Most of us are fortunate enough not to have lost a child, or a loved one, to suicide. Our hearts go out to those families who have.
READ MORE:
• The full Break The Silence series can be read here
• Investigation: The untold story teen suicide in the North
• Ministry to revisit advice for schools
In some communities the devastating impact of New Zealand's staggeringly high youth suicide rate is regularly on display.
It can seem as if it has always been this way, but it hasn't. When I looked back at the suicide trends in this country I was astonished to see that youth suicide rates went from the lowest in all population groups in 1985 to the highest in 1995.
In fact, the youth suicide rate tripled over this period. While rates have improved since the statistical high points in the mid-90s, youth suicide rates have remained among the highest by age group for the 20 years since.
We cannot accept these levels of youth suicide as inevitable, intractable, or as a sad but unavoidable fact of life. We need to understand what has happened in the past few decades to cause young people to act in such a devastating way, in such numbers, so rapidly.
Professor Sir Peter Gluckman, the Prime Minister's Chief Science Advisor has recently released a very carefully researched report on exactly this topic.
His report, Youth Suicide in New Zealand: A Discussion Paper, is a sobering review of this complex and uncomfortable topic. The report is helpful in emphasising that it is wrong to see youth suicide as purely a mental health issue. While this may be one driver, the other risk factors are an array of inter-related issues, and often difficult to isolate.
As Gluckman noted, rapid increases in youth suicides can't be explained by increases in diagnosable mental illnesses among young people - it happened too quickly for that.
Neither do coroners' reports seem to signal any increase in mental health disorders associated with suicide, such as schizophrenia or severe bipolar disorder.
A number of key factors seem to interplay. These include socio-demographic factors, poor family relationships, impulsivity, low self-esteem, hopelessness, loneliness, drug and alcohol misuse, and a history of suicidal behaviour amongst family and friends.
Adolescence is a vulnerable and potentially volatile period. Reflecting on this report, some interesting questions came to mind for me:
• Given that more than half of youth suicides involve alcohol or illicit drug exposure, why are these drugs so easily available to children in New Zealand?
• How do we build mental resilience and reduce impulsive behaviour in our teenagers?
• What is the relationship between social media and bullying, especially given that we have the second highest rates of reported child bullying in the world?
• What are the effects of child material disadvantage and relative income-related child poverty - itself a relatively recent phenomenon, dating from the late 1980s and early 1990s?
In youth suicide statistics, as in so many other child measures, Māori are drastically overrepresented. This year I have made improving outcomes for tamariki and rangatahi Māori one of my priorities.
Past attempts to address this over-representation from a deficit-based, Western worldview have failed. I encourage more efforts to draw on the wisdom of Te Ao Māori for positive, strengths-based solutions.
Gluckman helpfully concludes that working closer with communities in co-designing solutions, particularly with Māori perspectives, will be crucial to making a difference.
It is not enough to carve out a few specific elements to tackle youth suicide - in doing this in the past we have failed to take account of the whole young person and all of their needs. In this context, Gluckman's report should be required reading for all those concerned with youth suicide.
We need to address the range of challenges that face children and young people, including poverty and ethnic disadvantage.
This means prioritising things like adequate family income, suitable housing, and fostering connections with community, family and culture. It means listening and talking to young people about the issues that affect them.
And having such important conversations is the right place to start. Last week, the Herald reported that young people want to talk openly about suicide, but they feel the discussion gets shut down by adults.
Perhaps this is understandable. These are not easy conversations. But we must have them - at home, in classrooms, in workplaces, and in our newspapers.
Youth suicide is not inevitable. It changed rapidly for the worse 30 years ago. It could change for the better today. We can and must do better.
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call 111.
If you need to talk to someone, the following free helplines operate 24/7:
DEPRESSION HELPLINE: 0800 111 757
LIFELINE: 0800 543 354
NEED TO TALK? Call or text 1737
SAMARITANS: 0800 726 666
YOUTHLINE: 0800 376 633 or text 234
There are lots of places to get support. For others, click here.