introduce you to experts in the field and learn more about innovative practices and programs.

My name is Loretta O’Connor. I head up the Council of the Federation Secretariat, an organization that supports the work of Canada’s Premiers. The goal of Premiers is that this podcast reduces the stigma associated with mental illness and addictions, and also enables a more focused and collaborative approach by provinces and territories.

Today, we are in Nunavut, a massive and sparsely populated territory in northern Canada. All of Nunavut’s communities are remote, isolated and fly-in only communities, which often makes delivering services challenging. Almost half the population is under the age of 25. Nunavut’s people are close-knit, resilient and caring. They are also kind and generous. However, like many places, there remains a stigma around mental illness and addiction. Various social factors contribute to Nunavut being worse off than other areas in Canada. For example, many people live in overcrowded homes, many people experience economic hardship, and many families often struggle to put food on the table, among many other things. These factors contribute to a suicide rate in Nunavut that is higher than the national average.

I would like to remind everyone listening that if you or someone you know is struggling, help is available. Please reach out for help if you need it. Call the Kamatsiatut HelpLine at 1-800-265-3333 or Kids Help Phone at 1-800-669-6868. For online resources, check out wemattercampaign.org.

Let’s start the podcast by welcoming the Premier of Nunavut, Joe Savikataaq, who will introduce us to Nunavut, its people and the importance given to providing mental health and addictions services to those in need.

Premier Joe Savikataaq: Welcome to Nunavut’s podcast on mental health and addictions. I am Joe Savikataaq, the Premier of Nunavut. In our podcast you will likely hear the word Nunavummiut. This is a widely used Inuktitut term we use when we talk about Nunavut residents.

Nunavut is a jurisdiction with the smallest population size in Canada, with about 40,000 residents, spread very widely over a large land mass in Canada. It is the only jurisdiction where all 25 communities are remote and isolated. This means that Nunavut’s 25 communities are fly-in and fly-out only – we have no roads and no connection between our communities.

Nunavut is a unique jurisdiction in Canada. It has the highest percentage of Indigenous People, with roughly 85% of the population being Inuit. We also have the highest percentage of Indigenous language speakers, and roughly 70% of Nunavummiut speak Inuktut languages – Inuktitut and Inuinnaqtun. Nunavut has four official languages, Inuktut, as well as English and French.

Our territory’s remoteness, our population demographics and our unique language requirements mean that we have to find unique ways to deliver mental health and addictions services to Nunavummiut. We often have to provide mental health and addictions services that are culturally appropriate for the largely Inuit population. It also means that the services we provide are in our Inuktut language.

As well, we often have to find unique ways to provide mental health and addictions services to our remote and isolated communities. We provide virtual and mobile services and, when that is not available, Nunavummiut may have to travel long distances to access mental health and addictions services in other communities. We are proud of the mental health and addictions services we provide to Nunavummiut.

On our podcast, we have Victoria Madsen, who is the Assistant Deputy Minister for Inuusivut for the Department of Health, who will be interviewing Jukipa Kotierk, who is the Wellness Program Specialist, and Sheila Schweder, a Child and Youth Outreach Worker. We hope you enjoy our podcast and learn more about the amazing services we offer to Nunavummiut.

Loretta O’Connor: We just heard from Premier Savikataaq about the unique and special challenges that Nunavut faces in delivering mental health and addictions services to its residents.  We will now hear from Lorne Kusugak, Nunavut’s Minister of Health and Minister responsible for Suicide Prevention, who will tell us more about the state of mental health in Nunavut and the ultimate goal of providing the necessary supports and resources to build stronger families and communities.

Minister Lorne Kusugak: Mental health is an important part of everyone’s well-being, and it is an aspect of care that the Department of Health is committed to.

We know that Nunavummiut struggle with issues that contribute to high rates of addiction and suicide. Compared to the rest of Canada, Nunavummiut, and particularly Inuit, struggle with rates of addiction and suicide that are reportedly higher when compared to other Canadian peers. These unfortunate statistics are compounded in youth who make up nearly 40% of the Nunavut population.

