The Three R’s
Reports, Reviews, and Research:
A Synthesis and Discussion of Documentation on Initiatives around Death by
Suicide in Nunavut, 2003
Joan Brackenbury
April, 2004
List of Articles Considered in this Synthesis
A. Reports
1. Arctic Best Practices Workshop
2. Innuqatigiisiaqniq Forum Report
3. Piguninga Unipkaat: The Power of Storytelling:
Youth Engagement Conference
4. Inungi Sapuijjijiit: Our Words Must Come Back to Us:
Nunavut Suicide Task Force Report
B. Reviews
1. National Inuit Youth Suicide Prevention Framework
2. Suicide and Community Wellness in Nunavut
3. Mental Health Task Force, Government of Nunavut
C. Research
1. Unikkaartuit: Meanings of Well-being, Sadness, etc.
2. On the feasibility of conducting „psychological autopsies‟
in Nunavut communities
3. Suicide Response Plans: A Comparative Cross-jurisdictional Analysis
Reports for 2004 inclusion…currently under review
Tan, J.
Nunavut Kamatsiaqtut Help Line Survey Report
Zamparo, J.
Report on Availability of Information and Suicide Prevention Issues in
Nunavut Communities
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Reports, Reviews, and Research: Documentation on Initiatives around
Death by Suicide in Nunavut, 2003
Background
The Centre for Excellence for Children and Adolescents with Special Needs in Rural
Remote and Northern Canada based at Lakehead University, Ontario includes the
Mental Health Task Force sponsored by the Government of Nunavut, as one of its
many projects. This document, commissioned by the Mental Health Task Force, is
intended to provide a summary of initiatives taken around the issue of death by
suicide in Nunavut, 2003.
Introduction
Death by suicide continues to undermine the well-being of Nunavummiut.
Communities and families are bereft with the sense of loss. The Nunavut of vision,
planning, and hard work struggles with depression, anger, and housing deficit.
What has gone wrong? Why are youth not able to see opportunity? Identity, intimacy,
and ideals are replaced with isolation, ideation, and issues. Where do Nunavummiut
search for new resources? Return to the values of observation and listening. Look
within. The answers lie within the culture. It is time for Nunavummiut to raise their
voices and ask the questions of each other. It is significant that the title of the recent
Task Force on Suicide Prevention and Community Healing is subtitled, “Our Words
Must Come Back to Us”.
Despite prevention programs, healing sessions, preaching, interviews, surveys, and
statistics on the topic, the number of deaths by suicide in Nunavut continues to soar.
Since the formation of Nunavut in 1999 until March 2004, there have been 143 deaths
by suicide recorded. In Nunavut last year, 2003, there were 37 deaths by suicide an
increase of 61% over the 2002 total of 23.1
At the same time, in 2003, there were many attempts to answer the question as to what
was happening in Nunavut and what could be done about it. Events included the Best
Practices in Suicide Prevention Workshop, Iqaluit, the Rankin Inlet Youth and Elder
Conference on Suicide, the Innuqatigiisiaqniq Forum for elders and youth, the Power of
Storytelling Youth Engagement Conference, the Canadian Association for Suicide
Prevention Conference, the National Inuit Youth Conference on Suicide, and Inungni
Sapujjijiit, the Nunavut Task Force on Suicide Prevention and Community Healing.
Linked to these events were other community projects such as consultations and
interviews from which there was created a series of reports.
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Purpose
This paper will synopsize the results of the findings within ten of the Nunavut suicide
related documents written in 2003, with a particular reference to the at-risk for suicide
indicators identified in these documents. Currently, a Nunavut Suicide Prevention
Council, Isaksimagit Innusirmi Katujjiqatigiit, is at the implementation stage. It is
hoped that this document will provide a valuable reference for their work.
Organization of this report
The reports reviewed in this paper are grouped by type, named, and their purpose is
outlined. They are then examined for their references to at-risk for suicide indicators.
Insights as to the findings are discussed and finally, the summation theorizes about the
significance of the findings.
Reports: Types: Titles: Purposes
Event-based: What do we think we should do about youth suicide in Nunavut?
The theme of most event-based reports was to address the question, “What do we think
we should do about youth suicide in Nunavut?” Frequently the events included Inuit.
These reports are factual accounts of what happened during a particular event. The
events were broad-spectrum hence the reports do not deal only with risk indicators for
suicide: the indicators are embedded in the work. Frequently, the reports include
recommendations for what might work in communities to improve the current
conditions thereby presumably lowering the incidence of death by suicide.
