Tackling the silence around Pacific youth suicide

Auckland University's Dr Jemaima Tiatia-Seath says we need to work together to bring Pacific youth suicide out in the open

Pacific youth suicide is complex: There is no single explanation as to why our young people choose to die by their own hands. It is complex too for those of us who have experienced the loss of a loved one to suicide. We are consumed by the question ‘Why?’ and caught in self-blame and tortuous thoughts of ‘I should’ve been there’ or ‘I should’ve done more’.

But one thing that is clear: we all want Pacific youth suicidal behaviours reduced and that means we must work together and not shy away from the issue, or even from the term itself – suicide. In fact, the word is not the issue, it’s the silence around it.

According to the World Health Organisation, more than 800,000 people die by suicide around the world each year, and for 15 to 29-year-olds it is the second leading cause of death worldwide. New Zealand Ministry of Health data shows that in 2012, 549 people died by suicide - 30 of which were Pacific suicides. A study I published recently in the New Zealand Medical Journal indicates that over a 17-year period (1996-2013), 22 Pacific lives on average were lost to suicide each year.

Some may consider Pacific numbers, by comparison, small, but what is staggering is that Pacific peoples have the highest rate of suicide attempts, suicide plans and suicidal thoughts than any other ethnic group in New Zealand. Moreover, while Pacific peoples have higher rates of mental illness than the general population, they are less likely to seek professional help.

Exploring ways to alleviate this problem is something I have been deeply committed to over many years. In this time, it has become apparent that because Pacific youth suicides are different, a cultural response is exactly what is needed. Whether this is from the perspective of an island-born, multi-ethnic, or Pacific NZ-born point of view, for those of us who acknowledge our Pacific heritage, this insight is vital to ensuring suicide prevention makes sense to us first, beyond the confines of imperialist assumptions.

I am often asked what brought me to this place and motivated me to address Pacific suicide prevention, particularly as it is such a delicate, challenging and, for some, a tapu (taboo) subject.

Simply put, I too have lost loved ones and been at the side of many immediately after a suicide attempt. I have worked closely with individuals and families who have shared their most intimate stories around a suicide attempt, suicidal thoughts and engagement with, or lack of, mental health services. They too have shared the experience of losing a loved one to suicide. Without their courage, I would not have been able to unearth the authenticity, treasure, knowledge, values and truths behind the richness of these lived experiences. These are the very voices that strengthen and help inform Pacific family, youth and community-driven solutions. It is these experiences that have brought me to this place. It is these experiences that hold the answers.

The question remains – what can we do? Suicide is rife with intricacies but there are key messages I strongly consider are effective strategies for Pacific suicide prevention and better mental health outcomes.

Open and consistent communication in the family is the first. This is about what we can do within our own families, having those conversations whether at the dinner table, a kava session or watching the game. In some families it might not be the cultural norm to have this type of communication with parents or elders, in which case siblings and cousins can help ease the load. It’s about ‘checking in’ on our loved ones and it should not just happen during the highs. If anything, it should happen more so during the low times.

Secondly is ‘bringing the defence line up’. This term is normally associated with Rugby League and it means moving your defence line up to meet the opponent. If the line becomes staggered, it leaves gaping holes that the opponent can penetrate. In the same way, families, communities and more importantly, mental health systems, need to bring their line up together to strengthen and sustain family resilience.

Thirdly is the acceptance that it is OK as Pacific parents/caregivers/older family members to expose our vulnerabilities to younger family members. This sends a powerful message to our youth that they can do the same without fear or judgment. Our young people and children need safe environments that encourage and nurture connectedness, positive affirmation, support and access to someone they can talk to and trust.

The reality is our Pacific communities are ever evolving with various spiritual beliefs, sometimes intergenerational misconceptions (between elders and youth), negotiation around gender roles and identities, cyber world activities, condemnation by way of sexual orientation, confusion around ethnic identities, and the pressure of high expectations with regard to academic, sporting or musical excellence. These contemporary realities remind us that our young people are facing new and multiple challenges, and for those of us familiar with these worlds, it is our responsibility to guide them through.

Fourthly, Pacific workforce development and cultural competence is required to ensure relevant and appropriate people are working in partnership with Pacific families and communities in suicide prevention. We must support and foster the development and capabilities of our very own Pacific community support workers, spiritual leaders, emerging and seasoned researchers, social workers and health professionals within the field of suicide and mental health.

The fact is, our traditional Pacific values continue to be diluted by mainstream ideals and here lies the problem. Urgency is needed to address ethnic disparities, inequities, cultural irrelevancy, invisibility, institutionalised and internalised racism and unconscious bias. We need to take the lead in helping to navigate our youth back to the understandings and an appreciation of our Pacific traditional concepts, beliefs and values – to give a much-needed cultural injection.

I do recognise the reality for some of our New Zealand born and/or multi-ethnic Pacific youth who may find it difficult to negotiate their Pacific values of communalism and respect against the competitive and modern stresses of individualism. Our job is to help them find a balanced compromise.

If I may digress – statistics indicate that the most common method of suicide for our Pacific youth is hanging. There is a sad irony of rope as a tool of death when sennit, or lashings of coconut base, were the very materials our predecessors used for sustenance, life and survival. Rope-like, they were used to tie together architectural structures for shelter, create modes of transport and crafted for ceremonial or embellished adornment. Could we reintroduce our youth to the beauty, respect and life accorded to that rope? I acknowledge there are a multitude of traditional concepts and values to draw from, but could something as simple as this make a positive impact? Safe, ethical and powerful messaging is crucial.

Suicide is preventable. We all have a part to play.

Where to get help:

- Lifeline: 0800 543 354 (24/7), Youthline: 0800 376 633 (24/7), text free to 234 (8am-midnight) or live chat (7pm-11pm)

- Kidsline: 0800 54 37 54 (24/7; Kidsline Buddies available 4pm-9pm)

- Suicide Crisis Helpline: 0508 TAUTOKO / 0508 828 865 (24/7)

- What's Up: 0800 WHATSUP / 0800 942 8787 (1pm-10pm weekdays, 3pm-10pm weekends) or live chat (5pm-10pm)

- Healthline: 0800 611 116 (24/7)

- Samaritans: 0800 726 666 (24/7)

- Depression Helpline: 0800 111 757 or text free to 4202 (24/7)

- If you feel you or someone you know is at immediate risk, call 111.

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