This article chronicles my experience as a psychiatrist in Greenland - from digital consultations and “coastal visits” to confronting the country’s high suicide rate, I reflect on the realities of the Greenlandic psychiatry. Working in Greenland’s breathtaking landscape was both challenging and deeply fulfilling, leaving me with insights and memories that I’ll carry for a lifetime.
Tikilluarit Kalaallit Nunaat – Welcome to Greenland
I always wanted to visit Greenland, but I had imagined it would be a vacation on a cruise ship. Instead, my journey began with an Air Greenland flight from Copenhagen to Kangerlussuaq, marking the start of my working summer in this magical land.
It was a sunny day in early June when we finally landed at our destination in Nuuk, just an hour’s flight from Kangerlussuaq, Greenland’s international airport. I made my way to Oasen, a relatively old green-painted wooden building that provides housing for healthcare staff. It would be my home for almost three months.
Oasen is only a few hundred meters from Queen Ingrid Hospital in Nuuk, which houses Greenland’s only psychiatric department. This wouldn’t be particularly noteworthy if Greenland weren’t nearly 2 million square kilometers—almost five times the size of Sweden and seven times larger than Norway.
The people, the land, and the language
Despite its vast size, Greenland is home to only about 57,000 people, nearly half of whom live in the capital, Nuuk. The rest live in small towns and settlements along the coast. Greenland is now a self-governing entity within the Kingdom of Denmark, enjoying a high degree of autonomy. Certain areas, like citizenship, the police, and defense, remain under Danish control.
The Kingdom of Denmark includes Greenland, the Faroe Islands, and Denmark itself, with citizens of all three holding Danish citizenship and passports. Although Greenlanders have EU citizenship, Greenland is no longer part of the EU, having withdrawn in 1985.
The official language is Greenlandic, an Inuit language similar to that spoken in Nunavut, Canada. Danish, however, serves as a “working” language in healthcare, meaning that an interpreter from Greenlandic to Danish is often required during healthcare visits. On a couple of occasions, I was reminded that it was I who needed the interpreter—not the patient—as Greenlandic is the national and the official language of the country.
Working as a psychiatrist in Greenland
Greenland’s psychiatric service does not have a full-time psychiatrist; instead, most psychiatrists, often from Denmark, work on short-term contracts usually ranging between few weeks and a few months.
I also learned that employees in Denmark have the right to take unpaid leave for work in Greenland.
Reflecting on my experience practicing psychiatry on the world’s largest island, I would say that the first two weeks were somewhat challenging. This was partly due to the language (in my case Danish, I wasn´t brave enough to try to master Greenlandic), and the unique aspects of Greenland’s psychiatric service. For a couple of weeks in June, holding the role of the only Consultant Psychiatrist in Greenland was both flattering and highlighted the immense responsibility that came with it. Given that the entire country has only one psychiatric department, a significant number of psychiatric consultations are done digitally, and patients needing inpatient care must fly to Nuuk.
Greenland has its own psychiatric law on involuntary treatment, which is adapted to the country’s specific needs. From a “continental” perspective, it may seem unusual that an involuntary admission can be initiated at a local hospital without specialized psychiatric services. The patient is then flown to Nuuk for continued treatment when possible. Unpredictable weather conditions and flight delays can mean days before a patient arrives at Queen Ingrid Hospital, with consultations often done digitally or by phone in the interim.
For those outside Nuuk, follow-up care is conducted through telemedicine, and once a year, a psychiatrist makes a “coastal visit” to smaller towns and settlements. Local healthcare professionals plan the schedule for these visits and inform patients about appointments.
Regarding psychological treatment, three clinical pathways are available: anxiety, depression, and suicide prevention. Greenland’s suicide rate is among the highest in the world, with some estimates as high as 96 per 100,000 people, and the rate among young people is particularly concerning.
Trip to South Greenland
A couple of weeks before my planned return home, I took a boat trip to southern Greenland. On the second day, as the ferry approached the harbor of a beautiful coastal town, I noticed people gathered on the shore, some wearing sports jerseys. I assumed they were preparing for a local football tournament.
As I disembarked, I noticed a group standing near the ferry, including those in sports jerseys. At first I didn´t realize what the gathering was about, however, it soon became clear to me that it was a sad occasion. Two people stood on the dock, with tears running down their faces. Others were approaching them and embracing them into a hug. They too were crying.
Well, they are not very old, maybe one of their parents died, I thought to myself, while I was making my way towards the road.
The day was beautiful—sunny, with blue skies and the green hills of southern Greenland on the horizon. I sat by the pier waiting for a boat to take me to Igaliku, and in conversation with a friendly German couple, I mentioned the scene at the harbor. “Ah,” the woman said, “that explains why we saw a coffin being unloaded from the ferry.” She gestured toward the crane that had lowered a white coffin into a smaller boat below.
The family boarded a separate boat, and together they sailed out of the harbor. There was something beautiful and peaceful in that scene – the white coffin covered with purple flowers sailing on a calm sea, lit by the sun, the family is sailing behind them, and the people who came to pay their respects standing calmly on the shore.
But the white coffin, it was probably someone young. What did he die of? Maybe she was sick? Could it be suicide? I wondered about that scene for a while.
However, the gorgeous weather and beautiful scenery quickly occupied the thoughts and senses.
I really enjoyed that short trip to Igaliku, where the UNESCO site of Kujataa is located, and the visit to Hvalsey Church, which is the best-preserved Old Norse church in Greenland, dating back to the 13th century. As I woke up in the middle of the night, I even managed to see the magical aurora borealis in the middle of August.
Suicide in Greenland
Back in Nuuk, I mentioned the funeral to a Greenlandic colleague. “Oh,” she said sadly, “you were on the same ferry as them.” She continued, “It was a young person. His parents tried very hard; everyone tried, but they couldn’t help him. He took his own life.”
Or perhaps it’s better to say “died by suicide,” as I recently read.
A deep sorrow settled over me. There are certainly many reasons for Greenland’s high suicide rate. It seemed to me that I started to understand the magnitude of this issue and its impact on the entire Greenlandic society. I do believe that it represents a collective trauma for Greenlanders. What can we as a profession do and how can we contribute to finding a solution and hopefully reversing the trend?
In conclusion
Working in Greenland was one of the most enriching professional experiences I’ve had so far. Although challenging at times, it was deeply rewarding and fulfilling. I learned far more than I had anticipated, and I enjoyed it more than I could have imagined.
I hope that sharing my experience of living and working in this magical country has sparked your interest in the possibility of working as a psychiatrist in Greenland. Nothing would make me happier. □
The text is partially modified from my recent contribution to the Newsletter of the Psychoanalytical Society of Serbia.
