How can suicide be prevented?

A range of initiatives need to be in place across a number of settings supported by Government, service providers, communities and families. Such interventions are generally aimed at promoting protective factors and reducing risk factors for suicide.

What are the risk factors for suicide?

Research shows young people who die by suicide generally:

come from disturbed or unhappy family and childhood backgrounds

come from socially and educationally disadvantaged backgrounds

have a history of suicide attempts

have an underlying mental health problem such as depression, alcohol and drug abuse and anti-social behaviour

have behavioural problems, such as conduct disorder or antisocial behaviours

have been exposed to a stressful life event prior to the suicidal act

have underlying individual and personal vulnerability (eg poor problem solving capabilities, impulsively and low self esteem).

As well, young Maori face additional risk factors linked to a history of alienation from Maori culture and land, the difficulties they face within mainstream institutions (eg schools and health services) and the breakdown of cultural identity and the whanau.

What are some examples of where we can focus suicide prevention initiatives?

Support communities, families and whanau to provide emotionally safe and nurturing environments for children and young people.

Expand family support and early intervention services to help keep children and young people safe and healthy.

Promote positive mental health for young people (such as in schools).

Improve services for young people (mental health, emergency and general health services).

Promote awareness of mental health issues at the community level.

Increase public understanding of what to do if someone is suicidal.

Improve the support and treatment of those who have already attempted suicide.

Implement measures to restrict access to the means of suicide.

Provide guidance to the media about the reporting and publicity of suicide to minimise the potential of imitative suicides.

Improve our knowledge and information systems so we can better target suicide prevention strategies for the best outcomes.

How does New Zealand's youth suicide rate compare internationally?

In comparison with selected OECD countries (OECD countries compared with are, Finland, Australia, Canada, USA, Norway, France, Sweden, Germany Japan, United Kingdom and Netherlands), New Zealand's 1999 youth suicide rate still among the highest.

The increase in youth suicide appears to be a global trend, particularly in developed countries. Suicide trends appear to differ across cultures, for example, while New Zealand has a high rate of young male suicide; China has a high rate for females.

How accurate are international comparisons?

Comparing international rates of suicide is inherently problematic given that different methods are used to classify suicide, and because the classification of suicide is, to some degree, culturally determined.

Why has New Zealand got a high rate of youth suicide?

We don't really know why New Zealand has a high rate. There are many factors that may have some level of influence, such as increasing rates of depression and alcohol and drug abuse, rising rates of violence and abuse, cultural alienation, changes in family structure and in society as a whole, reduced influence of religion, high unemployment, and trends towards a more risk-taking and individualistic society.

There is also a greater awareness of suicide and suicide is portrayed in the media more than before. Some researchers argue that suicide has become "normalised" leading to some people perceiving suicide as an "acceptable" solution to an emotional crisis. Why do more young males die by suicide than females?

The youth suicide (15-24) ratio in New Zealand is about three male suicides to every female suicide. This appears to be a common pattern in most countries.

There are a number of theories for this pattern, for example, men tend to be more reluctant to seek help for emotional problems (or even express their distress to friends and family), they tend to use more lethal methods of suicide, and are generally more impulsive than women. Females, however, make more non-fatal suicide attempts.

How many young people died by suicide in 1999?

In 1999 a provisional total of 119 people aged 15?24 years died by suicide. Of these 119 people, 37 were female and 82 were male. (In 1998 there were 140 youth suicides, in 1995 there were 156 youth suicides and in 1987 there were 113 youth suicides.)

What is the rate of youth suicide in New Zealand?

The rate of youth suicide for males (aged 15?24) in 1999 was 30.3 per 100,000.

The rate of youth suicide for females (aged 15?24) in 1999 was 14.2 per 100,000. The total rate of youth suicide in 1999 was 22.4 per 100,000.

In 1999, there were 6 deaths in the 10?14 age group compared with 12 in 1998. The male rate of suicide in 1999 (30.3 per 100 000 population) was more than twice the female rate (14.2 per 100 000 population). The male rate of suicide was variable between 1980 and 1999. The female rate of suicide increased between 1980 and 1999 and the rate for 1999 was the highest of the 20 year period.

