health & science

Lack of funding questioned as suicide toll rises

Despite a national mental health inquiry and $1.9 billion towards mental health in the budget, the annual suicide statistics continue to raise. Laura Walters reports.

The number of people who killed themselves in the past year has risen again, with the rate of Māori and Pasifika deaths by suicide surging.

In the 2019 financial year, 685 people died by suicide, rising from 668 the previous year. The rate of deaths per 100,000 people rose from 13.7 to 13.9.

This is the highest number of deaths by suicide since the Chief Coroner began collecting the data 12 years ago.

Despite a record investment in mental health and a national mental health and addiction inquiry, the numbers continue to rise, and experts say more money, more resources and more leadership are needed.

Delays in setting a national strategy on suicide prevention and appointing leadership to give a clear direction on suicide prevention had also been felt throughout the sector. And in relation to a $1.9 billion spend over four years, the $40m targeted specifically at suicide prevention seems paltry.

But with a raft of announcements imminent, those working on the frontline of this epidemic say these tangible efforts to reduce the number of devastating deaths are better late than never.

On Monday, the Chief Coroner released the annual provisional suicide statistics, which showed the number of Māori and Pasifika dying by suicide rose significantly, with 169 Māori dying by suicide in the past year, at a rate of 28.2, up from 142 the previous year.

And the number of Pasifika people to die by suicide increased to 34, from 23 the previous year, an almost 50 percent rise.

Te Rau Ora chief executive Maria Baker said Māori had been calling for New Zealand to prioritise Māori suicide prevention, and to better understand the issues affecting Māori.

“These statistics show just how urgent that call is. Māori are key to the solutions needed in our communities.”

While the drivers and risk factors of suicide and self-harm are varied and complex, Baker said if she had a magic wand to change one thing that would make a significant difference, it would be deprivation.

“Socio-economic deprivation is a major issue for us.”

Te Rau Ora chief executive Maria Baker says Health Minister David Clark is front and centre in the charge to reduce the number of suicide deaths. Photo: Laura Walters

People are more likely to take their own lives when they don’t have an income, a sense of purpose, warm dry housing and an education.

“All those wonderful things New Zealand was known for - the land of milk and honey ... we’re a far cry from that.”

Monique Faleafa, clinical psychologist and chief executive of organisation Le Va, said it was “devastatingly disappointing” to see the number of Pasifika deaths rise by 48 percent.

After about a decade of raising awareness and recognising risk factors and warning signs in Pasifika communities, the number and rates of Pasifika deaths were at an all-time low last year.

However, a couple of clusters of suicides among young people had seen those numbers increase significantly this year.

Faleafa said more work needed to be done in post-vention to stop panic and the contagion effect. Currently there was one post-vention service in the country.

This year's numbers also showed an increase in the number of young people dying, particularly in the 15-19 age bracket, in which 73 took their own lives in the past year. The number and rates of deaths in the 20-24 age grouping also rose.

“The time has passed just to raise awareness of suicide. We need to raise awareness of suicide prevention and what’s working.”

While New Zealand sat about mid-range in terms of overall suicide deaths in the OECD - higher than the UK and Ireland, but lower than the US and Australia - it had one of the worst youth suicide rates among the group of rich countries.

Chief Censor David Shanks also spoke about young people and suicide, saying more could be done by media and streaming services to safeguard against harm.

The message comes in the wake of the controversial Netflix show 13 Reasons Why. While there was a correlation between the show and the number of youth suicides in the US, it was impossible to say this was the cause of death.

But Shanks said it was important to prevent anything that could contribute to suicide, especially when someone was already feeling suicidal, and policy work was under way to look at the introduction of mandatory warnings and pre-classification for streaming sites offering services in New Zealand.

Suicide prevention funding not enough

While this Government has made significant promises around both mental health and suicide, the number of deaths by suicide casualties has continued to rise.

In this year’s budget, the Government committed $1.9 billion to mental health over four years.

However, only $40 million over four years – $10m a year – will go towards suicide prevention.

The majority of the focus has been on the ‘missing middle’, those with mild-to-moderate mental health issues.

And the fact that half of those who kill themselves do not have a mental health diagnosis, and have not had contact with health services in the past year, is often overlooked.

