Question Period Note: SUICIDE PREVENTION IN CANADA

Suicide is a significant public health issue that affects people of all ages and backgrounds across Canada. On December 2, 2021, a CTV News report highlighted the suicide epidemic in Nunavut. In an email to CTVNews.ca, Nunavut’s Chief Coroner Khen Sagadraca said 36 suicides had been recorded so far in the territory as of November 18, 2021.

Key Messages
• The Government of Canada recognizes the importance for all Canadians to have access to critical mental health resources and suicide prevention services and is committed to expanding the capacity to deliver virtual services.
• Budget 2019 provided $21 million over five years, starting in 2020/21, to the Centre for Addiction and Mental Health to develop, implement, and sustain a fully operational pan-Canadian suicide prevention service.
• Through this initiative, by 2023, people across Canada will have access to crisis support in English and French 24 hours a day, seven days a week, 365 days per year, using the technology of their choice – either voice, text or online chat.
• The Canada Suicide Prevention Service currently provides 24/7 suicide crisis support over the phone to everyone in Canada, including residents of Nunavut.
If Pressed on the Implementation of a 3-Digit Number for Suicide Prevention Crisis Support
• The Government of Canada is interested in implementing a national three-digit number for suicide prevention in Canada, supported by the unanimous vote in favour of the related motion in the House of Commons in December 2020.
• The Canadian Radio-television and Telecommunications Commission launched a public consultation in summer 2021 to build a fulsome public record about implementing a three-digit suicide prevention number in Canada. The public consultation reopened on November 30, 2021 and will close on January 31, 2022.
• This record will help the Commission determine the need for a three-digit number. It will also help identify barriers, and should any be identified, determine how best to address them.If Pressed on COVID-19 Mental Health Crisis Supports
• The Government is providing $7.5 million over 21 months to Kids Help Phone to provide crisis supports for children and youth during the pandemic.
• In addition to investments in suicide crisis services, the 2020 Fall Economic Statement announced a $50 million investment to bolster the capacity of distress centres across the country, which are experiencing a surge in demand for crisis support during the COVID-19 pandemic.
• The Public Health Agency of Canada is also providing additional funding for the Canada Suicide Prevention Service to support the increased demand for crisis support at this time.

Over the past 10 years, there has been an average of 4,000 deaths by suicide per year in Canada, which resulted in 10 to 12 people that died by suicide every day. Suicide is the 9th leading cause of death among all Canadians, and the 2nd leading cause of death among individuals aged 15 to 34, behind unintentional injuries (Statistics Canada). There is no single cause that fully explains or predicts suicide; a combination of factors are associated with suicide, such as mental illness, physical health, personal issues and loss, childhood abuse and neglect, and exposure to trauma.
Suicide in Nunavut
A CTV News report on December 2, 2021, highlights the ongoing suicide epidemic in Nunavut. According to the report, the suicide rate among the Inuit was approximately nine times higher than the non-Indigenous rate in Canada from 2011 to 2016, according to Statistics Canada, with 250 deaths by suicide reported.
According to the Survey on COVID and Mental Health, in 2020 the prevalence of suicide ideation in Canada was 2.4%. The prevalence of suicide ideation since the pandemic began in Nunavut (Iqaluit) was 3.3%. Due to overlapping and wide confidence intervals surrounding the prevalence of suicide ideation in Iqaluit, due to small sample size, we cannot conclude it is higher than other territory capitals or the prevalence of suicide ideation when compared to all of Canada.
In 2019, there were a total of 32 deaths by suicide in Nunavut, corresponding to a suicide mortality rate of 78.1 per 100,000 population, compared to 10.7 per 100,000 population in Canada.
The Public Health Agency of Canada (PHAC) will work with Statistics Canada to report on deaths by suicide by province and territory in February, after Statistics Canada releases the 2020 mortality data at the end of January 2022. PHAC is also working with Statistics Canada and all the Chief Coroners and Medical Examiners to use their data to report on deaths by suicide.
Government of Canada’s Suicide Prevention Initiatives in Nunavut
Budget 2019 announced $50 million over ten years with $5 million ongoing to support the continued implementation of the Inuit Tapiriit Kanatami's National Inuit Suicide Prevention Strategy (NISPS). The NISPS has also been used as a guide to develop a regional suicide prevention strategy in Nunavik, which was launched in November 2019. An early evaluation has shown that the NISPS has supported initiatives that have benefited Inuit within Inuit Nunangat. Taking the regional and community context into consideration was highlighted as an important factor in this progress, as was the effectiveness of an Inuit-specific approach.

Aiming to reduce the impacts of suicide within communities across Canada, the Mental Health Commission of Canada (MHCC) has continued its work on the Roots of Hope Research Demonstration Project. Multi-site and community-led, the project builds upon community expertise to implement suicide prevention interventions that are tailored to the local context. There are currently eight communities participating in the project, including Iqaluit in Nunavut. Officially launched on September 5, 2019, the Roots of Hope project will lead to the development of an evidence base, including best practices and suicide prevention guidelines and tools, to support the scale up and implementation of this “made-in-Canada” model across the country.

