IntroductionThe increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country.ObjectiveThis article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived) is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method.MethodA retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed.ResultsThe psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations.

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Seasonal mood changes in this Inuit group living in the Canadian Arctic are elevated above the rates found in other studies using similar survey methods.

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The Transition into Primary Care Psychiatry (TIPP) clinical model, a shared mental healthcare service implemented at London and Thunder Bay, Ontario, facilitates collaboration in mental health service delivery for patients with chronic mental illness. In this program, people with stable but chronic mental illness are transitioned back to the family physician with assistance from a team consisting of a mental health nurse with expertise in psychiatry and a psychiatrist. Continuity of care is provided in the family physician's office by regular consultations with the psychiatrist and nurse, and community services are provided as needed for individual clients. The experience with TIPP suggests that collaboration and satisfaction can be achieved among the different disciplines involved in providing shared mental healthcare. These findings contribute valuable information for policy research and may be used to determine if the TIPP clinical model can be more widely applied in the province of Ontario.