Health Minister Andrew Little has expressed disappointment with the lack of progress in suicide prevention. Photo / Michael Cunningham, File
Health Minister Andrew Little has expressed disappointment with the lack of progress in suicide prevention. Photo / Michael Cunningham, File
Opinion
OPINION
"Every life matters... there is one goal. No suicides," said David Clark, then Health Minister, launching Zero Suicide Strategy 2019-2029.
Coming home after a loved one - young with their whole life ahead of them - has taken their own life. There is nothing that can prepare you forthe shock. Grief, guilt, depression follow; life will never be the same.
New Zealand's youth suicide rate is the highest in the developed world. Fifty per cent of all Māori and 40 per cent of Pasifika suicides are youth (15-24 years old).
Rates for Māori males are two times that of Pākehā and females, four times. The youth suicide rate in the most deprived areas is a staggering four times that of the most affluent. Twenty-seven per cent of all suicides are unemployed, a rate over six times the employed.
A wide range of causes contributes to suicide - mental health, family violence, income adequacy, housing issues, lack of stable employment, etc. Economic aspects have deteriorated significantly over the past 35 years for low-income earners. And the increase in youth suicide rates is most likely caused by these issues- unemployment, inadequate benefits, housing etc.
Before 1985, our youth suicide rate was 40 per cent lower than for retirees; now, it's 80 per cent higher. Conversely, the suicide rate for retirees is less than half the pre-1985 rate. (Global rates paint a vastly different picture – higher suicide rates are among the elderly). The divergent paths can be attributed to the improved wealth of the seniors arising from high homeownership rates and superannuation. The departing Childrens' Commissioner's words that we take better care of our seniors than children is undoubtedly reflected in the suicide numbers.
The economic reforms commenced in 1985, and resulting upheavals sharply increased suicide rates. The sharpest rise was for youth, rising 80 per cent over the next five years. Since then, suicide rates for 19-24-year-olds have decreased (still higher than pre-1985). However, the rates for teens 15-19-year-olds are well over double (even higher for females) the pre-1985 rates.
Significant areas we need to improve are: Economic issues; a strengthened role for the Suicide Prevention Office; enhanced data collection; and better resourced mental health.
New Zealand moved from a full employment policy to one that considers 4 per cent unemployment optimal. Youth unemployment is typically double the overall rate and four times for Māori and Pasifika youth. One in six (16 per cent) Māori and Pasifika youth are unemployed at the best of times. Almost 40 per cent of all unemployed are youth. Increasing apprenticeships and employment opportunities for youth should be a key focus.
We temporarily increased support for apprenticeships as a Covid-19 initiative; why temporary when so many young are unemployed? The proposed unemployment insurance scheme is unlikely to help youth; these schemes typically require a minimum employment period. Improving benefits will help the higher age groups.
The Suicide Prevention Office started in 2019 with a relatively small budget; $40m over four years. Positioning the Suicide Prevention Office within the Ministry of Health makes no sense, given that suicide prevention covers a broad swathe of areas outside mental health. Some estimate only a third of suicides are due to mental health issues. Advocacy is muted within a ministry compared to more independent roles. In Australia, the National Suicide Advisor reports directly to the Prime Minister.
Data collection and timeliness need improvement. Our Chief Coroner releases provisional figures annually. However, these tell only part of the story; for example, the complete statistics relating to self-harm incidents aren't in this report. Final numbers and detailed statistics follow three years or more later, too late to evaluate the success of strategies and redeploy resources where relevant.
Also, we don't track the numbers of suicides with prior attempts, which is critical to ascertain the success of aftercare. A survey in the UK found that 43 per cent of suicides occur within one month of a self-harm attempt.
Kushlan Sugathapala. Photo / Supplied
The $1.9b mental health budget initiative was announced with great fanfare in 2019.
Andrew Little, the Health Minister two years on, noted a review found the initiative had "failed to achieve" in aspects around infrastructure. "The report identifies there is more to do in the mental health infrastructure space," Little told Newshub. "Although the funding has been provided, the ministry has struggled to achieve as much as we would have liked them to."
We need more robust mental health facilities.
The Suicide Prevention Commissioner Carla na Nagara left the organisation on completing her two-year contract in October 2021 and has not yet been replaced. The head of the Mental Health Foundation, Shaun Robinson, expressed dissatisfaction with the progress.
The co-ordination role expected of the Suicide Prevention Office to bring together various public, private, and community organisations in this sphere did not happen.
Activists like Mike King are extremely unhappy with the progress, which the Chief Coroner's latest report describes as "statistically insignificant" over the last decade.
There is a staggering amount of work to do; we need a strong, independent Suicide Prevention Director. And, perhaps the answers lie more in economics than mental health.
In the meantime, we lose over six hundred lives to suicide in Aotearoa every year.
• Kushlan Sugathapala is a researcher and writer on social justice issues.
This article has been updated to clarify Health Minister Andrew Little's comments about mental health infrastructure.