Mental Health Foundation chief executive Shaun Robinson said those working in this space knew many things needed to happen to prevent suicide, both on an individual level and a wider community and societal level.

Mental Health Foundation chief executive Shaun Robinson says the time for talking and raising awareness is over, now is the time for action on prevention. Photo: Supplied

“Thousands of suicides are prevented every year. As a country we need to be better at learning from these experiences and working to ensure every single New Zealander has the support they need to look after themselves and the ones they love when times are tough," he said.

“The time has passed just to raise awareness of suicide. We need to raise awareness of suicide prevention and what’s working.”

Robinson spoke about the initiatives and programmes that did make a difference, but both he and Baker said there was not enough money and resources put into these initiatives, and it would take time for the latest investment to trickle out.

But he welcomed Health Minister David Clark’s commitment to deliver more money in coming budgets.

There was also the perennial issue of workforce capacity – while there might be the money to employ more staff, it would take time to train and recruit them.

Clear direction overdue

Within its first 100 days in office, the Government launched a national mental health and addiction inquiry, and earlier this year accepted 38 out of 40 of its recommendations.

While the Government refused to adopt a reduction target, it did accept recommendations for a suicide prevention strategy and stronger leadership.

The previous strategy expired in 2016 and work to update it had been marred by internal politics and delays.

In 2017, the draft strategy was released but there were serious misgivings regarding the lack of focus or priority placed on Māori.

“It’s up to all of us to look out for our family, friends and neighbours – to ask how they’re going and coping with pressures in life, and offer our support, to offer hope."

But announcements regarding the establishment of the Suicide Prevention Office, inside the Ministry of Health, and the long-awaited Suicide Prevention Strategy, would be made in the coming weeks.

Later this week will also see the launch of the cross-party Mental Health and Addictions Wellbeing group, with representatives from each political party, and John Kirwan and Moe Milne at the helm.

This group was one of the key recommendations to come out of the inquiry, “as a tangible demonstration of collective and enduring political commitment to improved mental health and wellbeing in New Zealand”.

The 2017 election saw suicide and mental health used as political footballs, but on Monday, the Prime Minister described suicide as “one of our biggest long-term challenges as a nation – not as a government – as a nation”.

“There is no question that our suicide rate is too high, there is no question that as a government we need to put our all into turning that around,” she said.

Clark said it would take more than one budget to turn around the country’s high number of suicides, but the Government was committed to putting more help and resources in place to help fix the problem.

 Jacinda Ardern and David Clark at the announcement of the Government response to the mental health and addictions inquiry in May. Photo: Lynn Grieveson

The minister acknowledged there were no quick fixes.

“Suicide is an incredibly complicated issue, and turning around our terrible rate will take time," he said.

Chief Coroner Deborah Marshall said the reasons people made this decision were numerous and depended on many factors: their early life experiences at home and at school, their employment status, their mental health, their economic and health status, their sense of belonging, their sense of purpose, their worldview and more.

Like others, Marshall and Clark recognised the numbers represented real people, and behind them was a story of loss and devastation.

“It’s up to all of us to look out for our family, friends and neighbours – to ask how they’re going and coping with pressures in life, and offer our support, to offer hope," Marshall said.

“Because there is hope. I’m encouraged by the suicide prevention initiatives taking place, the conversations people are having, and the success stories of individuals who battled with suicidal thoughts but have come through stronger the other side."

Where to get help

1737, Need to talk? Free call or text 1737 any time for support from a trained counsellor

Lifeline – 0800 543 354 or (09) 5222 999 within Auckland

Youthline – 0800 376 633, free text 234 or email talk@youthline.co.nz or online chat

Samaritans – 0800 726 666

Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)

What's Up – 0800 942 8787 (for 5–18 year olds). Phone counselling is available Monday to Friday, midday–11pm and weekends, 3pm–11pm. Online chat is available 7pm–10pm daily.

Kidsline – 0800 54 37 54 (0800 kidsline) for young people up to 18 years of age. Open 24/7.

thelowdown.co.nz – or email team@thelowdown.co.nz or free text 5626

Anxiety New Zealand - 0800 ANXIETY (0800 269 4389)

Rural Support Trust - 0800 787 254 (0800 RURAL HELP)

Supporting Families in Mental Illness - 0800 732 825

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