The highest rate of suicide death in 1999 was for Maori males (42.4 per 100 000 population), significantly higher than the non-Maori male rate (27.2 per 100 000 population). The Maori female suicide rate (18.7 per 100 000 population) was higher than the non- Maori female rate (13.1 per 100 000 population).

How do 1998 statistics compare across all age groups?

For all ages there were a total of 574 people who died by suicide in 1998. This is an increase of 13 from the 561 suicide deaths in 1997.

Youth suicides represented 25 percent of total suicides in 1998; despite youth aged 15?24 making up only 14 percent of the population. Most suicides (75 percent) occur among people over the age of 25.

The highest numbers and rates of suicide for males was among the 20-24 and 25-29 year age group, which were almost identical (65, 66 deaths respectively, at rates of 48.7 and 48.4 per 100,000).

For females, the highest number and rate of deaths both in 1997 and 1998 was in the 15?19 year age group (26, 19.8 per 100,000).

What are some key suicide prevention initiatives already in place?

Guidelines for primary healthcare practitioners on the identification and management of young people at risk of suicide have been developed by the Royal New Zealand College of General Practitioners. The Ministry of Youth Affairs and the Health Funding Authority funded the guidelines.

Guidelines for schools on the prevention, recognition and management of young people at risk of suicide have been published by Ministry of Education and the National Health Committee, and training is underway on these guidelines throughout New Zealand.

Guidelines for Department of Child, Youth and Family social workers on the identification and management of young people at risk of suicide have been developed to screen and assess suicide risk in young people. This is part of the Department's Youth Services Strategy.

SPINZ (Suicide Prevention Information New Zealand) is a national service, which is funded by the Ministry of Youth Affairs, and provides advice and information to the community on youth suicide and youth suicide prevention.

The Community Youth Development Fund has been established by the Department of Internal Affairs which funds seven projects around New Zealand aimed at young people at risk of suicide.

The Crisis Response Fund has been established and is administered by the Ministry of Youth Affairs to support communities following a suicide.

Suicide and the Media. A Resource on the reporting and portrayal of suicide in the media has been published by the Ministry of Health.

Specialist mental health services for children and young people around the country are being expanded and will continue to grow.

Pamphlets for parents and young people (Helping Troubled Young People and Spin) on suicide prevention awareness and help-seeking for emotional problems have been Te Awhina I Nga Rangatahi e Raru nei . Pamphlets for Maori parents, caregivers and whanau on how to encourage and support rangatahi and seek additional support for their families has been funded by the Ministry of Youth Affairs.

Family Start and Social Workers in Schools pilots are funded through the Strengthening Families programme to help address problems as early as possible.

Like Minds, Like Mine. The national programme to address stigma and discrimination associated with mental illness is being funded by the Ministry of Health.

A Practical Guide on Coping with Suicide has been published by the Mental Health Foundation. This community resource provides information on myths and warning signs, how and where to get help, coping after a suicide, resources and background information on youth suicide in new Zealand.

Mental Health Matters, a mental health awareness curriculum for junior secondary schools, is currently being implemented in over 200 secondary schools throughout New Zealand by the Mental Health.

The Health and Physical Education Curriculum has just been revised by the Ministry of Education and includes a leaning module on mental health.

Mentally Healthy Schools is a mental health promotion initiative being piloted in schools in the Northern region schools by the Mental Health Foundation.

Custodial suicide prevention training is provided to Police and a new training module for Police Youth Aid Officers in now available.

Initiatives to prevent Maori suicide in prisons are in place such as increasing whanau, hapu, and iwi contact with at-risk inmates and increasing cultural responsiveness of prisons.

Prison officers are trained in the management of suicidal inmates and have procedures to identify and monitor at risk inmates.

Youth Health Centres have been established around the country to provide youth-friendly and youth appropriate health services.

Young People and Depression is a resource for people who work with youth, such as school guidance counsellors, teachers, youth workers, and TOPS Tutors. It is published by the Mental Health Foundation.

Guidelines for General Practitioners on the treatment and management of depression, anxiety disorders and alcohol and drug misuse have been published by the National Health Committee.

E Tipu E Ria: a framework for Taiohi Maori Development This project aims to increase the capacity of rangatahi Maori to fully participate in all aspects of Maori development (Ministry of Youth Affairs).

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