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Telehealth may reduce Nunavut suicide rate

Better access to mental health care could help turn the tide

CHARLOTTE PETRIE

Nunavut health and social services officials believe better access to mental health specialists through video-conferencing could significantly reduce the rate of suicide among Nunavummiut.

Tina McKinnon, the Nunavut government's manager of telehealth services, spoke passionately about the benefits of satellite health care at the 2003 conference of the Canadian Association for Suicide Prevention held at Inuksuk High School last week.

In communities where there is a shortage of qualified counsellors, persons at risk of committing suicide could receive the necessary treatment by accessing specialists in other communities, or in the South, through video-conferencing.

In communities such as Cambridge Bay, where many men in crisis are unwilling to receive counselling from a woman, video-conferencing could provide the alternative one-on-one male consultation.

Right now, 15 Nunavut communities have the ability to access health specialists outside their immediate area through the use of satellite video. McKinnon is pushing hard for federal funding to provide telehealth access to 10 more communities.

"The federal government should pay for this," McKinnon said. "We are not responsible for the fact that we live in these conditions."

In the South, it is possible to run underground fibre-optic cable at a relatively cheap price, but the only reasonable way to establish connectivity in Nunavut is through satellite.

The necessary satellite bandwidth was established in the 15 communities that currently have videoconferencing access.

The cost of satellite bandwidth is significantly higher than fibre, but due to many financial and logistical challenges created by the Arctic landscape, fibre connectivity is almost impossible, McKinnon said.

"If it cost them 10 cents to run a kilometre of fibre, it costs us $100 to get bandwidth. We couldn't go and string fibre across Nunavut because, for one we don't have roads, and it would take a long time on dog-sled.

"As the smallest jurisdiction, we simply can't afford to pay for it, so there has to be some sort of assistance in getting that bandwidth."

Yet competition for federal funding under the Canadian health infrastructure partnership program is fierce. Two years ago there were $500 million worth of applications for only $200 million available dollars.

"It took the federal government almost a year to evaluate the applications," McKinnon said.

In the end, McKinnon feels the GN did pretty well in being awarded $3.7 million, which it matched, to pay for the installation of satellite connections to the first 15 communities.

One of the difficulties in convincing the federal government to invest more in telehealth is that it may increase the cost of health care in Nunavut for the first five or 10 years, McKinnon said.

Whereas telehealth is ideal for decreasing the amount of time and money spent on sending patients and families out of Nunavut for the necessary care, costs could rise initially.

"An under-serviced population which suddenly has round-the-clock access will result in earlier diagnosis and better treatment," McKinnon predicted.

"Down the road what you will find is a better-served population through shorter hospital stays and less trips out, but it's hard to ask a government to invest in what looks like a pie-in-the-sky dream for 10 years when we have so many issues here today."

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