Coronavirus accelerates a mental-health crisis for Canada's indigenous youth

Farrah Dixon lives in Norway House Cree Nation, Manitoba.

Ottawa, Canada (CNN)For Farrah Dixon, the words come slowly and reluctantly, a measure of both how she's been feeling during this pandemic, and how she'd prefer to never talk about it again.

"Sometimes I feel like mostly I'm on my own. I learned to be independent at a young age. And I'm not typically the kind of person who is going to reach for help, for that, perseverance, I try to do it myself first. I've always been an introverted girl so oftentimes it's difficult for me to open up and find the motivation," she told CNN from her home in Norway House Cree Nation, Manitoba.
Canadian teenagers on reserves were already at higher risk of suicide and depression before the unprecedented shutdown for Covid-19 in March. But then came the isolation, fear and -- for many teenagers like Farrah -- a feeling that life was tough enough before the pandemic.
"I was really confused, I didn't know how to handle it at first. It was my last year of high school, so I was upset I didn't get to spend it with my friends and have the senior year we all wanted," says Farrah.
    "What really affected me was losing my grandmother a few months ago and I couldn't attend her funeral. I was 8 hours away, the roads were all blocked off, I was heavy-hearted and guilty because I hadn't been able to see her in months," she adds.
    Canada has already been dealing with an epidemic among its indigenous youth. First Nations' children and teenagers have a depression and suicide rate more than 3 times the average for non-indigenous people according to government statistics
    But the pandemic is adding a layer of risk to young indigenous lives and government officials tell CNN the impact on mental health may linger for years.
    "Living in a reserve it gets depressing over time. You begin to feel isolated, you find yourself parting ways with your friends. It takes a huge toll on your health," says Farrah.
    Indigenous peoples make up nearly 5% of Canada's population and for years their unemployment rate has been nearly double that of the rest of the population. For the nearly 1 in 4 indigenous youth living on reserve, disparities in educational and recreational opportunities are acute. Housing is inadequate on many reserves with some remote communities cut off from the rest of Canada for weeks or months during the year.
    For Jennifer Simpson, the effect of the lockdown on her teenage son Coda was almost immediate.
    Simpson told CNN that as a special needs child, explaining the pandemic to Coda wasn't possible. All her son knew was that the daily routines that brought him structure and safety were gone. No visits from support workers, no long drives through Norway House, no stopping to pick up a slushy at the local store.
    "He's had a lot of anxiety issues here at home and is trying to cope where we're had to get our doctor to change the meds. He's been isolated at home and having trouble," Simpson said.

    Surge in calls to mental health hotlines

    Within weeks of community shutdowns, Canadian government officials say mental health hotlines for indigenous youth were flooded with calls for counsellor support or emergency interventions. The calls came at a rate of about four times the pre-pandemic average they say.
    Samantha Folster didn't need to hear the numbers to know that a crisis was brewing. Folster is also from Norway House Cree Nation and as a mother and grandmother she knows all too well how the vulnerability of First Nations' youth can devastate a community.
    But her job now is more than 400 miles away in Winnipeg, and as a policy analyst for the Assembly of Manitoba Chiefs she is hearing from overwhelmed case workers and counsellors.
    "I was kind of floored by the conversations, they really needed the was very emotional for everyone," said Folster, describing a recent conference call where case workers and counselors described how families were feeling overwhelmed.
    "The youth were having anger outbursts because they couldn't understand or deal with the pressure of being under quarantine," said Folster, adding that parents were also overwhelmed. "They had to be the behavior specialist, the speech therapist, the occupation therapist, they had to do all of that."
    Throughout Canada, as schools and recreation centers closed, the void was most profound in remote communities and on reserves where schools and centers serve as a lifeline of social contact and care, especially for children and teenagers.
    "The extra pressure of Covid-19 caused more depression and more anxiety in our young people because the education system wasn't available to them either. It's their haven for young people and it was taken away instantly," said Folster.
    For months this year, children, parents and whole communities were left without the support they had fought so hard to establish.
    Dr. Anna Banerji and her son Nathan