Best of the Week

Mike King and the importance of being imperfect

Emma Espiner didn't know what to make of Mike King before attending one of his public meetings on suicide prevention, but came away impressed by his work.

Mike King told a packed auditorium at a high school in regional New Zealand that there are three reasons people commit suicide: because they're hurting, because they think they're causing hurt, because they want to hurt someone else.

Mike happened to be speaking in Katikati while I was there so I went along. Like lots of people I know, the whole suicide thing makes me feel anxious and useless and so I haven't done anything practical about it.

I wasn't sure what to expect of Mike. I've not followed his transition into mental health and suicide prevention advocacy, hadn't listened to his show The Nutters Club. I was vaguely aware that he'd gotten the shits with a government-run suicide prevention panel last year and thrown in the towel, claiming it wasn't going to achieve anything meaningful. 'Volatile' was the euphemism that had been circulated. I wondered if this was a not-so-subtle way to undermine someone who had been open about his own mental health issues.

I didn't expect him to tell his life story as a teenager, with all the achingly sad and desperate bits, complete with a frank description of his drug and alcohol addiction and ongoing struggles with self-esteem, his failures as a parent and as a friend. He did comedy, he said, because it was a way to make people like him - it was a mask. He wasn’t a fan of the cult of resilience, saying ‘The only thing resilience is good for is funding.’ He wants to invest in giving people self-esteem.

I must admit, the guy said some stuff that made me wince; gender stereotypes in experiences of depression, dismissal of colonisation, inequality and racism as reasons for suicidal thoughts - it was like a virtue-signalling bloodbath in my head.

But ... according to Mike, 155 young people killed themselves last year. Nothing I've done with my ‘correct’ opinions and appropriately reasoned arguments has contributed to shifting that - but I know Mike has.

Why is it that the 10th most liveable country in the world is number one in the OECD for youth suicide?

What has he done? In the two hours that I was watching he managed to fill a hall with teenagers, parents and community members in Katikati on a Tuesday night to talk about mental health and suicide. I hear he’s done that all over the country. The biggest problem we have in addressing these issues is getting people together to talk. He did that, and get this - the teenagers invited him to be there. When was the last time a teenager you know wanted to talk to some middle-aged guy about their mental health?

Mike created an environment where people felt safe to ask terribly raw questions. Someone in the audience asked what he should do about a daughter who attempted suicide six times in the last year. I can’t imagine what it would be like to carry that around, much less to say it out loud in front of your neighbours.

Of course, it’s not just telling stories. The second biggest problem we have in addressing these issues, is actually addressing the bloody issues. Why is it that the 10th most liveable country in the world is number one in the OECD for youth suicide?

Phil Quin wrote earlier this year that there is real hope that this Government might deliver on shifting that. It seems to hinge on the mental health and addiction inquiry which is due to report back in October this year. I agree with his priorities; that the availability of non-pharmacological treatments like cognitive behaviour therapy is increased, that protocols are implemented to fast-track new pharmaceutical treatments and that we look closely at the impact of deinstitutionalisation, and consider the benefits of therapeutic communities for those who need them.

I’m with Mike and every other person who’s struggled and tried again and helped others to see that it should just be the beginning and not the end.

It’s a tough one to wait for, given the urgency of the issue and the fact that we’ve already got a lot of information about the pressure points in the system and a comprehensive community-led mental health review which was presented to the Government late last year. In the time since then I’ve seen nurses and doctors working overtime to source emergency mental health services for people in urgent need, only to be told in many cases that resources are stretched, nothing is available, and everyone’s trying their best but hands are tied. A nurse told me this week that seeing kids who have attempted suicide has become the norm - she’s no longer shocked to see 13-year-olds arrive after overdosing - that’s just a normal day in ED. GPs and emergency department staff have consistently told the media, the DHBs, the Government and anyone who will listen for years now that the mental health needs of the patients they see are beyond their capacity to deal with and yet the pace of change has been agonisingly slow.

It’s personal for all of us. For me, I’m scared for my colleagues at medical school. We’ve already quietly lost some. A recent submission by Universities New Zealand claimed a ‘tsunami of need’ for tertiary students with mental health needs. They say wait times are discouraging students from seeking help at all, and with many students presenting at the ‘lower’ end of the spectrum of mental health disorders, they’re triaged to wait. And wait. The waiting lists for some treatment is three to four months long and much longer for others.

Although poverty compounds the risks, suicide isn’t just a risk for people in disadvantaged circumstances - the intensity of expectation for privileged kids to achieve is beyond anything I ever experienced growing up and it’s bloody dangerous. Kids who can’t make themselves believe that good enough is good enough, and if you’re a straight A student one year, you’re not a loser if you get Bs the next year. They’re afraid to fail, and to be seen to be failing and in our future profession, the acceptable margin of error is terrifyingly slim. Having role models who have lived through failure might just be the thing that gets you through the next dark moment. I think this is Mike's appeal and, in my experience, the most inspiring mentors have been those who have been open about their struggles. They’ve taught me that no matter how bad it gets, it should always be survivable.

So, I’m with Mike and every other person who’s struggled and tried again and helped others to see that it should just be the beginning and not the end. I hope this Government’s talk about putting mental health at the centre of their agenda gets practical, fast.

If you need help now:

Healthline: 0800 611 116

Suicide Crisis Helpline: 0508 828 865

Lifeline Aotearoa: 0800 543 354

Youthline: 0800 376 633

Samaritans: 0800 726 666

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