Nunavut looks to local Inuit for advice on new Mental Health Act

When Nunavutsplit from the Northwest Territories in 1999, it adopted several pieces of legislation, including the already decade-old Mental Health Act; now,the governmentwants a 'Made-in-Nunavut' version.

The legislation governs how the most severe cases of mental illness are handled, including when people need to be held against their will ormedevacedto another community for treatment.

"We [as Inuit]have a different culture and if we use our culture it will be better," David Iqaqrialu said in Inuktitut. "As people in Nunavut, we need to be involved in changes."

The unilingual elder was one of nearly two-dozen people many of them Inuit eldersto come out to a lively public consultation in Clyde River last week.

This 'affects peoples' rights'

A group of health officials from the territorial government came prepared with a list of discussion questions and translated materials outlining what the Act does and how it might be changed.

"The Mental Health Act affects peoples' rights," said Lynn Ryan MacKenzie, the executive director of planning for the health department.

The legislationisused when people are in "real crisis" and in danger of hurting themselves or others.

"Since it affects people in Nunavut and their families, it's really important that the people of Nunavut have an opportunity to reflect on what's involved," she said.

In particular, the government wants to know what Inuit think about:

• how patients and families are told about their rights;
• when and how health workers can consult with elders;
• how long a patient can be held against their will;
• if patients should be able to keep information about their health private from their parents;
• and if new 'community supported treatment orders' should be an option to help patients avoid crisis situations.

'All my kids' have contemplated suicide

At community consultation in Clyde River, elder after elderexpressed a similarconcern: few understood what the Mental Health Act does and many wondered why they were provided with the discussion questions in advance.

"This is my first time finding out about these things," said Iqaqrialu.

Nevertheless, residents took advantage of the rare audience with government officials to express their frustrations and talk about their personal experiences with traditional healing.

Mental health is "a big issue" in the community, said Taapitia Aapa in Inuktitut. In the past, youth spent more time sewing and hunting with family and less time alone on the computer.

"It's very different now," she explained."We never thought about suicide.

"Now, all my kids and mygrandkidshave thought about taking their own lives."

During the consultation, Aapatold the officials about a time when her nephew became suicidal and was medevaced to Iqaluit. Later on, he was sent south to Toronto to be assessed by a specialist.

She wants to see doctors include families more in treatment.

"It's bad when a family member is sent away and you are not informed, because you can't talk to them."

Not helping breeds 'anger and hurt'

Under the Mental Health Act, patients can invoke their right to privacy, effectively barring families from becoming involved.

Many say that's not the Inuit way.

"It's important for parents to be informed because if they're not informed, they won't be able to help," said Iqaqrialu."When they're not helping, it will breed anger and hurt in them."

During a recent coroner's inquest into Nunavut's high rate of suicide, Shuvinai Mike spoke candidly about the effect this policy has had on her life.

When Mike's daughter died by suicide, she learned that it was not her first attempt.

"If I had been informed of this," she said."I definitely would have intervened andsoughthelp with her."

In the end, the inquest's jury recommended the Mental Health Act be changed to ensure afamily member isalwayscontacted after suicide attempts something every person who spoke at the Clyde River consultation seemed to support.

The community consultations are set to wrap up in Iqaluiton November 26. After that, the health department is set to speak with local health practitioners and Inuit organizations.