We know that the state of mental health in Nunavut is impacted by a variety of factors and it is a complex issue. Overcrowded and inadequate housing, poor food security, unemployment, and multi-generational trauma all contribute to the struggles Nunavummiut face.

When combatting the harms of addictions and suicide, our goal is to provide Nunavummiut with the support and resources necessary to take care of their mental health and build stronger families and communities. We strive to make these supports available here in Nunavut whenever possible because we know that people have greater successes when they are supported by family, friends and community.

For instance, where we cannot provide the support in Nunavut, we have strong partnerships with facilities and professionals in the south who ensure access to quality and needed care.

Solving these problems requires not only a whole of government approach to address the issues I have mentioned, it also needs better recognition and resources from the federal government, who have a responsibility to Canada’s Inuit.

There is much to say on the topic of mental health in Nunavut, but I hope this brief outline has helped shed some light on the issues we face and the work we are doing to address them.

Loretta O’Connor: Thank you Minister Kusugak for that excellent overview.

Next off, I would like to introduce Victoria Madsen who is Nunavut’s Assistant Deputy Minister with responsibility for Mental Health and Addiction. Victoria will have a conversation with two individuals who are on the ground providing mental health services in Nunavut. We’ll hear about their challenges, as well as the people they’ve helped. First, we’ll hear from Sheila Shweder. Sheila is a Child and Youth Outreach Worker in the remote community of Rankin Inlet that is accessible only by air. We’ll also hear from Jukipa Kotierk. Jukipa is a Wellness Program Specialist in Iqaluit, the capital city of Nunavut. But first, here’s Victoria to start things off.

Victoria Madsen: Hello, I'm Victoria Madsen. Thanks for joining us for Nunavut's Promising Practice podcast. We're going to talk to two women from two communities: one is from Rankin Inlet in the Kivalliq region, and the other, the territory's capital, Iqaluit. Both of these women have developed and implemented programming to help fellow Nunavut Inuit with the pressures of today, as well as past trauma. Their creativity is applauded, as programming is difficult in our isolated communities, due to few supplies, staff shortage, and difficulties finding space for gatherings. Let’s hear what they have accomplished, and imagine how many people they have helped.

Sheila Schweder: My name is Sheila Schweder. I’m from Rankin Inlet, Nunavut, born and raised. We have a population of 3,633 people. The town itself was founded by the owners of Rankin Inlet mine, just north of Johnson Cove, starting in 1957. The mine produced nickel and copper ores from an underground operation. The mine was the first case of Inuit miners in Canada. When the mine closed in 1962, Rankin had a population of approximately 500 Inuit, and 70 to 80% had been mine workers. That includes my late grandparents Alphonse Naqulisik and Charlie Schweder.

Rankin Inlet is also the hub of seven developed communities: Arviat, Baker Lake, Chesterfield Inlet, Coral Harbour, Naujaat, Whale Cove. Rankin Inlet, being the hub, is the only location where the jet will land. They use a smaller aircraft, Calm Air, to fly into developed communities. I am a listener, and actively involved with my community as a Child and Youth Outreach Worker, running programs, and a member of the District Education Authority, with three schools in our community. The other committee that I'm in is the Community Justice Committee. We have helped support individuals by using restorative justice.

I feel having support services and running programs within our community helps individuals. Like many Canadians, I have struggled with mental health. I've seeked for help and support I knew I needed, and eventually was happy to overcome my challenges. As we all know, mental health issues impact many of us with mental health or addiction problems. I feel it makes it harder when we live in an isolated community that is only fly-in or out, or seasonal to other developed communities by boat or snow machine. This creates barriers to access services. On one hand, we have a close-knit community to help support; the other hand, lack of privacy can cause hurdles to deal with any situation to attempt to seek resources.

Victoria Madsen: Sheila, we know sometimes people do not access mental health services due to stigma. How do you work around this barrier?

Sheila Schweder: What I feel that helps with destigmatizing is running programs to help make new friendships, while learning a new experience with hand sewing, or using a sewing machine. When individuals first arrive to programs offered, they are unsure how to connect the pieces; how to ask for support to connect those pieces to complete their project, such as our personal life challenges. We aren't sure of because it's hard to relate to new situations with our mind and body to adjust to mental health challenges.

