The edge of The North

Author: Ania Filipowicz

Content Warning: Discussion of suicide

Attavik (suicide helpline Greenland), 19:00-21:00: call 146

Danish suicide prevention hotline, 11:00-23:00: call 70 20 12 01

“It is critical to understand the context around the suicide rates to develop effective health promotion strategies created with and for Greenlanders.”

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Kayak between icebergs

On Earth’s biggest island, where ice still outweighs green areas, many people are struggling with a devastating epidemic. Death by suicide became a public health issue in Greenland after the number of suicides per population started steadily growing during the mid 1950’s, only decreasing in some areas in the past few years. Nuuk, the capital city with a psychiatric ward, places itself at the lowest position in the comparison of suicide rates within the country. One may first put the blame on the long dark nights and a harsh climate, yet the reality is more complex. It is critical to understand the context around the suicide rates to develop effective health promotion strategies created with and for Greenlanders.

 

It was a sunny summer day when a few other students and I sat together in a classroom at the University of Copenhagen, ready to get immersed in all the new information presented in our Arctic Health course. This time the topic was mental health of Inuits in focus, who constitute 90% of Greenland’s population. Suicide in Greenland is persistent, as the percentage of people having serious suicidal thoughts over the past year and in a lifetime are almost equal (See Figure 4). When compared to the primarily indigenous communities in Sweden and Norway, the majority of people who have developed serious suicidal thoughts have managed to leave them in the past. Unfortunately this is not the case in Greenland and in many other Arctic areas like Alaska or Chukotka.

While trying to understand the pattern in which suicides in Greenland occur, the first strata that often comes to a global health student’s mind is gender. With global trends the gender difference on suicide rates in Greenland is significant and in favour of women (3), who tend to seek help more often than men. We also looked at the demographic variable of ethnicity, and saw additional trends in Greenlandic suicide rates. The country has a large Inuit population, of which is disproportionately affected by suicide. Concerning Inuit men and women, death by suicide peaks during the young age of 15-24, with men’s rates being more than four times higher than women’s. Meanwhile, for suicidal thoughts, rates for men and women are almost equal. Having a look at other Arctic regions and their indigenous populations such as Nunets in Northern Russia or Alaska Natives, suicide also affects mostly young indigenous men.

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Results from the Survey on Living Conditions in the Arctic (SLiCA)

Death by suicide in Greenland has various direct and indirect causes that often are linked to the lasting effects of the colonial and post-colonial period under the Danish governance. While assessing the impact it had on the population, one cannot merely measure it by structural changes. Social and mental health impacts, while often omitted, are of great importance in the assessment of the severity of any colonisation process and Greenland is no exception. Scandinavian colonisers enforced a sense of their cultural superiority and the resulting inequity is still seen today. For example, there is a frequent use of the Danish language in administration and education, which puts monolingual residents in a disadvantage. The post-colonial period brought intense changes in the infrastructure and economic development, which discredited the efficacy and value of their traditional livelihoods. Changes also included legalising alcohol use among Inuits, which caused a rapid increase in its consumption. High alcohol consumption combined with the decline of traditional lifestyles under Danish governance is another contributing factor to the high suicide rate.

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A man, his dogsled, and the Greenlandic landscape

Bjerregard and Larsen found an association between suicide prevalence and exposure to sexual abuse and alcohol problems in the childhood home. Being a survivor of childhood sexual abuse is a major risk factor for suicide in the present, and alcohol problems in the childhood home are found to be the biggest risk factor for sexual abuse in childhood. This association might be partially explained by binge drinking patterns, in which parents are periodically less able to maintain a safe environment and protect their children from potential sexual abuse.

ACE, a term referring to Adverse Childhood Experiences – such as having been brought up by parents who overuse alcohol, having experienced sexual abuse, or having witnessed death by suicide within a close circle – could be relevant in understanding the high suicide rates among Greenlanders. Many ACEs are prevalent in Greenland and regardless of their exact mechanisms may create a vicious circle, where children having ACEs grow up without a required support and in their young adult years fall into behaviours causing ACEs in the lives of their own children. While discussing this topic in class we stopped for a while to have a look at the concept of ‘inherited or transgenerational trauma’, which is seen among Inuit Greenlanders and may propel the vicious circle of poor  mental health. This type of trauma is seen in many subpopulations as well as individuals who have experienced traumatic events, and is believed to most likely be transferred through child-rearing behaviours.

“These positive initiatives are tackling the issue of suicide by fostering indigenous peoples’ pride in their heritage and developing supportive relationships within communities.”

While immersed in searching for patterns behind suicide rates, it is important to note that the topic is and will remain person-specific no matter how complex the pattern that appears. However, public health favours a population approach, which aims to improve health for many while creating a space for further, more specific actions to hopefully reach out to every individual in need. Thus, stepping back to see the bigger picture in many Arctic regions we can see many diverse initiatives. Qungasvik (Toolbox), has interventions rooted in Alaska Natives’ tradition such as outdoor trainings and activities reconnecting young people with elderly. Circumpolar Resilience, Engagement & Action Through Story (CREATes) focuses on sharing stories of Arctic indigenous youth as well as knowledge and giving young people a voice in suicide prevention. SAAFIK is a Greenlandic national counselling and knowledge centre, which follow up on sexual abuse cases and among others provide psychological and social support for children and adolescents in Greenland. These positive initiatives are tackling the issue of suicide by fostering indigenous peoples’ pride in their heritage and developing supportive relationships within communities.

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Map of the North Pole

Indigenous peoples of the Arctic face many challenges in our rapidly changing world. As we found in our summer course, the epidemic of death by suicide has many component causes; including colonial and post-colonial changes in social structures and a subsequent disconnection with traditional lifestyles, ACEs, and changes in the economy triggered by climate change affecting the Arctic ecosystems. Keeping in mind the complexity of the causes and how they are intertwined I will end with the words of the Inuit politician Aqqaluk Lynge who, while referring to climate change, made a statement that is relevant to many other challenges facing Greenlanders today:

“To adapt to rapidly changing circumstances, while at the same time preserving important elements of our culture, we as Inuit need to keep one foot in the past and one foot in the present and balance on both feet as we walk into the future.”

Author’s note:

As a non-Greenlander and non-Inuit it has been challenging for me to create a coherent picture of suicide in Greenland. Most of the studies I encountered were written from a European perspective. I tried to find a way of showing the global health related data without depriving the people in question of their personal truths and experiences. It was particularly difficult to find a balance between generalisations and familiar statements, which are comfortable for the reader, and individual experiences that may challenge popular views but cannot offer the basis for public health solutions. This led me to realise that the most appropriate way to communicate this is to show the complexity of the issue while maintaining sensitivity to an individual’s rights and personhood, which I hope I have achieved.

 

Further resources for Greenlanders seeking help and support:

  • Tusaannga anonymous counselling/helpline is free to contact everyday 16:00-22:00: call 80 11 80, SMS 1899
  • Children and adolescents’ telephone advice, weekdays from 19:00 – 21:00: ring 134
  • Anonymous family counseling, weekdays 19:00 – 21:00: ring 31 41 51
  • MIO’s SMS advice (free, nationwide), weekdays 16:00 – 18:00: send SMS to  1899.
  • Telephone counseling for adults with late effects after sexual abuse: Tuesday & Thursday at. 19:00 – 21:00 & Saturday at. 15:00 – 17:00: ring 141

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