Emeritus Professor John Werry wants to see one national crisis text line. Photo /Chris Loufte
Warning: This article is about youth suicide and may be distressing for some readers.
If you're feeling suicidal, who would you call?
Lifeline? Healthline? Youthline? How about the Depression Crisis Line or the Suicide Crisis Helpline?
New Zealand has about a dozen different depression, anxiety or suicide-related helplines.
Two expert psychiatrists - with more than 100 years' experience between them - want New Zealand to take a radical step and close all but one.
They want one national crisis line to be advertised with as much clout as 111.
"When you've got a fire or had a car accident you know you dial 111. When you're going to kill yourself, who do you call?" asked retired psychiatrist James Reardon.
"Eleven different numbers means confusion. They should all be removed because it's done nothing but create uncertainty and frustration," he said.
READ MORE
• New Zealand's self-harm epidemic
• The full Break The Silence series can be read here
• Investigation: The untold story teen suicide in the North
In an exclusive interview with the Herald this week, Health Minister Jonathan Coleman said having "everything funnelled into one place is a good idea".
"Off the top of my head it sounds like a good idea. There might be experts who come up with some other reason as to why it might not be a good idea, but intuitively it sounds like a good idea," Coleman said.
For the past five weeks the Herald has run a special series on youth suicide called Break the Silence which has analysed why we have the highest teen suicide rate in the developed world. This week we focus on solutions to reduce that rate.
• View the full Break the Silence series here.
Many of New Zealand's suicide-related helplines are crying out for more funding as they struggle to withstand growing demand.
The 0800 What's Up number, run by Barnardos for children up to the age of 18, reported more than 11,850 unanswered calls over the past year.
It only has enough funding to keep the call centre open between 1pm and 10pm and is currently crowdfunding to try to extend the service for another hour each night through a campaign called Keep Them Talking.
Samaritans says it's struggling financially, and in March, Lifeline lost an $800,000 suicide prevention training contract with the Ministry of Health which was a "huge blow" to the organisation.
Lifeline executive director Glenda Schnell agreed 11 helplines was too many for New Zealand, but warned against narrowing it down to just one.
"I get that having a 111 number in terms of suicide crisis is of value, but I also value choice," she said. "A few numbers would give people choice around who they might want to trust."
However, Emeritus Professor John Werry, formerly with the University of Auckland child and youth psychiatry department, backed Reardon's controversial proposal.
"Of course I agree with that," Werry, who worked as a psychiatrist in New Zealand and internationally for 57 years, said.
"Supposing you're in a crisis or have a kid with a problem what would you want? You'd want a single point of contact; a single number."
The crisis line should be the same across the country, but manned regionally so those answering the phones can triage callers to relevant local service providers, like Lifeline or Barnardos, he said.
However, streamlining helplines will likely go down like a lead balloon among current services, he warned.
"As soon as you talk about a takeover people are going to run a mile. There is a lot of rivalry between different agencies who think what they're doing is best."
Professor Max Abbott, dean of the Auckland University of Technology faculty of health and environmental sciences, said "simplification would certainly help" when it came down to a crisis number.
But he added that many of the current helplines offered an array of services beyond suicide support. "I sure as hell wouldn't want to be closing all those services down," he said.
New Zealand needs to follow the United States and adopt one national crisis text line, said retired psychiatrist James Reardon.
"It's been proven in America. Their crisis text line had 30 million people call in six years. They have one number and it's anonymous and it's the same in every state," said Reardon, who worked in the US for 35 years. "Keep it simple. That's the bottom line."
The National Telehealth Service, which is contracted by the Ministry of Health, agrees.
In June it launched the 1737 Need to Talk? helpline. It is the first of its kind in New Zealand and immediately connects anyone who calls or sends a text message to one of 300 mental health professionals at any time of the day or night.
"We did some research when we created 1737 and New Zealanders were telling us they wanted an easy to remember number, where they can talk to a professional 24/7," said Andrew Slater, chief executive of the service.
Since 1737 went live, Slater asked the ministry and Mental Health Foundation to remove all other helplines that fall under the umbrella of the National Telehealth Service on any related media guides or websites and promote only that one four-digit number.
"This is about delivering a much simpler message for people in distress and crisis," Slater said.
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
1737 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.
The 19-year-old disappeared without her wallet or mobile phone.