Once we are able to communicate with other individuals, things make more clear sense. Instead of replaying in our mind, we can lead to a healthy lifestyle, by educating how we can manage to put our pieces together, by service providers within our community: such as Mental Health, Victim Services, spousal abuse program, adult addiction with Baptist Church, Justice Outreach worker, Kivalliq counselling and services run by Pulaarvik Friendship Centre, with culture support workers, are some of the services Rankin Inlet has to offer.

Victoria Madsen: Along with the new skills, what else do people develop from these programs?

Sheila Schweder: With that said, once the program is complete, we create new friendships and new skills to take home with us, such as new myths and new understanding that, after all, we aren't alone, because we have different learning techniques. And this is one we can be proud of: our culture to help with our mental health, by sewing for our loved ones during long winter seasons, or a snuggly that we can carry our baby during warmer seasons.

Victoria Madsen: These are very needed and wonderful programs. What else have you been able to offer the people of Rankin Inlet?

Sheila Schweder: Other programs that Mental Health in our community ran, was the “Embrace Life Week,” where we were able to embrace our support by decorating our windows with quotes and pictures. And at the end of the month, we drew names for a chance to win a few prizes to acknowledge their support. And at the end of the week, we did a community “Embrace Life Walk,” which I felt helped individuals that did take part, who lost a loved one die by suicide. I feel we all have our life journey. And when we are ready for change, we reach out to understand our grief – in many ways, to cope. And this is one way that helped many people.

Victoria Madsen: Sheila, are there any mental health programming for the children of Nunavut?

Sheila Schweder: We also have helped children and youth by starting a mentorship program. Inuit are living with intergenerational trauma from residential schools, that made such a big impact in parenting, child-rearing practices, mother tongue, identity, and trying to understand two worlds they live in. Inuit were resilient artists, nomads that survived on the land for decades before residential school. The first residential school was in the 1950s in Chesterfield Inlet, and ran until 1969. There was also tuberculosis that affected many Inuit, leaving their homes at a very young age for a very long time, which affected attachment, and withdrawn to their culture.

When we ran the mentorship program, we praised them for taking part; for helping each other, eating a meal, arts and crafts, and working as a group, without bullying, and we made it fun for everyone. Local youth from the high school were trained and hired to run the after-school program from Monday to Friday. This helped with self-esteem, able to understand we can reach out for help, empowerment from themselves to be a big brother and sister in the community, even if they see each other in the community.

It helped everyone that attended the program to understand and learn as a group; we ran for three years in our community. This year I trained the local after-school drop-in centre staff, so the local hamlet can try to run the after-school mentorship again. This would help benefit with cognitive behaviors for all ages. The youth praising the children and youth that attended also gained themselves by noticing the good consistency, having a structured routine, and gaining new continued friendship and support in our community. I hope I inspired you with our culture and community. Continue to grow and learn by listening.

Victoria Madsen: Absolutely. This has been an inspiration. Thank you, Sheila.

Sheila Schweder: It was my pleasure, Victoria.

Victoria Madsen: Hello, Jukipa. We are excited to hear about the programming you've helped design and implement for Nunavut Inuit. Can you first tell us a little bit about land-based programming?

Jukipa Kotierk: Thank you for having me. My name is Jukipa Kotierk. The Nunavut Land-Based Treatment program is based on existing Connections program that has successfully been delivered in Cambridge Bay, Nunavut. It is being revised to better reflect Inuit culture across Nunavut, with representatives from each regional Wellness Centre. It is based on both clinical and culturally appropriate programming. This program is designed to meet the needs of Inuit in Nunavut. It is currently in its novel stages, and it has been offered in Kanngiqtugaapik, or Clyde River, Nunavut, with the Ilisaqsivik Society. It is also set to take place in Cambridge Bay, with the Department of Healthy Living, as well as Pulaarvik Kablu Friendship Centre in the coming year. The program is based on an adaptive approach that is reflective of regional and seasonal distinctions to meet the needs of all Nunavummiut. Flexibility is a functional asset and part of the program's foundational structure.

