First Nations and Métis Youth Suicide in Saskatchewan:

The Need for a National Collaborative Population Health Model in Research and Policy

Kelly Patrick #10838821 CHEP 813.3 April 9, 2010

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Introduction

With the incidence of suicide in aboriginal communities throughout Canada greatly

increasing over the years, a more effective means of studying, measuring and responding to youth

suicide is needed in order to identify, address and prevent conditions which contribute to the despair

and hopelessness which leads young aboriginal Canadians to end their lives to leave their loved ones

and community behind to grieve and not ask why, but why can this not be prevented?

Historically across Canada Canadian, First Nations, Métis and Inuit governance has created

jurisdictional separation in the area of health. This has kept all groups apart, not knowing what the

other is doing nor feeling responsible to each other, to those who live in our towns, our cities, our

provinces and our nation. Aboriginal youth suicide in Canada is a tragic but perfect opportunity for

aboriginal and non aboriginal political leaders, academics and health care officials to come together

and address the truth as to why aboriginal youth see and feel no hope.

Considering aboriginal youth is the fastest growing demographic in Canada, there is no better

time than now to address aboriginal youth suicide head on. If not, the cost to the nation as a whole

will be greater than the indelible negative cost currently in remote communities scattered throughout

this country.

This paper will provide current statistics on aboriginal youth suicide in Canada, specifically in

Saskatchewan; a review of research and the need for a change in direction; and government response

to aboriginal youth suicide. It will further propose the need for a population health model which

brings together aboriginal governance and community based agencies, Federal and Provincial policy

agencies, academics and health care providers, to collaborate on establishing means to research

properly aboriginal youth suicide. The model would develop and implement a long term strategic

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mechanism which engages communities to provide sustained leadership and government programs

that unite nationally the sporadic and isolated approach currently taken in the area of aboriginal

youth suicide research, policy and prevention strategies.

Suicide - Canadian and Saskatchewan Stats

According to Statistics Canada, suicide is the second leading cause of death in Canadian youth

ages 13-19 and the leading cause for those ages 25-34. The statistics indicate that males kill

themselves three times more often than females, supposedly due to the use of more lethal methods.

Across the lifespan, aboriginal youth between the ages of 15-25 are at the highest risk of

suicide. Those living on a reserve are six times more likely to die by suicide than their non-native

peers; those living within cities have a suicide rate equal to non-native youth. First Nations/Inuit are

eleven times more likely to commit suicide than their non-aboriginal counterparts. (www.hc-

sc.gc.ca/fniah-spnia/promotion/suicide/index-eng.php)

Although there is a lack of conclusive research on aboriginal mental illness and addictions

and its relation to the cause of suicide, Statistics Canada does provide data indicating 60% of

aboriginal people who die by suicide were intoxicated. This is compared to 40% of non-native

people who were intoxicated at the time of the suicide. (www.nandecade.ca/article/aboriginal-

suicide-statistics-71.asp)

The trauma and effects of sexual abuse on an individual are devastating and can increase a

person's suicide risk nine times. The effects of aboriginal residential school abuse suffered by many

First Nations and Métis Canadians, the sexual behavoir and further abuse by victims on family

members has gone undetected in aboriginal youth suicide research leaving large gaps in

understanding social determinants that may lead to suicide in aboriginal youth.

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If an aboriginal youth is gay, lesbian or bisexual they are up to six times more likely to die by

suicide due to homophobic discrimination, lack of healthy role models and lack of support.

Copycat suicides or clusters are increasingly occurring after an aboriginal youth commits

suicide. Friends, girlfriends, sisters and brothers are vulnerable as the demoralizing effect grips the

family and community who feel sad and guilty and are helpless in their grief.

The following two charts show a 5-year average suicide rate in Northern Saskatchewan by

Health Authority between 1998-2007 (Fig. 1) and age-sex adjusted rate of persons hospitalized with

injuries due to suicide attempt and self-inflicted harm between 1995 and 2005 (Fig. 2). Figure 2

shows a comparison of not only Northern Saskatchewan health authorities but all other regional

health authorities throughout the province.

