Hope area students struggle with suicidal thoughts and often can't get help: report

Students in the Fraser-Cascade School District are thinking about suicide at an alarming rate and struggling to access health care like the rest of BC, according to a survey of local kids.

Almost one-third of Grade 7 to 12 students in the district said they seriously considered suicide between 2022 and 2023, according to a report conducted by the McCreary Centre Society. And only 66% of students who needed medical treatment got it in 2023, as opposed to the 82% of youth who did provincially.

The numbers shine a light on a lack of health services in Hope and other low-income areas in the eastern Fraser Valley, and the reliance many youth have on elders and public transit to access specific care in a vast geographical area.

“I don’t think the government sees rural communities as needing a lot of certain things,” said Nikki-Jade Draven, a 25-year-old from Hope who recently underwent a gender transition. “Through this transition, I had to go to Chilliwack because there’s no resources [in Hope].”

Why are so many struggling?

Mental and physical health can vary from person to person. But SD78 students today are reporting that their health is worse now than what it was in 2018, when the last survey was conducted.

That year, nearly three-quarters of youth said their health status was good or excellent. Five years later, only about half of students reported the same for their mental and physical health.

A decrease in wellbeing was common among all students in BC, said Dr. Annie Smith, executive director of the McCreary Centre Society. McCreary, which has published health studies about every five years since 1992, conducted similar surveys in 59 of BC’s 60 school districts. A minimum of 20% of Grade 7-to-12 students participated in each study.

The downward trend in wellbeing was more pronounced in rural communities, where there are far fewer services and major geographic hurdles compared to urban areas, Smith said.

“Barriers to physical activity, transportation is an issue,” she said. “These big, systematic issues are challenging in BC’s geography when you’ve got such large distances between communities.”

There is no single explanation why so many youth in this pocket of the province are struggling with suicidal thoughts, health care access, sexual harrasment and abuse. (One-third of students said they had experienced physical sexual harassment, and a hair under one-fifth reported physical abuse.)

But communities with higher levels of poverty and large Indigenous communities tend to have more vulnerable populations.

In Hope, where more than one in 10 people are Indigenous, people make about $25,000 less than the provincial average and are more likely to have chronic diseases like COPD and diabetes, according to the BC Centre for Disease Control.

At first glance, it may be hard to see how lower income directly leads to negative health outcomes, especially in a place like Canada with universal health care. But money is closely tied to housing, stress levels, and access to health food, which can significantly disrupt healthy living conditions.

Those systemic barriers have been proven to impact young people.

Hope youth are far more likely to enter kindergarten scoring high vulnerability in a variety of areas—physical health, social skills, emotional maturity, communication skills, and general knowledge—that commonly predict healthy living conditions into adulthood.

‘An Elder who just listens’

SD78 serves 14 Indigenous bands, and nearly half of its student body is made up of Indigenous people, a group that has historically struggled to access health care services.

Pam Robertson, chief of the Boston Bar First Nation, thinks mistrust in the health care system stems from having a family member who was previously misdiagnosed or mistreated. There’s also a fundamental difference between the way many Indigenous communities prefer using traditional medicines, compared to the western way of treating people.

A student living on reserve that is considering suicide may be directed to see a counsellor and relocated to a treatment centre outside of their community under western health practices—a stark difference to how youth may be helped under traditional methods.

“Treatment for us could be going to harvest, spending time with an Elder who just listens. An Elder from whatever nation, somebody who cares, listens, and is just being present,” Robertson said. “I find that’s lost in a lot of westernized [practices].”

Evidence shows that Indigenous people benefit from traditional knowledge, and there’s a demand from western doctors to learn more about Indigenous healing practices.

Most doctors in BC and Ontario welcome Indigenous healers, and 90 per cent of northwestern Ontario physicians said Indigenous healing helped improve psychosocial health, according to a 2020 report in the National Library of Medicine.

Draven, the 25-year-old from Hope, who is also Indigenous, has been seeing an Indigenous counsellor for years. The counsellor helped them navigate some of their darkest moments. Before that, while they were living in a different community, Draven struggled to find another doctor who took their thoughts about switching genders seriously.

“I started trying to talk about it at 14, and my counselor at the time said, ‘Oh, you don’t need to worry about that, you need to worry about your math grades,’” Draven said.

There is one clinic on Boston Bar’s reserve, but it’s only open for five hours one day a week. The community needs more specialized care that focuses on sexual identity, racism, bullying, and other health-related issues, Robertson said. Especially in a smaller community, it can be hard for youth to talk about those issues without family members or neighbours finding out.

“They want to have that safe space where they can have a youthful doctor or nurse practitioner to talk to and say, ‘I’m struggling with my sexual identity, my parents don’t understand,’” she said.

Not every nation can be painted with the same brush, but Kelsey John, a councillor at Chawathil First Nation, believes understanding the issues begins with centring youth.

Nothing is finalized, but John is currently working on a health fair that could connect youth and Elders with kinesologists, registered massage therapists, home health workers, sex education teachers, and other health experts.

“It would be great to have that dialogue with the kids to say, ‘When did this start for you?’ ‘What was your trigger? Is it at home? Is it at school?’” he said.