The presence of risk indicators is both stated and implied in each report. There is a
recurring theme or understanding that the at-risk for suicide indicators are experienced
by large numbers of youth. Underlying that theme is the assumption that specific
conditions linked to risk indicators for suicide and youth who demonstrate warning
signs for suicide, are widely evident in the communities of Nunavut.
In order to answer the question of what should be done about youth suicide in Nunavut,
the following guiding questions were frequently raised:
What used to work (before contact with the Western-European culture)?
What is working well in our communities?
What assistance do we need (to get on with our lives)?
Who can assist us?
What are Inuit, other than those in Nunavut, doing (about suicide)?
This section outlines the events and their reports around suicide that took place in 2003.
It includes a brief overview and some highlights.
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Best Practices in Suicide Prevention and the Evaluation of Suicide Prevention Programs
in the Arctic: Henderson, A., March, 2003.
This report came out of a weekend workshop attended by approximately 40 delegates
from Alaska, Australia, Greenland, Nunavik, and Nunavut who were invited to listen
to, share ideas, and discuss recent developments in the area of effective suicide
prevention programming in the circumpolar world. Among the several speakers from
each region was Mr. Chris Aquino who described an Alaska program strategy that
focuses on the empowerment of local communities. Dr. Laurence Kirmayer from
Montreal, while speaking about at-risk for suicide indicators, mentioned depoliticizing
the issue of suicide, while engaging youth in political processes in order to create a selfdirection that might aid in suicide reduction.2 Dr. Tracy Westerman described her
aboriginal-specific research in Western Australia that has resulted in the development
of an at-risk for suicide early screening tool for aboriginal children. There were many
speakers – the workshop agenda was full. The report from this event is seventy-one
pages long and includes actionable recommendations and guidelines for moving
forward on the issue of suicide prevention.
Innuqatigiisiaqniq Forum Report: Government of Nunavut, Brackenbury, J.J., May,
2003.
The purpose of the Innuqatigiisiaqniq Forum was to focus youth and elders on an Inuit
discussion about suicide. The report purpose is to share the actual events of the forum
with those who did not attend in a manner that depicts the „feeling‟ of the event.
Twenty-six elders and twenty-six youth representing all of the communities in Nunavut
gathered to discuss death by suicide form their perspective. There was opportunity for
elders to discuss with other elders, and youth to discuss with youth, as well as the
intergenerational discussion groups. The sounds, sights, and stories, as well as the
teachings of the forum, are outlined in order to challenge the reader to think about the
next steps in preventing suicide – the action step. During discussions, at-risk for suicide
indicators were cited when delegates listed what and why something was working in
their home communities.
Piguninga Unipkaat: The Power of Storytelling: Youth Engagement Conference: May,
2003.
This conference was designed to engage youth in learning more about themselves, each
other, and wellness activities related to suicide prevention. Through the power of telling
a personal story, one realizes the significance of living one‟s entire life journey. Selfesteem and sense of purpose will be strengthened through the story-telling process.
Youth and elders worked through exercises and discussion together and, through this
process, suicide indicators were listed. Youth initiated concrete plans to assist with
suicide prevention in home communities. There is a section of recommendations from
Elders.
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Sivummut: Moving Forward (CASP): May, 2003
Although no formal report of this event is available, the purpose of the Canadian
Association for Suicide Prevention (CASP) Conference is to annually bring together
both national and international speakers to present on a variety of issues around the
topic of death by suicide. In May, 2003, the conference was held in Iqaluit, Nunavut‟s
capital. Many speakers participated in this huge and hugely successful gathering. Inuit
and non-Inuit presenters spoke to some 700 delegates. Consequently, the information
gleaned from the conference was carried far and wide. The CASP Conference
reflected a sense of national and international caring about the numbers of deaths by
suicide in Nunavut. One of a host of keynote speakers was Dr. Colin Tatz from New
Zealand.
Inungni Sapujjijiit: Task Force on Suicide and Community Healing: Our Words Must
Come Back to Us, Government of Nunavut: October, 2003.
The Nunavut Task Force visited seven Nunavut communities. Task Force members
participated on local radio to answer questions and listen to community members; they
visited elders, and held open community meetings. These efforts focused on hearing
more about suicide from the community perspective. The very comprehensive report
makes thirty-four recommendations based on a set of eight themes and in that process,
mentions many at-risk for suicide indicators.