Figure 1: Suicide Rate, 5-yr Average, Northern Saskatchewan by Health Authority, 1998-2007 (not age-standardized)

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Figure 2: Age-sex adjusted rate of persons hospitalized with injuries due to suicide attempt and self-inflicted harm 1995 – 2005

Source: Saskatchewan Comprehensive Injury Surveillance Report, 1995-2005

However incomplete or inconsistent with actual suicide rates to reported rates of suicide, these

numbers show an alarming rate of suicide and self inflicted harm in Northern Saskatchewan, where

the population is 62.7% First Nations, 21% Metis and 14.7% non aborignal. (APS 2006)

First Nation and Métis Health Indicators and Socio Economic Status

From birth and throughout the course of one’s life, the relationship one has with parents,

where one lives and how one can sustain independence and self sufficiency all depend on family

structure, education and employment. If there is significant dysfunction and gaps in these three

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social and economic indicators, the chance of individual confidence and personal success is greatly

reduced. If one is not provided proper supports and is confronted with a lack of opportunity

depression, anxiety and hopelessness, measured by mental illness, increases.

Family Structure

Nishnawbe Aski Nation of Ontario, a northern reserve who has suffered greatly with over 300

suicides between 1986 and 2009, cite parenting statistics when discussing suicide on their website.

Sixty five percent aboriginal children living on a reserve live with two parents. This compares with

only 50% in census metropolitan areas. In contrast, almost 83% of non-aboriginal children lived

with two parents. Conversely, twice the proportion of aboriginal children lived with a lone parent in

2001 as did non-aboriginal children. On reserves, 32% of aboriginal children lived with a lone

parent. This percentage jumped to 46% for those in the census metropolitan areas. Only 17% of

non-aboriginal children lived with a lone parent. (www.nandecade.ca/article/aboriginal-suicide-

statistics-71.asp)

The lack of parenting skills, support to lone family parents, and limited funds provided by

band or welfare agencies, does not provide a solid foundation for First Nations, Métis and Inuit

children. Many young mothers try their best, but the obstacles they confront are enormous.

Education and Employment

Education and income are directly associated with how one participates and contributes to

society. A lack of education leads to decreased lack of employment opportunities for many

Canadians, especially First Nations, Métis and Inuit. The lack of properly supported and sustained

education facilities on reserves and in remote communities fail to provide aboriginal youth with solid

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long term educational development with many aboriginal youth dropping out of high school before

graduating.

According to a December 2005 report by the Canadian Council on Learning, aboriginal youth

in urban communities remain significantly less likely to complete high school than non-aboriginal

youth and aboriginal males fell further behind their aboriginal female counterparts in terms of high

school completion between 1981 and 2001. In 1981, aboriginal attendance rates ranged from a low

of 30.6% in Edmonton to a high of 51.3% in Ottawa- Hull. In 2001, the low end of the range had

moved up to 47.9% in Toronto and the high end was at 66.4% in Sudbury (CCL 2005).

On-reserve, the proportion of Registered Indians that graduated from high school by age 20 is

lower than the equivalent proportion of other Canadians, 36.0% vs. 84.6% (1999-2003 Statistics

Canada).

This may relate to the employment rate for Registered Indians on-reserve which is lower than

the general Canadian rate, 37.4% vs. 61.7% (1999-2003 Statistics Canada). Considering there are

few job opportunities on reserves, this number reflects the lack of opportunity for gainful

employment and participation in economic opportunities for aboriginal youth.

In a recently completed Métis Nation Saskatchewan/University of Saskatchewan Community

Based Evidence Informed Participatory Survey, May 2010, 36.7 % of Métis in Saskatchewan

indicated they have not finished high school. However, Métis rates of employment are higher than

First Nations with 62.1% (796/1282) between the ages of 18-65 employed, this compared to 69%

for Saskatchewan average (MNS/UofS Survey 2010). This may be due to the assimilation of Métis

into urban centres which has occurred historically compared to First Nations and Inuit living on

treaty lands and reserves only to move back and forth to the city later on in life. Over 69% of the

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approximately 295,000 Métis in Canada live in cities. However, in Northern and remote

communities where Métis preside employment is much lower.

Income

Studying Canadian rates of income, there is a large gap between aboriginal and non-aboriginal

Canadians. For Registered Indians on reserve, the median annual income is almost half that of the

general Canadian population reported at $10,631 vs. $22,274 (1999-2003 Statistics Canada).

According to the MNS/U of S Survey, May 2010, 61 .7% (744/1205) of Métis fall below the

median income for Saskatchewan, and 44.90% (541/1205) fall below $20,000-$29,999 which is the

average Saskatchewan income. The median income for Saskatchewan (Saskatchewan Bureau of

Statistics, May, 2008) was reported to be $35,948 and the average income in 2006 as $28,872.

