On multiple occasions over years, Gjoa Haven MLA Tony Akoak rose in the legislative assembly and demanded better mental health services for his community.
First elected in 2013, Akoak said he remains just as concerned about the situation today.
"There's no improvements in the system that's supposed to help out there," said Akoak. "We have a lot of people that do need help in this community. There's still not enough services to help them out. I'm still very concerned of their well-being. I've been trying to bring it up a lot of times and it still seems to be on deaf ears."
The Kitikmeot MLA's comments come on the heels of a recent damning decision from Nunavut Justice Bonnie Tulloch in regards to a 2017 fatal stabbing death in Gjoa Haven. Tulloch stated that "limited resources devoted to mental health by the Government of Nunavut played the largest role" in the homicide.
A mental health specialist occasionally comes into the community, Akoak said. There was a very good counsellor who was appreciated by local residents, but he transferred to Cambridge Bay. The lack of continuity is a drawback, he acknowledged, adding that the small number of mental health professionals is another impediment.
"We have people here who help out when needed, but they're so short-staffed. They get tired too, just like the nurses," said Akoak.
The MLA still wants a mental health and addictions treatment centre to be based in Gjoa Haven that would also serve Kugaaruk and Taloyoak.
An Oct. 18, 2018 letter from then-Gjoa Haven mayor Joanni Sallerina to members of territorial cabinet referenced a related letter sent several months earlier. The correspondence again emphasized the need for a regional mental health and addictions centre to be located in the community.
'An unbreakable hold'
"Sometimes it feels like the accumulative effects have an unbreakable hold on our (residents), especially the mentally ill, who struggle to find the ability to fight back," the letter reads. "If nothing is done, these types of addictions will significantly contribute to a vicious cycle of poverty for future generations as they will not be given the right environment to develop properly into good contributing citizens."
The hamlet's correspondence cites the dangers of addictions to alcohol, cannabis, gambling, cigarettes and poor food choices, particularly as those issues directly affect youth. This contributes to low attendance rates in schools, according to the letter.
"We also believe that the accumulation of all these types of health issues contribute significantly to the high rate of suicides of our loved ones," the 2018 letter states.
"If we consider (mental health and addictions) as the root of a lot of our other social problems, then we should want to focus our resources on solving these issues as opposed to spending money trying to solve the symptoms that will never go away if the root problems never get resolved."
Nunavut News asked the Department of Health to list the mental health resources available to residents of Gjoa Haven and also for comment on the recent court decision that found much responsibility lies with the GN for a 2017 Gjoa Haven stabbing death, where the assailant had very limited access to mental health services. No response came from the territorial government before press deadline.
An addictions treatment centre – a project with commitment from the federal government, Nunavut Tunngavik Incorporated and the Government of Nunavut – is expected to open in Iqaluit in 2025.
Remote help
The GN has a couple of active requests for contractor services pertaining to the well-being of Nunavummiut. One is for Inuit and Indigenous support addiction treatment programs, the other for remotely delivered counselling/therapy and clinical supervision services.
The former seeks recovery and treatment services that are "grounded in traditional Inuit or Indigenous cultural practices or ways of knowing and being."
"At present Nunavummiut have limited access to addictions treatment which is founded on Inuit and/or Indigenous culture. This (request for proposals) seeks to rectify this gap..." the document states.
High cost, limited services
The GN acknowledges that its existing focus is on high-cost acute services, "which is driven by the need to respond to acute issues such as suicidality and unmanaged psychosis." However, the territorial government expresses its long-term aspiration to develop "community-based service capacity ... with a focus on prevention and early intervention programming.
A current timeline for the development of specific community-based capacity increases does not exist at this time. It is recognized that it is necessary to continue to use out of territory service arrangements while service capacity within the territory is established."
In regards to remote counselling, the GN states, "there is a need to contract for services in order to establish the necessary capacity to address the significant burden of mental health and addictions pressures within the territory.
"It is expected that OOT (out-of-territory) mental health and addictions services will remain a necessary part of the Nunavut system of care for some time."