The Canadian First Nations community of Attawapiskat declared a state of emergency this month after 11 people tried to kill themselves in a single night, bringing the total number of suicide attempts since September to more than 100.
The spike this month snapped the world's attention to the tragedy unfolding in the remote coastal community of around 1,500 people in northeastern Ontario. The crisis has since deepened, with another five children reportedly attempting suicide on Friday, leading local MP Charlie Angus to denounce "a spiralling situation that is taking us into unknown territory".
Although the surge is alarming, the crisis itself is not new. For decades, Attawapiskat and other First Nations communities throughout Canada have experienced high rates of suicide, amid long-standing social problems that include systemic poverty, family violence, educational failures and substance abuse.
Al Jazeera spoke with Ontario Health Minister Eric Hoskins, who recently visited Attawapiskat, about why life in the community has degenerated to this extent, and what is being done to address the problem.
READ MORE: Canada and the aboriginal mental health crisis
Al Jazeera: Why has the situation in Attawapiskat escalated to the point where more than 100 people have attempted suicide in a matter of months?
Eric Hoskins: There's a whole set of circumstances - whether it's inadequate housing, or a lack of income opportunities, or the massive and continuing negative impact of the residential schools saga - that have all contributed to making this situation that we're finding today.
We've been investing in mental health services, but part of the challenge has been that for the last decade, the level of coordination with our federal partners and the commitment from the federal government has not been what we believe it should have been, so that made it more challenging for us to approach this in a coordinated way.
The resources that we've provided to date at all levels of government have been clearly inadequate. We've failed the youth in First Nations communities, particularly those in the remote, northern, fly-in communities. And that's not unique to Ontario - that's something that we all share nationally as well.
Al Jazeera: When you visited Attawapiskat last week, what was the mood like?
Hoskins: It's clearly a community in crisis. We heard a cry for help coming from the leadership representing this community.
On the one hand, we saw frontline healthcare workers who were clearly overwhelmed. We found a band council and a local chief who were doing everything they could to manage this enormous challenge and crisis, but they were also clearly exhausted and in desperate need of support.
We spent a few hours with the band council and the local chief, and also with dozens of youth from the community, which was incredibly impactful. We heard from the mother of a 14-year-old girl who tragically took her life last October. It was very moving and very distressing, but it was also incredibly empowering.
It was amazing to hear from the youth, who were obviously in great distress and very anxious and concerned - but despite that, they knew where the community and themselves needed to go. They knew what kinds of support they needed, and mapped out a plan for us that they believed would take the community from a place of hopelessness to a place of hope for the future.
Al Jazeera: What was involved in that plan, and what concrete steps will the province take to help alleviate the fundamental social and economic problems plaguing Attawapiskat?
Hoskins: This is really challenging, and it goes far beyond health - it's the social determinants of health.
The conditions are so appalling and so inadequate. We have a moral and historic responsibility to address that.
In the immediate short term, we announced $2m in funding, some going to youth supports, and the majority going to a team of 13 health-care workers to deal with this surge and provide immediate support to the individuals, but also their families, who have reached the point where they attempted to take their own lives.
But almost all of our conversations were focused on the medium and long term. It's become clear that there's a need for all levels of government and not-for-profit organisations to do a better job of coordinating what we're doing together so it has a maximum impact.
There's no question that's going to require additional resources to deal with everything from access to clean water, to decent housing - because the housing is so inadequate, it's dilapidated, and there's mould, and they're crowded and the windows are boarded up - to education, to income support and revenue sharing. It's important that First Nations communities be able to benefit from the resource extraction and economic activity that occurs in their areas.
The number one request of youth was to have a youth centre and to have programmes and activities that would help them reconnect with the land and their culture and their history, so we're looking at that.
Obviously none of this is going to happen overnight, but it's almost like the stars have aligned, so we have a responsibility to not get caught up in jurisdictional discussions, which have stopped action in the past. We must come together, all of us at all levels, and start to chip away at these seemingly enormous challenges.
Al Jazeera: On the federal side, First Nations representatives have called for a national strategy to combat indigenous suicide. Do you support this proposal, and what would that look like?
Hoskins: I think that's a great idea. It speaks to the reality that this is regrettably present in First Nations reserves right across this country, particularly in those northern, remote, fly-in reserves. I wholeheartedly support a national strategy to look at this in all its aspects, alongside the social determinants, such as housing and economics.
This is about putting supports in place to prevent young people from the pain being so bad that suicide is something they would actually consider.
Al Jazeera: Considering that the treatment of First Nations communities has been an ongoing problem in Canada for decades, why should anyone be convinced that after the Attawapiskat story fades from the headlines, anything will substantively change?
Hoskins: My perspective on this is that this is such a tremendous moral and ethical and historic obligation. There's no guarantee that this time will be different, but if those of us who believe we have an opportunity, as well as an obligation, collect that fortitude to move forward, I truly believe we can begin to make the progress that's so necessary.
But when you look at the conditions, Canada is sixth on the human development index; First Nations communities are number 63. The conditions are so appalling and so inadequate. We have a moral and historic responsibility to address that.
It's easy to look back at the failure it has been, but it can't prevent us from trying to find that resolve to hopefully make this time different than the past.
This has really captured Canada's attention, and I hope it is that catalyst to make us realise not just how serious and in crisis many of the communities are, but to make us finally say we can do this if we work together and bring the resources forward.
This interview has been edited and condensed.
Follow Megan O'Toole on Twitter: @megan_otoole
Source: Al Jazeera