Mental Illness

In 2000-2001, approximately 13.2 percent of the aboriginal population living off-reserve had

experienced a major depressive episode in the past year. This is 1.8 times higher than the non-

aboriginal population (Statistics Canada 2002).

As much as these statistics provide insight into living conditions and health indicators of First

Nations, Métis and Inuit as aboriginal Canadians, they also provide an incomplete picture. There are

various studies with numerous results based on untested variables such as self indentifying as First

Nations, Métis or Inuit even though all three distinct groups live under three different cultural,

historical and geographical sets of differences. There have been attempts to differentiate between

on-reserve and off-reserve First Nations, but this does not take into account many First Nations

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who move from one community to another, to the city and back to reserves several times over the

course of their lives.

Directions in Aboriginal Youth Suicide in Canada

Emile Durkheim

Emile Durkheim (1858-1917) was a French sociologist who focused on the ways in which

changes in economic and social structures interfered with those institutions and identities that serve

to weave together or regulate the social order, and so maintain a sense of collective morale and

shared meaning in life. (www.bolenderinitiatives.com/sociology/emile-durkheim-1858-1917)

Durkheim defined suicide as "all cases of death resulting directly or indirectly from a positive

or negative act of the victim himself, which he knows will produce this result." Durkheim believed

that social forces would affect the overall suicide rate. These forces became his independent

variables. (cuip.uchicago.edu/~ldernbach/msw/xsdurkhm.pdf)

Michael Chandler and Christopher Lalonde

As a Professor of Psychology at the University of British Columbia, Michael Chandler is

probably one the most prominent Canadian researchers in the area of aboriginal youth suicide. He

has collaborated with Christopher Lalonde from the University of Victoria on numerous studies.

Their early works were greatly influenced by Durkeim and European psychology elaborating on

identity, self-identity and later cultural continuity and how it relates to aboriginal youth suicide.

By comparing 196 First Nation bands in British Columbia, using age, gender, date and band

association, Chandler and Lalonde deducted that those communities who had indentified increased

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“protective factors” had lower incidences of suicide. These factors are: land claims, self -

government, fire protective services, education services, health services and cultural facilities

(Chandler and Lalonde 1998). The greater the protective factors, the greater existence of “cultural

continuity” and “self continuity” for First Nations youth as these two are strongly linked. Failure in

self-continuity is strongly associated with suicide risk.

As much as Chandler and Lalonde have tried to make progress in understanding social and

health indicators that affect rates of suicide among aboriginal youth, the lack of understanding of

First Nations, Métis and Inuit traditions, culture and place in Canadian history, makes

communicating their research knowledge with success and meaning to aboriginal communities

difficult. Their research success pales greatly in contrast to the lack of acceptance of the findings by

aboriginal communities who must feel alienated from the research not able to place themselves in

European frameworks of study which Chandler continues to premise all his research methods on.

Need for Change in Direction in Aboriginal Health Research

Depending on why research is conducted, aboriginal youth suicide cannot be treated

exclusively as an academic endeavour or a government initiative. Lives are literally at stake and a

greater methodology that provides direct engagement and action based outcomes must be at the

forefront of ethics and process when scholars and others embark on tackling this extremely sensitive

and complicated issue. Research priorities need to be set on the basis of health status and health

determinants of the aboriginal population (Young, 2003).

First Nations, Métis and Inuit are best to confront their own existence and must be given the

chance to lead if change in community development is to occur allowing for healthy leadership and

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participation of all citizens, especially youth. The increasing amount of First Nations, Métis and Inuit

graduating from universities is a positive first step in true community development and the women

tend to be leading the way going to school, graduating and making more money than non-aboriginal

graduates in some cases as reported recently by the Canadian Centre for Policy Alternatives.

Graduates in health, social development and nursing are best to lead research and program

development. The challenge today is to highlight indigenous epistemology and means of knowledge

validation in policy-based research and in policy implementation and practice (Kenny, 2004).

There must be meaningful commitment by aboriginal and non aboriginal government towards

understanding the extent of aboriginal youth suicide and why it occurs. Limited data exist regarding

the various contexts and life experience of aboriginal youth thought to place them at risk for

attempted or completed suicide (MacNeal, 2008). Funding a national registry which imposes a

collaborative mechanism that monitors suicide and especially aboriginal suicide, would bring

together many who work to try to address the issue. Governments need facts and evidence before

they can justify funding programs that address issues that at times are misunderstood and

overwhelming for the general public to acknowledge and support. Removing politics from

aboriginal youth suicide would allow for a professional approach to properly start addressing it. By

starting with the evidence, focus becomes more knowledge based, less political and more honest

lending to greater success in effectively overcoming the destructive statistics that are increasing and

scattered throughout the country.

