Indigenous youth suicide incidence is high globally, and mostly involves young males. However, the Inuit of Arctic Canada have a suicide rate that is among the highest in the world (and ten times that for the rest of Canada). The author suggests that suicide increase has emerged because of changes stemming in part from the Canadian government era in the Arctic in the 1950s and 1960s. The effects of government intervention dramatically affected kin relations, roles, and responsibilities, and affinal/romantic relationships. Suicide is embedded in these relationships. The author also discusses the polarization between psychiatric and indigenous/community methods of healing, demonstrating that government-based intervention approaches to mental health are not working well, and traditional cultural healing practices often take place outside of the mainstream clinics in these communities. The main questions of the paper are: Who should control suicide prevention? What is the best knowledge base for suicide prevention?