Reviews
The review type of document creates an overview of what has happened and what is
currently happening around the topic of death by suicide in Nunavut. The review
documents do not make recommendations, except in the case of the National Inuit
Youth Suicide Prevention Framework.
National Inuit Youth Suicide Prevention Framework: Qikiqtani Inuit Association,
Stevenson, L. & Ellsworth, Q.: March, 2003.
Since youth are most at risk for suicide in the Nunavut population, the National Inuit
Youth Suicide Prevention Framework not only reviewed what was happening in terms
of programs, reports, and conferences on suicide among Inuit, it consequently created a
specific list of actionable tasks directed to Inuit youth and organizations.
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As examples:

from the Findings section comes the conclusion:
“There is
not enough knowledge of specific risk factors and there is a need for a
culturally specific risk assessment tool.”

from the Quality of Life section comes this recommendation:
“All stakeholders, including youth, adults, elders, governments, organizations must:
 change their emphasis from “the avoidance of death” to “the promotion of
life and well-being”: instead of focusing on problems, focus on building
strong communities.
Suicide and Community Wellness in Nunavut: Henderson, A.: July, 2003.
Commissioned by the Government of Nunavut, Health and Social Services, the purpose
of this report was to review current material and provide information on death by
suicide to the Nunavut Task Force on Suicide Prevention and Community Healing,
prior to their departure: it provides a clear summation of information as of July, 2003.
This comprehensive report examined what is known about suicide in Nunavut to that
date and what can be inferred from information about similar populations in the
circumpolar world.
Research
The purpose of each research paper is clearly stated in a thesis statement. Each is
focused on a specific aspect of death by suicide. They include the results of a long-term
study on conversations with Nunavummiut in Igloolik about perceptions of feelings, the
feasibility of conducting what is referred to as a, „psychological autopsy‟ interview of
Nunavummiut, a comparative analysis on suicide response plans, and an examination
of the Nunavut Helpline impacts , a report currently under review.
Unikaartuit: Meanings of Well-Being, Sadness, Suicide, and Change in Two Inuit
Communities: Kral, M.: February, 2003.
This feelings-related research paper recounts interviews with Inuit of Igloolik and
Qikiqtarjuak, Nunavut, about how they experience sadness, happiness, suicide. Because
the feelings include sadness, there are many references to what causes sadness, hence
the indicator of loss related to suicide is frequently cited. This type of research is rare in
that an interview team or individual must get to the core of others‟ feelings and
opinions. It is delicate and time-consuming process. The purpose of such research is
that it provides greater insight into how Inuit might relate feelings and death by suicide.
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On the Feasibility of conducting „psychological autopsies‟ in Nunavut communities: A
research report for GN Evaluation and Statistics: Government of Nunavut, Davidee,
Grier, Wenczler, & Stevenson: March, 2003.
The purpose of this work was to determine the feasibility of conducting „psychological
autopsies‟ in Nunavut. A psychological autopsy involves interviews of those persons
close to the deceased. The purpose of the psychological autopsy is to gather
information about risk indicators for death by suicide as well as increase knowledge
about what are protective factors against suicide. The report cites a lack of data on the
underlying factors as justification for this process and supports this approach if the
research “is done in a way that is culturally sensitive and that the interviewees receive
adequate psychological support.”
Suicide Response Plans: a Comparative Cross-jurisdictional Analysis: Minore, B. &
Hopkins, H.: April, 2003.
This research report produced a comprehensive policy document which supports and
supplements debate around suicide response planning specific to children and youth.
It examines the response plans that exist in each province and territory of Canada and
activities linked to establishing a nation-wide plan (for suicide response in Canada) are
explored.
The Mental Health Task Force: Government of Nunavut: Seburn, L.: November, 2003.
This research paper is a survey to assess what is known about, and the ease of access to,
information related to mental health and suicide prevention in Nunavut. Two key issues
are emphasized by the data: the need for more numerous and culturally specific
resources and information sharing in Nunavut. Collaboration, technology expansion to
ensure the availability of current information, increased service provider confidence,
and the availability of information in Inuktitut are elements of this report.
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Links between the Reports and Risk Indicators for Death by Suicide
Definitions
To avoid confusion around terminology, risk indicators versus warning signs are
defined; in the research there was evidence of these terms being used interchangeably.