Governments, community leaders and community members must be open to real change.

They must show respect towards each other and for themselves if a healthy outcome is to be

expected. The history of why aboriginal youth feel despair and the inability of many communities to

affectively reverse this trend must be taken into account. To explore the origins of health for

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aboriginal peoples, the unique context includes the socio-political factors, a holistic perspective of

health with health optimization at each stage of the life course, from preconception to death

(Reading, 2009). A broad determinants of health perspective will also ground the discussion of risk

factors. That is biological, social, economic, environmental, and political factors that affect one’s

health and the health of communities, populations, and generations will all be included. This will

enable a broad discussion of the complex risk factor environment for aboriginal populations in

Canada (Senate of Canada, 2009).

A life course epidemiology approach embraces the complexity of disease risk and

acknowledges the long-term effects of physical, social, psychological, and behaviour pathways,

operating across an individual’s life, a community’s generation, and a population’s development, on

health and well-being (Estey, Kmetic and Reading, 2007).

Given the complex situation faced by many aboriginal communities, there must be

understanding of the origins of suicide and its prevention in ways that bring together both

psychological and social explanations (Kirmayer, 2007). The following chart provides a model on

the origins of aboriginal suicide. It clearly includes the history of relationships between aboriginal

and non aboriginals which have contributed to the lack of education, lack of opportunity, mistrust,

hopelessness and other negative conditions as a result of colonization, oppression and disrespect

that must change before aboriginal youth suicide rates are reduced. Children learn by example and

if that example is negative, negative behavoir will persist and prevail.

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An Integrated Model of the Origins of Suicide (Kirmayer, AFN 2007)

Dr. Laurence Kirmayer of McGill Univeristy, as a co-director of the National Newtork for

Aborignal Mental Health Research and Training, provides a clear understanding of indicators that

lead to suicide incorporating a perspective that has lacked in the past, an aborignal perspective. It

serves as evidence where indicators are brought together to paint a clear picture of what First

Nations, Metis and Inuit have been confronted with for many years. As tragic as it appears, at least

it appears clearly for all to see.

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Canadian and Saskatchewan Government Research and Policy Response to Aboriginal Health and Youth Suicide

Very little is said from government on the increasing and alarming statistics on aboriginal

youth suicide. It is primarily a devastating condition in remote communities across Canada where

communities are left to deal with the effects on their own. Many attempts over the years to improve

the plight of Canadian Fist Nations, Métis and Inuit have been mostly political in nature and political

in the countless failures. To say the least, it has been difficult for Canada to properly address

conditions which today lead to unmitigated numbers of youth taking their lives in response to

inability of all before them to create opportunity to participate in Canadian society and feel a part of

something good and decent.

Throughout the years there have been countless attempts to document the experiences of

Canadian First Nations, Métis and Inuit. In 1969 The White Paper was released after extensive

consultations with aboriginal groups across Canada. In the end, the document primarily ignored

what First Nations, Métis and Inuit told the commission and created an unhealthy relationship as

expectations were dashed and mistrust set in. In 1991, the Government of Canada launched the

most extensive study and consideration of issues affecting aboriginal people. For five years, the

Royal Commission on Aboriginal Peoples (RCAP) engaged, analyzed and carefully considered a

balanced strategy to move forward (AFN 2009).

In 2005, then Prime Minister Paul Martin embarked on an ambitious goal to address

economic and social inequity between aboriginal and non aboriginal Canadians. The Kelowna

Accord attempted to deal with social determinants of health and inequity pledging 5 billion dollars

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to aboriginal communities, but was not signed into legislation before defeat of the Liberal minority

government who introduced the policy.

None of these commissions and initiatives specifically addresses suicide possibly because it

was not prevalent earlier in Canadian history and if it was, it was unknown to policy makers and

elected officials. Possibly the numbers did not demand as much attention as other issues such as

housing, safe water, education, employment and Chronic Diseases. The focus and commitment

from leaders across Canada to address aboriginal youth suicide is not there and lends greatly to why

aboriginal youth suicide continues. Communities and kids need commitment and capacity on this

one issue alone if anything is going to change.

