This regional dialogue was unique on many fronts. Twenty-five people from across Nunavut participated, including four elders (two of whom were unilingual), the president of Inuit Tapiriit Kanatami and MHCC Board Member Mary May Simon, representatives from Nunavut Tunngavik Inc., the Embrace Life Council, the Government of Nunavut, and a group of mental health worker students from Arctic College. 

Two thirds of the participants were Inuit, and much of the discussion was held in Inuktitut with simultaneous translation services (in-kind support from the Government of Nunavut and Nunavut Tunngavik was much appreciated!). All of the materials for the meeting were also translated into Inuktitut.  Support from the Embrace Life Council was critical for the success of the meeting. 

After prayers from the elders, Mary Simon welcomed the participants, and expressed her hope that the work of the Mental Health Commission would help to address the acute gaps in access to mental health services for Inuit and northerners, even relative to the shortages and barriers experienced elsewhere in the country. 

Participants were largely supportive of the draft framework, and called on the MHCC to:  use more positive, strengths-focused, and plain language; give more consideration to the impact of colonization and residential schools on Inuit; frame the issues more in terms of developing communities and families; support an Inuit-specific strategy; and  acknowledge the acute mental health needs and service shortages for Inuit.

With regard to the hope of recovery, this seemed to resonate for people in terms of the recovery of community and culture, but less in terms of individuals and families struggling with a mental health problem of illness. Does the term “recovery” make sense for Inuit who are coming to terms with the legacy of residential schools and historical traumas?  Is there a more positive, holistic term that could be used? 

In a great Canadian moment, Jesse Mike, president of the Embrace Life Council, “you can recover the puck if it is stolen, but is not so clear cut with a mental health issue.”  Can more emphasis be placed on teaching life skills and coping skills for those who may face significant and life-long limitations arising from a mental illness?

The discussion around promotion and prevention focused on the need to recognize and support community-driven, Inuit-specific programs.   This theme carried on through the discussion of cultural safety, which was viewed as critical for the success of mental health services in Nunavut.   Key aspects that were mentioned included culture, environment, language, and country foods.   Will the rest of Canada support the need for an Inuit-specific mental health plan?

While many others across the country have called on the MHCC to define families more openly, I found it interesting that this group felt that we had defined families very openly and flexibly.  One of the elders told a story that illustrated an aspect of family life that I think we had overlooked:  taking responsibility for one’s family can lift people up, give them a reason for living and be a major component of a “meaningful life.” 

The discussion about access and integration issues in Nunavut was very passionate.  Participants liked the goal and saw it as absolutely critical for their communities, but felt that the mention of the unique needs in “northern, rural and remote communities” and the mention of “as close to home as possible” did not go far enough.  Can the MHCC do more to acknowledge the acute lack of access in Nunavut to even the most basic mental health services that most Canadians take for granted? 

The research goal was supported, but less strongly than the other goals.  The group echoed concerns we have heard elsewhere about research not leading to change on the ground, and to more effective programs and services.  Given the issues in the north, would it make more sense to place a higher priority on improving access to services? 

Language was a critical issue for addressing stigma among Inuit.  How can Inuit develop Inuktitut terms for mental health and mental illness that can help to raise awareness and support mental health literacy across generations? 

With regard to the social movement, a link was made to the social movement that lead to the settlement of the land claim and the establishment of the Government of Nunavut.  To the extent that this movement has had mixed results, this colours the reaction to the idea of a broad social movement on mental health.  A hope was expressed:  Will the mental health social movement include a recognition of those with the greatest needs, including Inuit? 

All in all, this was a very significant dialogue for the Mental Health Commission.  The feedback offered by participants will be very helpful in bringing a Nunavut perspective to the work of developing a mental health strategy for Canada. 

Blog entry by Mary Bartram