In May 2019, Infrastructure Canada’s Smart Cities Challenge awarded Katinnganiq: Community, Connectivity, and Digital Access for Life Promotion in Nunavut $10 million over five years to implement protective and preventative measures, to reduce the risk of suicide in Nunavut, and increase the amount and accessibility of peer support networks, educational resources and creative outlets that promote positive mental health to all Nunavummiut (people of Nunavut).
• Katinnganiq is based on and guided by Inuit Qaujimajatuqangit, the Inuit knowledge system and worldview that provides the foundations upon which social, emotional, spiritual, cognitive, and physical well-being define health and wellness. In particular, the initiative aligns with the objectives of strengthening self-reliance, wellbeing, and distinct territorial identity (Inuusivut); enhancing education, training and employment (Sivummuaqpalliajjutivut); and working in partnership to advance the goals and aspirations of Nunavummiut (Katujjiqatigiinnivut).
• This initiative will see the creation of a network of Makerspaces which offer a gathering space (both physical and digital) for people to come together to be creative, using a mix of technology learning, digital fabrication, open hardware, software hacking and traditional crafts to innovate for themselves. The project will leverage digital access and connectivity to increase the availability and accessibility of mental health resources and support systems.

The Government of Canada is promoting the Arctic Council Sustainable Development Working Group's initiative, Project CREATeS, which focuses on suicide prevention among Indigenous youth in the circumpolar north, and supports the next CREATeS project iteration, Local2Global. Through Crown-Indigenous Relations and Northern Affairs Canada's Circumpolar Directorate, approximately $240,000 has been invested over two fiscal years (2017-18 and 2018-19) to support the Sustainable Development Working Group's CREATeS Project. In addition, in 2020, $170,000 was allocated for Local 2 Global.

The Hope for Wellness Helpline provides immediate, culturally safe, telephone and chat crisis intervention services for First Nations and Inuit across Canada. It is available 24 hours a day, seven days a week, in English and French. Upon request, phone counselling is also available in Inuktitut, Cree and Ojibway.
Motion 174 – A National Suicide Prevention Action Plan: In April 2018, MP Charlie Angus (NDP, Timmins-James Bay) sponsored motion M-174, calling for the Government to establish a national suicide prevention action plan. On May 8, 2019, parliamentarians voted unanimously in favour of M-174, though it is non-binding. The proposed actions in the plan are aligned with the Framework. The Public Health Agency of Canada (PHAC) will facilitate coordination and collaboration on elements of the action plan with relevant departments, agencies and key stakeholders through its convening role on the Framework. An update on M-174 was included in the December 2020 Progress Report on the Federal Framework for Suicide Prevention.
3-Digit Suicide Prevention National Telephone Line – 9-8-8 Campaign in Canada: On December 11, 2020, parliamentarians voted unanimously in favour of a motion sponsored by MP Todd Doherty (Conservative, British Columbia) calling on the federal government to act immediately to set up a national 988 number to consolidate all existing suicide crisis numbers.
The Canadian Radio-television and Telecommunications Commission (CRTC) is responsible for establishing any three digit abbreviated codes. The CRTC launched a regulatory proceeding on June 3, 2021 to consult on a proposed three-digit hotline. The public consultation closed on September 1, 2021, resulting in 247 interventions submitted by stakeholders and members of the general public. These interventions are currently available online, and parties were able to file replies to these interventions before October 1, 2021. Following a petition from stakeholders representing persons with disabilities, the CRTC reopened the consultation in November 2021 to allow for new interventions in accessible formats, such as video. The public consultation will remain open until January 31, 2022. These interventions and replies will become part of the public record that the Commission will examine to make its determinations. The CRTC is unable to comment on anticipated timelines for releasing these determinations. As highlighted in Budget 2021, the government is committed to ensuring funds are available to support the creation of this three-digit number.
COVID-19 Mental Health Crisis Supports: Through the 2020 Fall Economic Statement, the Government of Canada announced a $50 million investment to bolster the capacity of distress centres. PHAC is administering an initial round of grants to 57 distress centres in winter/spring 2021-22. A second solicitation, which closed on October 6, 2021, for recipients with remaining or emerging needs, or for eligible organizations not included in the first round of funding. Funding applications are now under review. In addition, $2 million of this funding will support the development of resources to assist distress centres in meeting the needs of diverse and vulnerable populations.
Survey on COVID-19 and Mental Health and Survey on Mental Health and Stressful Events: PHAC is currently conducting surveillance to understand the impact of COVID-19 on suicide and self-harm. The 2020 Survey on COVID-19 and Mental Health has shown that during the early stage of the pandemic, the percentage of Canadians reporting suicide ideation since the pandemic began was not significantly different from the percentage reporting in 2019. Risk factors of reporting suicide ideation during the pandemic included being under 65, Canadian-born, a frontline worker, reporting pandemic-related income/job loss or loneliness/isolation, experiencing a highly stressful/traumatic event during one's lifetime, and having lower household income and educational attainment. Continued surveillance of suicide and risk/protective factors is needed to inform suicide prevention efforts.

Key Facts
• Suicide is the 9th leading cause of death among all Canadians, and the 2nd leading cause of death among individuals aged 15 to 34, behind unintentional injuries (Statistics Canada).
• In 2019, there was a total of 32 deaths by suicide in Nunavut, which is a suicide mortality rate of 78.1 per 100,000 population, compared to 10.7 per 100,000 population in Canada.
• The Public Health Agency of Canada is supporting the implementation of a fully operational pan-Canadian suicide prevention service, which provides 24/7 toll-free crisis support.