Victoria Madsen: Wonderful. Can you please tell me a little bit about yourself and the work you've done with treatment programs in Nunavut?

Jukipa Kotierk: As a community member, I highly value culturally grounded and accessible programs and services. As a former public servant with the Government of Nunavut, I highly value being able to do what I can to help and make sure these programs are available to the population of Nunavut. I am mindful of the current reality that Inuit and Nunavummiut live with, as impacts of loss and trauma to suicide, and degradation of mental health because of these losses and traumas, have impacted me on a personal level.

Victoria Madsen: You are clearly invested in helping fellow Nunavummiut. What is important to you as you develop these programs?

Jukipa Kotierk: When it comes to unique individual hardships and traumas, I want to be able to know that my territory has the services that can meet the cultural needs of Inuit. It is important to me that this takes fold this way, so that the continued holistic approaches to wellness that our Territory creates and supports is reflective of the history, present-day reality, and works towards building and sustaining healthy, culturally rich features of Inuit.

Victoria Madsen: And how can this be done?

Jukipa Kotierk: One way that this is able to be done is through facilitating delivery and development of land-based treatment programs, with the help of clinical advisors with experience in Nunavut, as well as the three regional wellness and/or friendship centers, which are the Pulaarvik Kablu Friendship Centre based in Kangiqliniq in the Kivalliq region; the Ilisaqsivik Society based in Kanngiqtugaapik in the Qikiqtaaluk region; and the Department of Healthy Living with the hamlet of Cambridge Bay, based in Iqaluktuuttiaq in the Kitikmeot region.

This work is being supported by the Wellness Program Specialist position, with the Quality of Life division. This allows for the development of the land-based program to better reflect the diversity of Nunavut, and allow for all regions to be equally represented, while ensuring clinical measures are accounted for, as well as providing an opportunity for the Land-Based Treatment program to truly be a territorially collective program. The Land-Based Treatment program is for those suffering from substance addictions, and has been revised from the Connections program, which has successfully been offered in Cambridge Bay, and adapted to better reflect Nunavut and Inuit culture.

Victoria Madsen: This is wonderful, Jukipa. How has the program developed, and what plans might there be for the future?

Jukipa Kotierk: So, the Land-Based Treatment program for those suffering from substance addictions is currently in its novel stages, given that it has recently been collaboratively redeveloped to better reflect Inuit culture across the Territory. At this point in time, we are looking to roll out the new program and pilot sessions across the Territory. We are looking to build capacity to ensure that the program can be offered in a way that meets Inuktitut speakers where they are most comfortable.

After-care is also very paramount and an area that requires additional attention, as well as ongoing measures are taking place to better offer after-care services across the Territory. It has been a pleasure to take part in the development and revision of this program to better fit the needs of Inuit and Nunavummiut. I'm looking forward to the continued services and delivery of this program. And in terms of future development, my hope is that it continues to be successfully supported across the Territory, and is able to meet the needs of Inuit.

Victoria Madsen: Thank you so much Jukipa.

Jukipa Kotierk: Thank you for having me. I'm really happy to be able to have shined some attention on this Land-Based Treatment program.

Loretta O’Connor: Thank you to Sheila Shweder and Jukipa Kotierk for sharing information on programs designed to meet the mental health needs of the people of Nunavut. The strong focus on flexibility and culturally appropriate options truly demonstrates Nunavut’s holistic approach to healing and wellness. Nunavut’s isolated communities certainly make it more challenging for people to access mental health and addiction services.  However, by using creative and unique approaches, such as youth mentorship programs, friendship sewing groups, community walks and land-based healing programs, Nunavut has begun to address some of these significant challenges.

Join us again next week when we’ll learn about New Brunswick’s Clinical Framework Model from the Acadian Peninsula.  This model helps to provide better mental health services to young people with complex needs. It allows for a strategic approach to identify the clinical interventions that best meet the needs of the young person and their family.

So, please join us again next week for another promising practice in the field of mental health and addictions.

 

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