Collaboration essential to suicide prevention initiatives

Suicide rates have dropped since the peak in the late 1990s but there is no room for complacency.

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Address to the 5th National Suicide Prevention Symposium, Wellington School of Medicine and Health Sciences

I would like to start out with an acknowledgement of Brian Mishara. We are honoured to have the President of the International Association for Suicide Prevention here from Canada as our guest.

I'd like to also acknowledge the Mental Health Foundation and Judi Clements for introductions today; Materoa Mar, who opened the symposium yesterday; and Merryn Statham from SPINZ.

I'd also like to acknowledge the keynote speakers:
. Annette Beautrais
. Phyllis Tangitu
. Maria Cotter
. Simon Hatcher
. Sunny Collings
. David Fergusson and
. Barry Taylor

This is a long list of pre-eminent and passionate people who do incredible work in the area of suicide and suicide prevention.

And I acknowledge the contribution also of other presenters here and thank everyone for attending this fifth National Suicide Prevention Symposium.

This is a very important issue. It's important because five hundred lives a year − nearly ten a week − end in New Zealand through suicide.

We have made progress in bringing down suicide rates from their peak in the late nineties. But there is a lot more to do.

Today I am releasing the facts that show we have a lot more to do: the latest annual suicide statistics publication, "Suicide Facts". It contains 2005 suicide data and the 2006 hospitalisation admissions for intentional self-harm data.

The document shows our suicide rate has dropped nineteen percent from the 1990s, but on the most recent figures it has stopped coming down. The figures show that the rate of hospitalisation for intentional self-harm has actually increased.

I am told that we don't really know whether this represents a true total increase. That is at least partially because we are getting better at recording when someone is admitted for self-harm. There has been an improvement in information gathering about hospitalisation for self-harm because of an initiative that has emergency departments, mental health services and Maori health services working together.

But whatever the reason, there were 5400 hospitalisation events recorded in 2006. This is important, not only because it is a serious health issue that needs to be addressed, but also because these people are also at risk of more self-harm and of the act of suicide itself.

Those hospitalised are more likely to be young women aged 15 to 24 years old, and Maori are more likely to be hospitalised for self-harm than non-Maori.

Among suicide rates, there are more than three times as many young men aged between 15 and 44 as there are young women.

The rates for Maori are significantly higher: 17-point-9 suicides per hundred thousand compared to the non-Maori rate of twelve per hundred thousand. And what is really concerning is that the difference in rates between Maori and non-Maori is increasing.

These are more than just numbers. These figures represent the real lives of young New Zealanders. They represent a devastating harvest among families and loved ones. They represent a tragedy for our community, as well as personally for the lives suicide touches. And they represent a responsibility for us all, because we know we can make a difference.

Because we can make a difference, we have a duty to do so.

The analogy that comes to mind is our drink-driving approach. The figures for lives lost on roads each year are not wildly different to figures for lives lost through suicide. The road toll is a national scandal that we have slowly, as a nation, taken responsibility for addressing.

It doesn't come down easily though, and whenever rates have begun to stabilise, authorities have developed tough new programmes to reduce the most dangerous patterns even further.

And so with our suicide figures, we are posed with the challenge of keeping the pressure on. We need to be pushing on with new programmes as we find out more, and as our ability to make a difference improves.

Responding to suicide is about having the strength to care. We are a country that should be strong enough to acknowledge that a caring country acts when we see a problem we need to resolve. And to be caring, we need a health system and social support structures strong enough to deliver.

So I want to turn to what we are doing. Last year I launched the New Zealand Suicide Prevention Strategy. Its goals include promoting mental health, and providing personal services for those with disorders − for people who are already making suicide attempts. We used to just patch people up physically − pump out stomachs to repair self-inflicted injuries − and send them home without fixing mental sickness as well. Now the plan is to do much better than that.

The strategy includes steps to reduce access to the means of suicide, and safer ways of publicly portraying suicide as an issue. The strategy sets out a goal of caring for bereaved families. And it recognises we don't know enough, and we need more research and information.

