Vers une décolonisation des ressources de soins et services sociaux : les travailleurs communautaires locaux au Nunavik.

OBJECTIVES: According to the World Health Organization, discrepancies in health statistics reflect unequal access to resources. The Truth and Reconciliation Commission of Canada calls for an increase in the number of Indigenous workers within health and social services. The involvement of local community workers is essential to ensure the cultural security of care and the decolonization of services. This article presents the role played by these workers in the expansion of mental health services and social interventions in Nunavik, the contextual considerations that influence their practice and their place within professional teams. METHODS: A thematic analysis was conducted on semi-structured interviews done in 2016 with 60 Inuit and non-Inuit individuals working in the broad field of health and social services in Nunavik. RESULTS: The integration of local community workers is perceived to bring several benefits, including the improvement of interventions and unique learning opportunities. However, several factors hinder this collaboration, such as clarity of mandates, access to pre-requisite training and diplomas, recognition of local knowledge, and staff turnover. More flexibility and support after hiring would allow for the service structure to be adapted to the complex reality of Nunavik. CONCLUSION: This article adds to the body of literature highlighting the importance of collaboration with local community workers. The decolonization of services necessarily involves redesigning structures in order to recognize their contribution and to give a place to local knowledge.

RéSUMé: OBJECTIFS: Selon l'Organisation mondiale de la santé, les écarts dans les statistiques de santé reflètent un accès inégal aux ressources. La Commission de vérité et de réconciliation du Canada appelle à l'accroissement du nombre de travailleurs autochtones dans le domaine des soins de santé et services sociaux. L'implication des travailleurs communautaires locaux est essentielle à la sécurisation culturelle des soins et la décolonisation des services. Cet article décrit le rôle de ces travailleurs dans l'extension des services de santé mentale et des interventions sociales au Nunavik et explore les considérations contextuelles qui influencent leur pratique et leur place au sein des équipes professionnelles. MéTHODE: Les résultats ont été obtenus par l'entremise d'une analyse thématique d'entrevues semi-structurées effectuées en 2016 auprès de 60 individus inuit et non-inuit travaillant dans le système de la santé et des services sociaux au Nunavik. RéSULTATS: L'intégration des travailleurs communautaires locaux est perçue comme apportant plusieurs bénéfices, notamment une amélioration des interventions. Cependant, plusieurs facteurs entravent cette collaboration tels que la clarté dans les mandats, l'accès aux formations et diplômes pré-requis, la reconnaissance du savoir local ainsi que le roulement de personnel. Plus de flexibilité et de soutien après l'embauche permettrait d'adapter la structure des services à la réalité complexe du Nunavik. CONCLUSION: Cet article s'ajoute au corpus de littérature qui met de l'avant l'importance de la collaboration avec les travailleurs locaux. La décolonisation des services passe nécessairement par le remaniement des structures afin de reconnaitre l'apport des travailleurs locaux.

Exploring the potential roles of community-university partnerships in northern suicide prevention implementation research.

This paper discusses the lessons learned from a partnership project on suicide prevention carried out with Inuit organisations in Nunavut and Nunavik. The aim was to identify research needs, processes, and opportunities for knowledge translation to guide suicide prevention activities. Key reflections among partners regarding regional needs and the potential roles of research in suicide prevention in northern Canada are described as well as the three identified priorities: (1) focusing on community mobilisation; (2) supporting access to scientific information; and (3) supporting the adaptation of evaluation criteria and protocols of ongoing community activities. Strategies to address these priorities are presented.

The Darknet and suicide.

CONTEXT: The Internet contains both public content ("Surface Web"), and private content ("Deep Web") sometimes hosted on exclusive networks ("Darknets") only accessible using dedicated software such as TOR (The Onion Router). This software makes it almost impossible to identify its users. Information media have reported on suicide-related aspects of Darknets, for example when poisons that can be used to kill oneself are offered for sale (Le Garff et al., 2016) when users discuss ways to kill oneself in anonymous forums (Ferrara, 2016; Franceschi-Bicchierai, 2015) and suicides that follow bullying or "doxing" (online divulgation without consent of intimate personal information) (Bartlett, 2015). Several recent studies have analyzed the nature of suicide content on the Surface Web, but to date, there have been no systematic investigations of suicidal content available on Darknets. OBJECTIVES: The object was to document the nature and accessibility of suicide-related information available on the TOR Darknet or via the TOR software. METHODS: We replicated the methodology used by Biddle et al. (2008, 2016) in their studies of the Surface Web, using TOR on the Darknet. We identified and chose nine search engines used on the TOR Darknet: TORCH the TOR search engine, Notevil, Ahmia, Candle, Hidden Wiki, Darknet (onion.link), Duckduckgo and Grams. Two research assistants independently coded the first 30 results of searches using the keywords, "suicide" and "suicide methods". RESULTS: There were 476 "hits" in the search for "suicide" and "suicide method" using TOR, with fewer sites dedicated to suicide (4%), compared to the Surface Web (23.1%) (Biddle et al., 2016). Over half of the sites proposed by the TOR search engines (252, 52.9%) were outdated, inaccessible or not containing content pertinent to suicide or suicide methods. Several of the TOR search engines provided access to forums ("chat boards") where suicide was a topic (70, 14.8%). These were usually pro-suicide, are blocked or filtered by most of the Surface Web engines (e.g. Google). DISCUSSION: Persons concerned with suicide prevention should conduct further investigations of pro-suicide forums that are accessible using TOR and their users, comparing them with the Surface Web. New strategies to prevent suicide may need to be developed for Darknets.