Further, there is a debate over what constitutes a risk indicator. Research based in
Canada clearly includes gender and race as precipitating factors, plus accepts that
suicide is largely a mental disorder however, a recent Australian publication states,
“The personification of the very existence of people themselves as at „suicide risk‟ must
cease: you don‟t suicide because you are Inuit, or Maori.”3 If one embraces the medical
approach to suicide indicators, frequently depression can be the catch-all for a variety
of behaviours. So too might loss become the catch-all in an anthropological approach.
For purposes of this paper, it is understood that statistics clearly confirm the prevalence
of suicide amongst young, male Inuit in Nunavut, so the focus will be on other
indicators.
At-risks for suicide indicators used in this paper are:
Previous suicide attempt
Loss related to culture – food, language, tradition, skills, respect, culture, clear
role identification, kinship. alienation
Loss of person – romantic partner, friend to suicide, divorce of parents, health
Family dysfunction – fighting, violence, between parents and/or between
children and parents, financial stressors, child neglect
Substance Abuse - drug and alcohol, suicide attempts in family
Abuse – sexual, physical, emotional, mental
Depression to the point of hopelessness
Impending court date
Poor communications/social skills - isolation
Low self-esteem
Poor coping and solution-seeking skills
Pressure to succeed
Alternatively, warning signs relate more to the thoughts, feelings, behaviours, and
appearance presented by a person who may be at-risk for suicide.
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Warning signs for attempting death by suicide may be:
Thoughts - guilt, loneliness, escapism, sacrificing, scattered, worthlessness,
planning (for suicide)
Feelings - sadness, lethargy, apathy, distress, anger, hopelessness, helplessness,
worthlessness
Behaviours - crying, withdrawal, quitting, alcohol or drug abuse, recklessness,
fighting & law-breaking, “tidying-up”, or giving gifts (preparing for death)
Physicality - no appetite, disturbed sleep, loss of interest in appearance, loss of
interest in sex, lack of physical energy, withdrawal.
The next section of this paper shows a comparison grid of at-risk for suicide indicators
and whether or not they were referenced in the reviewed reports. A search for the
definitive list of indicators was the first step in the development of the chart, and at this
juncture, it became apparent that such a set of at-risk for death by suicide indicators for
Nunavut has not yet been determined.
Kirmayer‟s work around indicators for suicide among Inuit youth, in one community in
Nunavik in 19964, has frequently been used as a guide however Nunavut, 2004 is vastly
different from Nunavik, 1996. While it may be cogent to think that the at-risk for
suicide indicators are similar everywhere in the world, it is prudent to ascertain any
indicators specific to Inuit in Nunavut, should they exist, because therein may lie a key
to interventions being more efficacious. In the prologue of his paper, “Aboriginal
Suicide is Different”5, Tatz finds that culture and history play a highly significant role
in understanding youth suicide among Aboriginals. A comparison of sets of youth from
different cultures such as Maori and Inuit may not hold true, but these words sound
applicable to both cultures:
“To understand Aboriginal suicide one has to understand Aboriginal
history: their way of life has been destroyed, resulting in a loss of
structure, cohesion, and meaning.”
So one must acknowledge the complexity, the many causes of youth suicide, while at
the same time, attempt to isolate those unique factors which may cast light on the
increasing numbers of death by suicide. Consequently, a chart was developed to clarify
the process of determining what indicators were mentioned in which papers. Mention of
at-risk indicators was largely embedded in accounts of discussions. The work that needs
to be done includes the determination of an emergent pattern of at-risk for suicide
indicators that are „mainstream‟, those that are Nunavut specific, as well as their
frequency of mention. This would best be gleaned from Inuit-to Inuit dialogue.
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Suicide and Community
Wellness
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GN Mental Health Task
Force
Arctic Best Practices
Workshop
Previous attempt
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Innuqatigiisiaqniq Forum
Piguninga Unipkaat:
Youth Engagement
Conference
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Inungi Sapujjijiit
Task Force
National Inuit Youth
Framework
Suicide Response Plans
Comparative Analysis
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Pressure to succeed
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Weak coping skills
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Pressure of court date
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Depression
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Documents
in chronological order
Weak communications
skills
Feasibility of
Psychological Autopsies
Low self-esteem
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Abused
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Substance abuse
Loss of Relationship
Unikaartuit
Family dysfunction
Loss of culture
Comparison Grid of Indicators Mentioned per Report
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Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Discussion
Insights
What can we deduce by examining one aspect - the inclusion of at-risk for death by
suicide indicators - in these reports?