A need for important conversations

Megan te Boekhorse, co-founder of Hope Pride who also facilitates a workshop with youth in SD78, thinks the issues for some stem from high rates of transphobia from peers and adults in the community.

“The comments being passed in schools is ‘you’re being one of those they/them’s,’” she said.

Alex Dagnino, the other co-founder of Hope Pride, says that it takes a village to raise a child—especially in rural communities, where youth have a higher suicide risk than those living in urban areas.

However, for those who are queer, Dagnino said the culture around town has not been welcoming to all residents. Some fear visiting certain businesses.

“If they feel scared in the streets, they need to be able to go into any business you would think to feel safe. Guess what? If you’re queer, that’s not necessarily the case,” Dagnino said.

Transgender youth are more likely to think about suicide compared to other people.

In a survey of nearly 7,000 youth between the ages of 15 and 17, transgender youth were over seven times more likely to attempt suicide, according to a 2022 report in the Canadian Medical Association Journal.

The issue is also prevalent in areas where transgender youth are forced to conform to new rules.

In the U.S., the rate of suicide among transgender youth rose by over 70 per cent in the years after a state passed anti-transgender laws.

Dagnino thinks that businesses and all service providers in the community should have more 2SLGBTQI+ training to handle topics and conversation that may be sensitive to those youth.

“They need to be educated that when these kids come to see them, they’re not coming so broken that they think something’s wrong with them,” Dagnino said.

A far, far away place

Others suggested that the vast geography of the region is the main culprit.

Sam Kelley, program manager for families and youth at Cedar Strong Prevention and Intervention Society, said youth living in Boston Bar have to travel to Hope (or beyond) to access medical care. That places strain on a town that is already dealing with an influx of new residents and an at-capacity medical system.

“Our population in Hope has grown more than our doctor’s office can manage,” she said.

Hope’s population grew by more than 500 residents from 2016 to 2021, according to the latest census data.

Kelley believes Hope gets overlooked for services due to its proximity to Chilliwack. Because of that, it can be tough for Hope youth to access specific services like gender care in Chilliwack without a vehicle, which could take hours on transit.

“Youth would have to miss the entire day of school for one appointment,” Kelley said.

The school district is a microcosm of the health care issues that are plaguing BC, said Balan Moorthy, the district’s superintendent. Nearly one million British Columbians don’t have a family doctor and emergency rooms are consistently clogged.

Even as students report feeling worse, they’re actually acting in ways that should improve their health—especially over the long-term. Students are smoking less tobacco, trying less cannabis, and drinking less alcohol compared to 2018. The McCreary study also reported that students felt “strong emotional connections” to schools in SD78, which measured whether students felt safe and cared about.

“The school has, from a social and emotional place, been a place of refuge and support,” Moorthy said.

What to do next?

Decision makers in the region agree that there needs to be some sort of community-based response to the survey’s findings.

John, the councillor at Chawathil First Nation, was unfamiliar with the McCreary findings prior to The Current’s interview request and believes that action starts with better cohesion between First Nations and those surveying youth.

“If there’s any surveying or any research done on our Indigenous youth, the nations would like to know about it,” John said.

The school district has taken multiple steps to address health concerns with other agencies.

SD78 has hired three mental health support workers and an Indigenous liaison, according to Moorthy. The liaison will work in tandem with the district and other health agencies to expedite support for students.

The district’s moves come in addition to the Integrated Child and Youth Team (ICY) that was launched in SD78 two years ago.

It’s a program co-funded by Fraser Health, SD78, Ministry of Health, and the Ministry of Children and Family Development that provides services to students within the school district. ICY workers collaborate with public health agencies to expedite care support for students in a vast geographical area.

But not everyone thinks that’s the best course of action.

Cedar Strong executive director Gerry Dyble says the ICY team is effective, however, she wishes that the community had a more centralized facility that wasn’t associated with the school district.

“In my experience, when you have an institution like a school delivering a service that’s very sensitive, students aren’t necessarily receptive to receiving those services,” Dyble said.

She said Hope has not been able to get a Foundry Centre, a province-wide network of facilities that provides multiple services to people between the ages of 12 and 24 in one building. The district has had its application turned down twice. She believes the ICY teams were created as an offshoot for Foundry in the community.

The closest Foundry Centres to SD78 are in Abbotsford and Langley. Chilliwack was recently given $1.5 million to set up a Foundry Centre.

Smith applauded the provincial government for building Foundry Centres across BC. But she agreed that they can be hard to access when those services aren’t in a young person’s community.

“For them to pluck up the courage, walk in, and go, ‘What if somebody recognizes me?’ ‘I’m not sure if I have to pay,’ there’s so many things they see as barriers,” Smith said.

Ultimately, Draven thinks the solution boils down to adding more services—family doctors, rural doctors, specialized doctors—in the region. That would make it easier for rural youth to visit doctors in their hometown, without driving or taking unreliable public transit to a larger city.

“I don’t want to keep going out to Chilliwack to visit my doctor every six months, I’d like to go maybe down the road,” said Draven. They noted their local family doctor hasn’t been helpful in the past with specialized care.

“You either have to go out to the city or you’re stuck.”