Nunavut's chief coroner has called a special inquiry in response to a record number of suicides in the territory last year.
Padma Suramala says 45 people killed themselves in 2013 — a significant increase from the previous high of 34 and one that brings the territory's suicide rate to 13 1/2 times the national average.
"It is devastating to me and to my coroners," she said Thursday.
"We are exhausted, mentally stressed out. There is no end to it."
Suicide, especially among the young, has long been one of Nunavut's most pressing and tragic social ills.
Almost everyone in Nunavut knows someone who has committed suicide. The territory is replete with heartbreaking stories, including one last May in which a grandmother, distraught over the suicide of her granddaughter, killed herself in turn.
A major study released last June revealed the depth of Nunavut's mental health problems, concluding it has higher rates of both major psychiatric illness and depression than the general Canadian population.
The study found that the deaths that were analyzed tended to be among single, unemployed males with relatively less education. The average age was 24. They had roughly double the rates of alcohol and cannabis abuse than control group members.
Almost half the people who killed themselves had been either sexually or physically abused as children compared with just over one-quarter of the comparison group. Almost two-thirds of those who killed themselves had been diagnosed before their deaths with severe depression.
The study also raised questions about the availability of mental health services in the North.
It found only 17 per cent of those who committed suicide had ever been hospitalized for mental health problems. About the same percentage had been prescribed medication.
Nunavut brought in a suicide prevention plan in 2011. Since then, the government and other partners have instituted public awareness and education campaigns and have sought to increase the availability of counsellors in Nunavut's tiny, isolated communities. Funding for such efforts has increased in the last two budgets.
Critics have criticized its implementation, pointing out that community meetings don't necessarily help someone struggling.
Suramala said that her inquiry can help the fight against suicide by keeping the issue in the public eye.
"We can bring the risk factors to the public in order to bring more awareness and let everybody know what the risk factors are," she said. "By this inquest, maybe we can bring more counselling services or more recreation centres in the communities which will reduce the social risk factors.
"By bringing in some recommendations, maybe governments will act and bring up more resources."
Suramala said the inquiry will likely be held in the Nunavut capital of Iqaluit this fall. It will hear from bereaved families and front-line workers as well as experts and mental health organizations in the territory.