Despite the number and diversity of the reports (event-based, review, and research),
there was consistency in the repeated reference to perceived at-risk for suicide
indicators.
The most likely type of report to consistently mention at-risk for suicide indicators is
the event-based report.
The previous suicide attempt indicator was rarely mentioned.
The pressure to succeed indicator was not mentioned
The feelings-based research report, Kral, 2003, did not forward the at-risk for suicide
indicators as a topic for discussion during interviews. Precipitated by the questions
used, the indicators emerged as a result of people describing how they experienced
sadness.
[NOTE]Losses are shown as two separate indicators on the previous chart but, in fact,
in discussion, losses can be considerably expanded and shown to play a significant
role in how people think about themselves.
The use of the term losses is an alternative, more concrete way of thinking about
trauma. Losses are compounded from one generation to the next so many
Nunavummiut are thought to be carrying an intergenerational loss (trauma) load.
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Summary
At-risk for suicide indicators are frequently mentioned in documentation and
speeches on death by suicide, despite the documentation having a different and
specifically stated intent.
According to the documentation reviewed, there appear to be two at-risk for death by
suicide indicators - a previous suicide attempt and pressure to succeed- to which
significant importance was not ascribed.
At-risk for death by suicide indicators in other countries have been researched and
have been supposed to be largely similar for Nunavut, but there is no research-based
evidence to determine cultural differences specific to Nunavut and how they relate to,
and are experienced, around death by suicide. As referenced at the beginning of this
report, Tatz claimed that to understand youth suicide, one must first understand the
history of heir culture.
“Aboriginal peoples in Canada have faced cultural oppression
through policies of forced assimilation on the part of EuroCanadian institutions since the earliest periods of contact.” 6
There is a deep sense of loss around identity, including clear roles, especially for
young males in Nunavut. Isolation may exacerbate that sense of loss. The losses
mount as more and more deaths by suicide are experienced in a community. Losses
due to death by suicide are supplemented by losses of cultural ways and affiliations.
As each generation bears its children, the losses are passed on, become
intergenerational, and are potentially experienced as a new norm.
Culture-based traditions began to be eroded after contact with European culture so a
related theory is that colonization by Europeans has been a strong causal factor in
Inuit feeling badly about themselves. The impact of the residential school experience
and of forced relocation into communities has been deleterious for Inuit individuals,
families, and communities, and there has not been a comprehensive approach to
healing for Nunavummiut.
“The legacy for the present generation is a loss of basic communal values.” 7
Traditional Inuit values set out a pattern of everyday observance of culturally specific
ways of being that supported Inuit for thousands of years, in the most threatening
environment: Inuit persevered, shared, and survived.
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Diagram:
Overlay of Euro-Canadian Culture on Inuit Culture
Inuit Culture Suffocation
Increased Inuit Loss Load (Trauma)
Conversely,
The more culture is respected, restored, and honoured, the greater the chances of
„throwing off‟ negative aspects of the cultural overlay.
Conclusion
The 2003 reports related to death by suicide in Nunavut, have been examined and
thought about in terms of at-risk for death by suicide indicators which are deemed
relevant to Nunavut. For all of the effort around suicide prevention in Nunavut,
positive change in the incidence of death by suicide amongst young Inuit has not
occurred.
At-risk for death by suicide indicators need to be clearly identified because they can
be transformed, „flipped‟ if you will, into recommendations for the content of a
suicide prevention program that is more culture-specific. For example, the at risk
indicator, loss of a close person to suicide, could become “Improved Awareness of
Suicide Survivor Needs”. While this is simplistic, one can see the potential for taking
an Appreciative Inquiry8 approach to develop future prevention strategies. There is a
need to build on what is positive, what is strong.
There is a prevalent belief among Inuit that they have been over-researched. In
respect to suicide, this is not likely to be the case because suicide has been
admittedly, „not talked about‟. The at-risk indicators for death by suicide in Nunavut
have not been researched. Today, the Nunavut Research Institute database confirms
that little psychological-sociological based research has taken place. There is no
central store of information about who has done what and/or where around death by
suicide in Nunavut communities. Helpful research information is being gathered by
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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the Nunavut Research Institute, but information about suicide prevention programs
and their effectiveness is fractured. There also remains social apprehension about
political and moral correctness around addressing death by suicide.