There are currently initiatives in place to better understand aboriginal youth suicide, such as

Health Canada’s, Acting On What We Know: Preventing Youth Suicide in First Nations, but even Health

Canada acknowledges “there is a gap in knowledge about what actually works in the area of suicide

prevention. With regard to First Nations populations, we lack rigorous evaluations of programs and

interventions as well as basic epidemiological information on risk and protective factors at the

individual and community levels” (Health Canada 2009).

Since 2007, Health Canada and the First Nations Inuit Health Branch have embarked on a

five year National Aboriginal Youth Suicide Prevention Strategy (NAYSPS), by providing 65 million

dollars to First Nations communities throughout Canada. In 2009, the Federation of Saskatchewan

Indian Nations, which represents 74 First Nations Bands throughout the province, engaged only six

Tribal Councils representing 30 bands who participated in a survey based questionnaire regarding

NAYSPS, its effectiveness and suggestions for improvement. Most noticed increased awareness but

suggested the need for community based initiatives that are accountable to their community and

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private and public funding sources (FSIN NAYSPS 2009). Little results are evident as aboriginal

youth suicide increases in Saskatchewan.

The Government of Saskatchewan through the Northern Human Services Partnership has

produced six drafts of a framework to address the high rates of suicide in Northern Saskatchewan,

A Suicide Prevention Framework for Northern Saskatchewan is predominately a literature review based on

little best practices and other suicide prevention strategies from across Canada. There has been little

direct engagement and research with First Nations and Métis communities which contrasts with The

Senate of Canada, Standing Committee on Population Health, 2009, which recommends that

aboriginal people – First Nations, Inuit and Métis – be involved in the design, development and

delivery of federal programs and services that address health determinants in their respective

communities (Senate of Canada 2009). Provincial or federal, youth suicide knows no jurisdictions or

boundaries.

Suicide Strategies: Crisis Management First Nations (AFN), Métis (MNC) and Inuit (ITK) Response

Due to lack of long term commitment on a national level which collaborates with aboriginal

and non-aboriginal governance, provincial counterparts and community leaders, communities are

left in crisis management mode when dealing with the devastating effects of increasing aboriginal

youth suicide.

In Fred Kelly’s, Traditional and Contemporary Approach to Youth Suicide Intervention,

Assembly of First Nations (AFN 2007), Kelly adds to Chandler’s list of protective factors but lists

contributing factors included in additional categories such as individual, family, peers, school,

community and culture. The document incorporates research which identifies experiences of

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aboriginal communities in attempts to create strategies to address the social determinants but is

incomplete without forceful and effective recommendations.

The National Aboriginal Health Organization, in its document, Understanding Health

Indicators, (NAHO 2007) addresses social determinants but does not provide strategies that are

tested and which work in prevention of aboriginal youth suicide.

The Assembly of First Nations, at the AFN National Policy and Planning Forum in

Saskatoon, Saskatchewan March 24-26, 2010 made no mention specific to policy or programming

specific to youth suicide.

Inuit Tapiriit Kanata (ITK), provides for a Suicide Prevention Coordinator to work with The

National Inuit Youth Council (NIYC), along with other staff which work on suicide prevention and

mental wellness but one must ask what one or two people can accomplish. However, the holistic,

strength-based Inuit approach to suicide prevention strongly influenced the draft Alianait Action

Plan for Inuit mental wellness (www.itk.ca/Inuit-Approaches-to-Suicide-Prevention).

The Métis National Council, which purportedly represents Métis across Canada, has no

strategy on youth suicide although money was allocated to the organization under NAPSYS funding.

Métis Nation Saskatchewan has just received funding to review strategies and best practices in

other communities to create a Northern Saskatchewan Métis Youth Suicide Prevention Strategy but

lacks experience, involvement in health care and collaboration with health authorities to guarantee

success. There has been community involvement in youth suicide through a forum hosted in

Northern Saskatchewan by the Northern Health Strategy (NHS), but the NHS lacks critical funding

to ensure community representation when strategies and programs are developed.

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There are programs such as Honouring Life, River of Life, ASSIST and gatekeeper strategies

but communities have no real proof that anything works. Most believe they can develop programs

on their own but without collaborative support, knowledge, evidence, sustained funding and shared

responsibility, these programs are in vain.

