Issues in northern Sask. communities are layered, complex, says psychiatrist

Northern communities needs more than "parachuted" supports in the wake of a crisis, according to a consulting psychiatrist who flies to La Ronge, Sask., and other remote communities.

Consulting psychiatrist says communities need more permanent supports

The biopsychosocial model of patient-centred care involves biological, physiological and psychological aspects. Ideally, parents are a huge part of the psychosocial aspect, says psychiatrist Sara Dungavell. (Allison Dempster/CBC)

Northern communities need more than "parachuted" supports in the wake of a crisis, according to a consulting psychiatrist who visits La Ronge, Sask., and other remote communities. 

Dr. Sara Dungavell with Northern Medical Services said the communities don't have enough people who regularly provide care, such as social workers. 

"When these crises happen, people get parachuted in for a month, two months to deal with the crisis and it's not long enough to build good coping strategies or the trust that you need for them to come in," she said. 

Today, Premier Brad Wall is meeting with northern leaders after six young girls took their lives in recent weeks. The girls, aged 10 to 14, came from the Saskatchewan communities La Ronge, Stanley Mission, Deschambault Lake and Makwa Sahgaiehcan First Nation. 

Dugavell said the issues plaguing northern communities are layered and complex, with rural under-funding and under-servicing at its baseline. 

On top of that, she said there is socioeconomic injustice where people in low income communities will not have the same access to things as people with money.
More than 250 people came together in La Ronge after a sixth suicide in northern Saskatchewan. (Submitted by Jim Searson)

It's a situation "where there are very real challenges because of low income [that] are getting dismissed as somehow their fault," she said.

Racism is an issue, too, she said.

"Day in, day out, they're being made to feel lesser because of their race, because of where they were born," Dungavell said.

The relationship with the Indigenous population and northern communities needs to be reorganized completely, she said.

"To actually make changes in this requires some very long-term commitments. If we're talking psychological, we have to talk about generations of care. We have to treat grandparents, parents, children," she said. "We need to make a 20- or 30-year commitment, not a two- or three-month commitment to psychological health." 

Patient-centred care

A biopsychosocial model of care is integral to patient-centred health care, Dungavell said.

The biological aspect, such as medications and operations, is what doctors are experts in and will help change the

These children are fed a steady diet of despair — same as their parents. There's only so much I can do.- Sara Dungavell, psychiatrist with Northern Medical Services

physiology of the patient. However, it is just one aspect of the situation, she said.

Dungavell said the psychological aspect is just as important, such as coping mechanisms and self-talks. These are usually administered by social workers, occupational therapists or nursing staff who have undergone mental health training.

"Ideally, it's also trained by healthy parents who have developed their own psychological coping skills for stressers and can model it for the children in their life, who then go on and model it to the next children," Dungavell said.

That area is one of the biggest problems, she said.

"I've met wonderful people up in all of my northern communities who are doing their best to provide this care, but are overwhelmed," Dungavell said.

"These communities have not been silent about the lack of resources that they have had. They've made it very clear that what they need is real change, real access to things that build children's hope, and as of yet there's been an inadequate response." 

Dungavell likens the situation in the north to the treatment of diabetes.

Ideally, she said, an endocrinologist would help with the administration of proper care but when all a person has access to — or can afford — is a steady diet of sugar, there is nothing that endocrinologist can do.

"These children are fed a steady diet of despair — same as their parents," Dungavell said. "There's only so much I can do."

With files from Allison Dempster