The questions originally asked have not been answered.
.
What used to work (before contact with the Western-European culture)?
What is working well in our communities?
What assistance do we need (to get on with our lives)?
Who can assist us (in our communities)?
What are Inuit, other than those in Nunavut, doing (about suicide)?
The direction of the Nunavut inquiry around suicide and suicide-related issues must
continue its shift to a grassroots community base, where questions as well as answers
will come from the people themselves. To assume otherwise is presumptuous, as death
by suicide is a personal act dependent on a personal belief system cradled within a
culture: when a young person is lost to death by suicide, the family, the community,
and the culture is altered. The solutions to this therefore lie within the culture itself.
Steps need to be taken that involve funding, infrastructure, policy, and tangible support
to community strategies.
How do Inuit view suicide in other cultures? Which part of the issue of suicide has
not been talked about yet? What new light can Elders shine on this issue? What are
Inuit artists showing us in their work? What issues do youth want to discuss? These
may or may not be questions Inuit wish to discuss, they will decide.
The early detection of children who exhibit at-risk for death by suicide indicator should
be advanced predicated by the establishment of clear, evidence-based indicators. The
necessary research for establishing how to proceed with suicide prevention in Nunavut
will evolve if a culturally-specific design is used. A prerequisite to the success of such
an endeavour, is a shift to a belief in „process‟ over „product‟, which would require a
real level of trust, and a giving up of control. Minor‟s outline of a design for culturespecific helping includes a three-step approach9 includes: control and direction from
within [the culture], defining “culture-specific”, and support, facilitation and testing.
“A culture-specific approach begins with an exploration of the traditional helping
systems within a group”10, and that needs to happen in Nunavut.
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Endnotes
1
Nunavut Suicide Statistics Report, 2003
2
Henderson, A. (2003). Best practices in suicide prevention and the evaluating of
suicide prevention programs in the Arctic
3
Tatz, C. (2001). Aboriginal, Maori, and Inuit youth suicide: Avenues to alleviation?
4
Malus, M., Kirmayer, L. & Boothroyd, L. (1996). Risk factors for attempted
suicide among Inuit youth: a community survey.
5
Tatz, C. (1999). Aboriginal suicide is different.
6
Kirmayer et al.
7
Tatz, C. p. 8.
8
Hammond, S.A. The Thin Book of Appreciative Inquiry outlines a paradigm shift
that is based on organizations understanding „what works‟ in their environment.
9
Minor, K. (1994). Issumatuq, p.21.
Rationale for three-step approach:
1. to ensure the participation and leadership of knowledgeable,
articulate, and influential members of the culture,
2. to explore, identify and understand the philosophy, psychology and
traditional patterns of i interpersonal interaction that prevail within
the group, and
3. to embark upon a program of helping that involves support and
facilitation and has evaluation criteria built into the design to
monitor the effectiveness of the efforts, so truly culture-specific
helping may be provided.
10
Minor, Appendix 1. p. 1
Nunavut, 2003, suicide-related documents report by Joan Brackenbury
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Related Readings
Briggs, J. (1995). Vicissitudes of attachment: Nurturance and dependence in
Canadian Inuit family relationships, old and new. Arctic Medical Research 54,
Suppl.1 24-32.
Brody, H. (1975). The people‟s land. Markham, ON: Penguin.
Battiste, M. & Barman, J. (1996). First Nations education in Canada: The circle
unfolds. UBC Press; Vancouver.
Capp, K., Deane, F.P., & Lambert, G. (2001) Suicide prevention in Aboriginal
communities: application of community gatekeeper training. Australian and new
Zealand Journal of Public Health: Aug. 2001: 25, 4: AB/INFORM Global, p.315
Grant, A. (1996). No end of grief: Indian residential schools in Canada. Winnipeg:
Pemmican.
Hammond, S.A. (1996). Appreciative inquiry. Plano, TX: Thin Book Publishing.
Harckham, R. C. (1998). Defining and servicing mental health in a remote northern
community. Calgary: University of Calgary.
Kirmayer, L.J., Malus, M. & Delage, M. (1993). Characteristics of completed suicides
among the Inuit of the east coast of Hudson Bay 1982-1991: a chart review study.
Native mental Health Research Group, Report No. 4, Montreal Institute of Community
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