This video looks at the bigger picture: how negative aspects of mental illness, relationships, society, culture and life events can combine to put a person at increased risk of suicide.
This video is part of a series, also available on DVD from the Mental Health Foundation shop
This video discusses the subject of suicide in some depth. If you think you may be distressed by this material, please have someone with you as a support while you watch this video.
If you're concerned about yourself or a loved one, here are some support numbers you can call:
Lifeline: 0800 543 354
Tautoko: 0508 82 88 65
Youthline: 0800 376 633
Samaritans: 0800 726 666
JUDY BAILEY: We Kiwis are a tough lot; we'd like to think we can stand up to anything, and most of the time we can. But a building is only as strong as the beams that hold it up; there are only so many that can be weakened before it can't stand up any longer.
This is how risk factors for suicide work. When a person attempts or completes suicide, we're most often only seeing the final block being pulled out.
Suicide usually follows a long history of problems which may not always be easy to spot. Predicting suicide is not an exact science, but if someone you know is at risk, there are patterns of behaviour you can look out for; and if you notice them, you can step in and help.
THERESA FLEMING – SCHOOL OF POPULATION HEALTH, UNIVERSITY OF AUCKLAND: Very seldom do people commit suicide because of one thing. There are some major challenges if you don't have current family support and if your future's not looking positive, and especially if you come from a history of trauma.
Most people who die from suicide have had a difficult time in the past, they've got current things that are really difficult, and they usually hae some kind of mental health problem, particularly depression.
Lots of people will be depressed at some point in their life – it's very normal. You probably want to check with everyone who's depressed whether they're feeling so down that they've wanted to end it all or they've tried.
The highest kind of risk is people who have been feeling down for a long time, if they might have difficulties enjoying things that they would have normally liked to do. They might have withdrawn quite a lot from people – sometimes they'll even be spending most of their time in their room or in their house and hardly getting up.
They might be having major difficulties with sleep; often they'll be using substances, so alcohol and drug use might be increasing.
Some people who are suicidal will present as more angry, anti-social; they might be quite aggressive. The biggest thing to be aware of is that they're feeling really hopeless – hopeless about life now, hopeless about the future, hopeless about things changing.
JUDY BAILEY: When we're growing up we often learn problem-solving skills that help us think of different alternatives or solutions for when things go wrong.
But when our brains are caught in the fog of deep depression it can be hard to see a way through. And if you've had a difficult or abusive early childhood it can make things even harder.
THERESA FLEMING: If you cannot think of a range of different ways of dealing with the problem, and try again when it fails, and seek help from others when you're really not doing well, then it's much more difficult.
One of the things to do to help people who are feeling down is to help people learn how to look at what the problems are in their lives, work out some possible solutions. Pick some even if they're not perfect, try them and, if they're not working, try something else.
JUDY BAILEY: Still, people in this vulnerable state may not be able to find solutions and, if another event or problem comes along at this point, the risk of suicide becomes even higher.
THERESA FLEMING: Across all age groups, recent loss, feeling very isolated, not having good social connections, often the trigger will be around relationship break-up, divorce, separation, maybe loss of contact with kids. It might be around job loss, or financial.
For young people you might see triggers, or things that are the final straw, being bullying, being what seem to adults like very trivial relationship break-ups, but can be very deep and meaningful when you're sixteen, seventeen.
And in older people it's also around loss, but loss of health and loss of ability to do everyday things.
Certainly it's very common for people to make a suicide attempt if they have been sexually assaulted or raped, or had some recent trauma like that, and a lack of coping resources and support.
JUDY BAILEY: Some risk factors are culturally based. In New Zealand, Māori rates of suicide are higher than the general population – a pattern seen in many indigenous populations around the world.
MATUA RAWIRI WHAREMATE – CULTURAL ADVISOR, MENTAL HEALTH FOUNDATION: I know that through my teenage years I really, really struggled. And if it wasn't for the fact that I played an incredible amount of sport and had friends around me, that life would have been really, really lonely for me.
Whakamomori means to come to, I guess, an apex - like the apex of a roof - and you're sitting right on the edge there, and you can either go life or death. So you're at a point in your life – whakamomori – where you're kind of wondering which side you're going to fall.
Culturally, I think knowing who you are, looking back to the marae, looking back to your iwi, your hapū, and feeling pride about knowing who you are, this is my tūrangawaewae, or this is my place where I stand.
I think to a large degree we have this male persona, and the male persona is 'harden up'. The statement 'harden up' is a regular male kōrero. 'Harden up' actually means 'I really don't know what to do'.
This issue of expectation that you are the protector, the provider, the warrior that can resolve issues within your whānau, that's coupled with issues such as substance abuse, violence, anger, inability to be able to control emotions, feelings and even to express those particular feelings.
I think Māori identity is such an important part to ensure that they are proud of who they are, and enjoy the experience of not just being a Māori, but being a Kiwi, being a New Zealander, being in this beautiful country.
JUDY BAILEY: Fortunately, suicide is still a rare occurrence. If you're aware of a person's history and what's going on in their life now, you're well-placed to make a difference if things aren't right. The key is not being afraid to talk.
THERESA FLEMING: Most people who are feeling depressed will not be suicidal. We don't want to run away from people because they're having a difficult time, and you don't have to talk about, you know, the problems all the time.
Just company, having fun, spending time with people, as well as sometimes checking out what's going on, is really important.
JUDY BAILEY: If you, or someone you love, is one of the thousands of New Zealanders who experiences depression or other kinds of mental distress, the most important thing is not to give up.
THERESA FLEMING: Suicide is preventable, and there are many people alive today having fulfilled, happy, successful lives where they're making meaningful contributions to the community, who have seriously wanted to kill themselves, seriously tried to kill themselves, and been depressed and had a really difficult time for a number of years in their life, and it's not like that for them anymore.
JUDY BAILEY: If you're concerned about a loved one, or are yourself feeling depressed or suicidal, help is available. Visit SPINZ online at www.spinz.org.nz for a list of the services in your area that can assist.