Aboriginal Youth Suicide: Gaps and Strengths in Research towards Policy

Earlier research does not incorporate an aboriginal perspective of suicide or those social and

health determinants that may increase incidence of suicide in aboriginal communities. This omits

the entire aboriginal community in any action forward- community based - evidence informed

research. Over the years, as research has been conducted on the subject, cases of suicide have only

increased in most communities. Government programming, at the behest of elections, budget cuts

and funding regulations have created disparate, sporadic strategies lacking in evidence, evaluation

and accountability. Lack of evidence and epidemiology suppresses much needed research in

surveillance and intervention analysis. However, there is increasing research by aboriginal

organizations such as Assembly of First Nations (AFN) and Inuit Tapiriit Kanata (ITK), which

should directly involve leaders and aboriginal health providers who are directed to report to regional

and local First Nations and Inuit communities in Canada.

Potential is great in increasing research towards population health models, life course

approaches including social determinants by partnering aboriginal organizations with others such as

the Canadian Institute for Health Research and NAHO.

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Why a Population Health Model?

As with public health programs, surveillance, and health statistics, public health research also

may be informed and guided by models of population health. The use of models of population

health can help to focus on the importance of considering the full range of influences on a

populations’ health (Freidman and Starfield, 2003).

Aboriginal youth suicide deserves utmost of focus that incorporates research methodology,

health care modelling, traditional knowledge, and consideration of partners that must be committed

and able to work towards the common goal of alleviating the statistics and the pain of suicide

reinstating hope to young people in aboriginal communities.

Public Health/Population Health Services in Saskatchewan outlines several key elements of a

Population Health Model. They are: addressing determinants of health, focus on the health of

populations, invest upstream, base decisions on evidence, apply multiple strategies to act on the

determinants of health, collaborate across levels and sectors, employ mechanisms to engage citizens,

and increase accountability for health outcomes (Saskatchewan Health 2004). These elements are

essential in addressing aboriginal youth suicide as they cover the spectrum of health analysis and

policy development towards programming in areas of education and prevention allowing for

accountability as a measured result. Although it suggests to employ mechanisms to engage citizens,

citizens must lead and be engaged at the onset of any development of a population health model,

research into its development and lastly accountability to the communities where rates of Aboriginal

youth suicide prove despair and dysfunction in all elements of government policy and programming.

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Two Worlds: Two Population Health Models

The following two population health frameworks show how aboriginal and non aboriginals

approach health policy and programming. The first western model, (Fig 3) seeks to improve health

at the top by acting on the health determinants (Health Canada 1999). The second First Nations

Regional Longitudinal Health Survey Cultural Framework (Fig 4) places people at the centre of the

circle and emphasizes the need for balance (NAHO 2006). There must be balance between the two

in order to bring balance to those communities who need help.

Figure 3 (NAHO 2007) Figure 4 (NAHO 2007)

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Conclusion

There is no collaborative approach to study and provide surveillance of aboriginal youth

suicide which brings together aboriginal and non aboriginal governments, aboriginal and non

aboriginal health researches and health service providers.

A population health model developed between aboriginal organizations, academic insti tutions

and partners, both provincially and federally, is needed. It may not affect suicide rates immediately,

but there must be some benefit to adequately addressing aboriginal youth suicide in a focused,

respectful, educated and professional manner that brings communities together with government,

health authorities with those who study suicide and lend research methodology to program

development and surveillance. This focus must bring together aboriginal scholars, leaders, and

community members with their non aboriginal counterparts incorporating the concept of aboriginal

modernity, where scholars and policy makers relinquish the labels of colonizers and victims yet

emphasize the importance of considering the life worlds and lived experiences of aboriginal peoples,

traditional and modern (Kenny 2007).

At present, Canada has no comprehensive national Suicide Prevention Strategy. An

Aboriginal Youth Suicide Population Health Model would assist in creating a universal approach

with knowledge transfer from aboriginal teachings, which we can all learn from.

An Aboriginal Youth Suicide Population Health Model is needed to depoliticize aboriginal

youth suicide. It should strive to create a national registry of suicide allowing for an epidemiological

life course approach towards universal, collaborative prevention strategies that can be modified

across multiple jurisdictions and a central agency for surveillance and monitoring to ensure direction

in research and policy. It must be a permanent mechanism with a realistic expedient time frame for

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operation and must be complemented by a social media campaign that truly engages communities

throughout Canada who do not deserve the pain, guilt and despair associated with youth suicide.

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