Not that long ago, we used to leave these issues with no one to take responsibility for them. So nothing got done.
Today we ask agencies and individuals in many sectors to take responsibility for a contribution where they can. This symposium is part of our effort to bring together people in different sectors, learn more and share understanding.

So the theme "Building the jigsaw: Collaborating for suicide prevention" is very important and timely.

One reason our suicide rates got so high is that there wasn't enough collaboration on the issue across agencies and institutions. No agency had the job of bringing together a strategy; there was no collaboration linking up research, policy and practice; and not enough to link health and social services to make sure that the needs of vulnerable citizens were met.

So we've been taking on this problem. The Budget this year invests more than $23 million to support suicide prevention initiatives.

To put that in perspective, when I took on responsibility for suicide, we had a total comparable operational national budget of $28-thousand dollars. That was it!

Now we are beefing up training in the health sector at primary care level and in emergency services to help prevent suicides. A new education programme is being developed.

A five-year Suicide Prevention Action Plan to implement the suicide prevention strategy has been developed − because we should always be mindful of the words of Winston Churchill, that "However beautiful the strategy, you should occasionally look at the results."

The Action Plan sets out the actions over the next five years; who will be responsible for leading them; and when things will get done. I expect to release it early next year.

This year's Budget will fund another example of expanded collaboration − up to five district health boards will pilot suicide prevention co-ordinator positions. Co-coordinators will work with the agencies that have contact with suicidal people and their families − health services, social services, community services, police, coroners, education providers and more. The pilots will start in the first half of next year.

There are a lot of other programmes underway that bring together different sectors to collaborate in preventing suicide. I can give you a few further examples:

ACC is paying for research into care after a suicide attempt has been made
In Child Youth and Family's innovative 'Towards WellBeing' project, mental health professionals work with social workers on the risk of suicide among children in welfare care.

The Ministry of Education is putting into schools programmes that provide guidance on suicide prevention. And a new coronial database is being developed so we will have more consistent information about people who die by suicide, and about emerging trends.

All of these examples involve collaboration between the agencies. For example, the Ministry of Youth Development's work around planning ways to improve youth health and social services also involves close collaboration with the Ministry of Health, the Ministry of Education and Child, Youth and Family.

The Government's aim is to make sure the right kind of support is available when it is needed − such as support for family and communities after a suicide; improving treatment in emergency departments for those who have made a suicide attempt; assisting GPs to better respond to those presenting with mental health problems; and ensuring a wide range of suicide prevention information is available.

Let me give you the example of the National Depression Initiative. The government put $6-point-7 million into this programme because we know depression is so strongly linked to suicide. The risk of suicide for people with major depression is twenty times greater than in the general population. (Not to mention that depression commonly occurs with other mental health and physical problems, including diabetes and heart disease.)

Out of that programme we got the outstanding anti-depression advertising campaign on tv featuring John Kirwan. It received an Effie award for the most effective non-commercial campaign on television. Everyone involved should be proud of the contribution the campaign is making.

Those ads are a great example of someone with a very strong image − one of our great All Blacks − also showing that it is okay to care. We know that campaign is making a difference and that many more people are seeking help for depression. The more people get treatment for depression, the more suicide rates will come down. The campaign is a real example of how we can work together to bring down suicide rates.

This symposium is part of the effort to get still more collaboration and information sharing. So before I finish, I would like to extend my thanks to SPINZ who have organised this event. I highly value the service SPINZ provides to the wider New Zealand community about suicide prevention information. It is vital that people are accurately informed about suicide initiatives that are safe.

The symposium is part of its service and the theme of increasing collaboration across all our agencies is a useful step in strengthening our response. Increasing collaboration is about increasing the strength we have to care, and for that reason I support it.

I am sure you will all have much to learn and to discuss from the high calibre speakers due to address this symposium and I wish you all the very best with the remainder of the event and for your future endeavours in this critical health area of suicide prevention.