Suicide prevention requires a multi-faceted approach which focuses on:

 building resiliency of the whole population, early identification and responding to those at risk providing ongoing support to those who may be suicidal or who have long term needs support to those that have been affected by a suicide or serious suicide attempt and improving our knowledge and understanding the causes and rates of suicidal behaviours.

The higher rate of Maori youth suicide and the Government?s commitment to improving Maori health is being addressed in part by a Maori-specific component to the strategy, Kia Piki te Ora o te Taitamariki. Prevention initiatives need to be well co-ordinated and engage a range of sectors, including central and local government, community, professional groups, iwi, hapu and families/whanau. Suicide prevention initiatives must take into account research and best practice to minimize the potential to do harm.

Range of Interventions

The range of interventions which contribute to the prevention of suicide are generally derived from reducing the impact of identified risk factors and by increasing resiliency by promoting protective factors. In many ways they attempt to interrupt the pathways which can lead to suicidal behaviour.

The New Zealand Youth Suicide Prevention Strategy as a whole draws together the full range of interventions spread across two parts of the strategy. Both merge within one core intervention approach as follows: Strengthening families, young people, whanau and communities.

A summary of interventions for In Our Hands Below is a summary of some of the interventions which help prevent and reduce youth suicide.

• Population based initiatives to promote resiliency and reduce harm: School-based mental health promotion programmes.

• Mental health destigmatisation programmes family/whanau support programmes and services.

• Strengthen hapu, iwi and community support structures.

• Promote help-seeking amongst young people.

Information for parents.

• Modify broader social factors that may contribute to suicide risk.

• Reduce social inequality, discrimination and abuse which impact of young people.

• Encourage participation of young people in all aspects of community life.

• Reduce access to lethal means of suicide, including modifying facilities to make them suicide resistant.

• Promote good practice in media reporting and portrayal of suicide.

Early identification of those who have risk factors:

• Improve practice with guidelines and training on early identification and assessment of risk (eg, for GPs, school guidance counsellors, police, CYPFS social workers etc).

• Expand and improve youth appropriate health services (including mental health and drug and alcohol services).

• Improve the cultural appropriateness of mainstream services to Maori, Pacific people and other cultures.

• Expand ?by Maori for Mäori? services:  targeted family support programmes (eg, Family Start, PAFT, Whanau Toko i te Ora).

• Early intervention services (eg, social workers in schools).

Improved treatment for those who are at special risk of suicide, including those who have attempted suicide:

• Improve effectiveness and accessibility of crisis support services.

• Expand and improve youth mental health services.

• Improve emergency department management and referral of those who have attempted suicide.

• Improve follow-up support for those who have attempted suicide.

• Provide support for families/whanau of those who have attempted suicide.

• Improve co-ordination between services.

Effective support and response after a suicide or serious suicide attempt:

• Skilled, accessible and culturally appropriate bereavement support services.

• Postvention plans for schools, workplaces and communities to reduce potential for cluster suicides.

Improved information about the rates and causes of suicide:

• Research into design and evaluation of suicide prevention programmes.

• Research to increase our understanding of suicidal behaviour, eg. for Maori, Pacific people, media impact, wider social changes, sexual orientation etc.

• Collection and dissemination of research and information to those involved in suicide prevention.

Improved statistical information about the trends and rates of suicidal behaviour Improve the classification of ethnicity in date so true rates of Maori and Pacific suicides are known.

Potential for interventions to do harm

One of the principles of the New Zealand Youth Suicide Prevention Strategy is that initiatives to prevent suicide must be informed by research and best practice to ensure that these initiatives do not put people at further risk of suicide. There is international evidence that some well intentioned initiatives, such as school-based suicide awareness programmes for students, have actually resulted in higher rates of suicidal behaviour.

Suicide prevention programmes which involve schools, the media or raising awareness if suicide need to be approached with extreme caution, be carefully pre-tested and evaluated for any potential unintended negative effects. The New Zealand Youth Suicide Prevention Strategy provides national leadership to ensure that programmes are not only effective, but do not put people at further risk of suicide.

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