Sask. psychiatrist says La Loche outbreak harm compounded by inadequate mental health resources

Dr. Sara Dungavell says COVID-19 is leading to increased stress and anxiety in the north, as people are living with less access to resources. On top of that, she said there wasn't enough resources in the community to begin with.

Dr. Sara Dungavell says more long-term, stable supports still needed

Psychiatrist Dr. Sara Dungavell provides fly-in psychiatric support for La Loche and other remote communities. Dungavell said there is a great community spirit and care that exists in La Loche, where people are 'resilient and strong and have survived so much.' (CBC)

Dr. Sara Dungavell says the COVID-19 outbreak in La Loche is causing more stress and anxiety in the northwest while programs are put on hold.

She also says that even if mental health services were business as usual — it wouldn't be enough. 

Asked if there had been enough mental health supports in place prior to the pandemic, Dungavell nearly choked and said "deeply, no. Horrifyingly, overwhelmingly no." 

The province did not provide requested information about mental health supports in the village.

Dungavell said people in the community, like those at the Dene High School, have tried their best to support others, but "for the past little while we haven't had an adult mental health worker in La Loche."

The Saskatoon-based psychiatrist has worked in La Loche once a month for four years and also provides telehealth appointments for northern patients. The time she can spend with patients is limited. 

"I'm basically med-management and it's just completely inadequate service, not to have counselling there."

She said the north needs stable, long-term supports . It's not the first time she's called for this. 

"We can't keep being reminded of the northern communities and of the complete marginalization and lack of services that have been going on every time there's a crisis, and act surprised," she said. 

"It's overwhelmingly frustrating. It is infuriating to see that folks are still having conversations about this [outbreak] somehow being La Loche's fault." 

Dungavell said the community was already vulnerable before the outbreak hit, with tragedy in its recent past along with high rates of suicide and addiction. Last year, Saskatchewan's provincial auditor called on the province to improve after finding suicide rates in northwest Saskatchewan exceed the provincial average by nearly 50 per cent.

Dungavell also said many of her clients have reported a history of tuberculosis. 

"We know that respiratory infections are likely to happen in the poor social determinants of health, historically colonized communities, and now our response to COVID is to say, 'oh, we should probably send PPE,'" she said. "We should send personal protective equipment, but we should also have —  years ago — intervened." 

Premier says 'there are needs'

When asked about gaps in services on Monday, Premier Scott Moe said he had "been on the ground in La Loche on this topic as well others just a few years ago, when we had a different challenge in that community." 

Moe was referring to a shooting that took four lives and injured several others. At the time, Moe was Minister of Advanced Education.

Moe said Monday there had been a lot of discussions about what supports exist in La Loche and who is providing them. 

"There are needs," he said.

"We've been working with that community on those needs for some time and will continue to work with them on the longer term needs that the people in that community do require.

"But this pandemic I think presents a number of other more immediate needs." 

Dungavell said existing problems might be made worse as the restrictions continue. She said families who struggle "under the strain of the social determinants of health and history of intergenerational trauma and colonialism … are now stuck together stuck in the same house."

The school acted as a hub for youth mental health services, she said, but it's closed.

So is the liquor store. Saskatchewan Health Authority has opened up a harm reduction alcohol management program to help people with severe addictions, but it's not clear what will happen to these people and the program once the store opens again. 

Long-term support needed 

Prior to the COVID-19 pandemic, there were 80 full and part-time Saskatchewan Health Authority staff members working in La Loche. Since the pandemic, 40 employees have been added to the community. 

Dungavell said the influx of good-hearted workers is important, but that it needs to be paired with long term care and support.

"This parachuting in of crisis response shouldn't be as necessary as it is, because we should be providing good quality long-term care to the communities and long-term support for them to build their own services," she said.

Members of the RCMP stand outside the La Loche Community School in La Loche, Sask. Monday, Jan. 25, 2016. (THE CANADIAN PRESS)

She noted that patients are challenged in the wake of a crisis or tragedy because the health-care workers they build relationships with eventually leave.

Other frustrations arise when there's not a crisis. She said people are resilient and strong, but when they reach out for mental health help they can't get it "because it doesn't exist in the community or there aren't enough counsellors there." 

"If you're constantly told 'if you're struggling, reach out for help,' and every time you reach out for help people are saying 'oh well we can't help you' — you stop reaching out."