Suicide Risk Assessment Guide - Ontario Hospital Association

32 I Suicide Risk Assesment Guide
Factors that may influence suicide risk in Aboriginal communities include
personal and socio-cultural factors that are to be considered in risk assessment
and intervention planning. Many of the immediate warning signs discussed in
previous sections are the same among Aboriginal people. However, the root
cause of person-level risk is often related to colonization and historical events
and inter-generational trauma. At the personal level, specific warning signs
to consider include a low sense of self-esteem and self-worth, loss of identity,
alcohol and substance use, binge drinking, social isolation, hopelessness,
feelings of anger and rage, and a sense of community discontentment and
disconnectedness. The presence of any of these factors, particularly in
combination, may indicate that the person may be at a higher risk of suicide.
A substantial socio-cultural potentiating risk factor for suicide among
Aboriginal communities in Canada is cultural continuity (Chandler &
LaLonde, 1995; Chandler & LaLonde, 2004). Cultural continuity needs to
be considered in addition to person-level risk factors, warning signs, and
protective factors.
Cultural continuity
Cultural continuity refers to the process of maintaining or preserving
ownership over past and future traditions, belief systems, and culture. This
sense of ownership or connection is lost and cultural identity fractured when
development or socio-cultural circumstances undermines or interrupts the
continuity from past through present to future.
The institution of residential schools that existed from the mid 1800’s to
as recently as 1996, is a glaring example of how cultural continuity can be
fractured (Indian and Northern Affairs Canada [INAC], 1998). This system
removed children from their homes and communities in an attempt at
assimilation (Aboriginal Healing Foundation, 2002; INAC, 1998). Similarly,
following World War II Canadian Government policies coerced Inuit to move
from traditional seasonal camps into new communities based around non-
Inuit values, education, governance, and laws (NSPSWG, 2010). Disconnected
from their heritage and without means to engage their culture, these
experiences left many from Aboriginal communities with feelings of extreme
loneliness, abandonment, loss of culture, lack of self-respect and dignity, and
problems with personal relationships.
During the risk assessment process, it is important to consider the community
context and cultural continuity of the person. Communities that do not have a
strong sense of their own culture and historical identity are not able to provide
resources for vulnerable community members to help them through periods