A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability

Abstract

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.

Suicide among Inuit: Results from a Large, Epidemiologically Representative Follow-Back Study in Nunavut

“…The project was developed in partnership with Nunavut community organizations. 13 A lay report was developed and presented to the stakeholders and community members for knowledge dissemination and approval by the stakeholders before the submission for publication, as required by chapter 9 of the second edition of the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. 14…”

“…Sociodemographic variables were assessed using a standardized instrument that was culturally adapted to Nunavut. 13 We also investigated the occurrence of childhood maltreatment, including physical, sexual, and (or) psychological abuse, using an abbreviated form of the Childhood Experience of Care and Abuse interview. 20 Information collected on history of maltreatment and legal problems was complemented with information collected from medical charts and criminal records.…”

Endogamy and suicide: An observation-based hypothesis

“…Of note, the groups described here differ from indigenous populations showing high rates of suicide, in whom recent massive acculturation has usually been the main explicative mechanism e.g. the Inuits in Northern Canada since the 1970s [19]. These descriptions are mainly extracted from the anthropological literature, which present the obvious strength of a precise cultural characterization but often lack the systematic search for risk factors revealed by other research fields (e.g.…”

Summary of psychometric properties of the French version of the questionnaire mental health profile of etindele (MHPE)

“…Identification of early signs of clinical parameters of mental diseases whatever the methodology, before invasive investigations, may reduces significantly onset of prevalence [16][17][18][19][20][21][22]. An environmental factor of depression, stress or anxiety, can be easily prevents with a regular self report of information by participant himself or professional healthcare.…”