Maori suicide study looks past taboos

The true extent of suicide attempts among Maori was hidden for many years due to cultural taboos, misunderstandings and inadequate statistics, according to University of Auckland researcher Nicole Coupe.

Ms Coupe, who headed a groundbreaking study by Tomaiora Maori Health Research Unit and the Injury Prevention Research Centre, became aware of the huge gaps in information about Maori and suicide when she started working for the research centre in 1994.

"People used to say that suicide was not so much of an issue for Maori and so there were no statistics on suicide attempts by Maori," she said.

In fact, about one-in-five suicides in New Zealand are Maori.

And although suicide deaths have reduced in non-Maori, they have remained almost the same in Maori, according to the Ministry of Health.



The biggest risk factor was found to be poor general health, particularly depression.

"What we discovered is that Maori who do attempt suicide are suffering from a poor general health status which is often missed by health professionals."

Doctors were failing to diagnose depression in Maori because it showed up differently than in non-Maori.

"Patients often present with symptoms such as a weariness and a lack of energy that is often mistaken for a physical ailment rather than a mental health problem," she said.

"Psychological problems are much more likely to manifest themselves as a bad back or sleeplessness."

Other secondary factors included marijuana use, and sexual, verbal, physical or psychological abuse in the 12 months leading up to the attempt.

Anecdotal evidence suggested that Maori who were "culturally isolated" - that is, identified as Maori but had no real connection with their community - were more likely to be suicidal.

As with the general population, Maori men are more likely to commit suicide, but women are more likely to attempt it, or other self-harm behaviours.

Suicide attempts could not be disregarded as merely "cries for help", Ms Coupe said. "It's important to take notice of any suicidal behaviour or intentional self-harm.

"Those 700-odd suicide attempts a year are just the ones that end up in hospital - there are probably many others who don't show up on the statistics."

Researchers spent 15 months interviewing people identified by three Auckland hospitals as having tried suicide or self-harm, and also surveyed specific neighbourhoods.

Urgent work was needed to identify those at risk, and ensure health workers were trained to detect and manage them, Ms Coupe said.

Cultural services within the hospital system did a great job but had to cover far too many people.

"Many people told us they hadn't really been followed up once they left hospital."

The breakdown

The rate of suicide in Maori was 13.1 per 100,000 in 2000 compared with 10.7 per 100,000 in non-Maori.

Male Maori aged 15 to 24 had a suicide rate of 42.4 per 100,000 in 1999 compared with 27.7 for non-Maori of the same age.

The suicide rate among young Maori women was 18.7 per 100,000 compared with 13.1 for non-Maori.

- NZPA