Suicide in communities
Transcript
JUDY BAILEY
Like a stone thrown into a pond, a suicide death in a community creates a ripple effect, touching not just the lives of loved ones, but others who may have felt connected to that person; even in ways that may not seem apparent to us.
While a death by suicide involves the actions of one troubled person, its implications are far wider reaching. In communities where a suicide’s occurred, the danger may have only just begun.
In some cases a death by suicide in a community can cause something of a viral effect, known as ‘contagion’.
SANDRA PALMER – CLINICAL MANAGER, CLINCAL ADVISORY SERVICES AOTEAROA (CASA)
We do know it’s more likely to happen when the death is in an under 25-year-old, because young people are more likely to kind of imitate.
Contagion is increased when there’s particularly unsafe media exposure. Contagion is more likely when there is a death within an institution like a school, mental health setting, army, police; because again, the likelihood of people being exposed is so much higher.
JUDY BAILEY
The work of Sandra’s team begins with a phone call from a concerned person in the community. The team will look at the community’s history, paying particular attention to traumatic events which may have had an impact. A core group is then formed by bringing together people of influence within that community.
SANDRA PALMER
About eighteen months ago we were called into a small rural farming community; there were three deaths over a number of months, which was quite unusual for that community.
JUDY BAILEY
With the help of local agencies, the team called a community meeting.
SANDRA PALMER
We had about 40 or 50 people come to that, and we provided some facts and some information to that group; we told them who we were. And from that, asked who they thought should be on a core group; so it was the community choosing who would be on a core postvention group, running that postvention response.
JUDY BAILEY
The group has been meeting for over a year now, and together they’ve worked to identify other people at risk of suicide within the community.
SANDRA PALMER
They have met monthly, and we have provided the ongoing support; so when they wanted to put a media release out, we helped them write a media release and helped them liaise with the media.
JUDY BAILEY
Bringing people together after a series of suicides requires understanding and respect for the culture of the community that CASA works in.
In Maori communities, Eliza Snelgar works with whanau, iwi and hapu to gain trust before work begins.
ELIZA SNELGAR - REGISTERED NURSE, CLINICAL ADVISORY SERVICES AOTEAROA (CASA)
With the Maori in the community there are definite steps that we take around the mihi, being able to first of all acknowledge the atua, acknowledge the whare that we’re in, acknowledge the awa, the maunga, the whenua, and allow the grieving and the wairua to take place.
It’s different to a tangi. This is is... they’re here to get some results in a certain... under a different kaupapa, under a different take.
It’s usually a really wide cross-section of the community there, made up of kaumatua, kuia, GPs, school principals, teachers. Ttere will sometimes... always be the actual whanau pani there, or the bereaved family. And that brings another dynamic into the group situation. And we need to show particular sensitivity.
JUDY BAILEY
A key part of any postvention plan is identifying the people at risk. There are what is known as circles of vulnerability – people who were physically close to the person who died, such as friends or family, acquaintances or colleagues; and others who identified with the person. They might see themselves or their situation as very similar.
ELIZA SNELGAR
There are different models, or Maori models of health that we can pull on to help us develop strategies to work with communities. But one community we worked with came up with their own model, and they called it the ‘koura model’ or the ‘crayfish’, because the area that they’re from is surrounded by crayfish.
And what they did was actually have the model as a way of helping them develop a strategy for their own community; to help their own community to deal with the numbers of suicides that were happening there. So they had the body of the koura as their... the actual community with all the different services coming off on the legs; and that was really beautiful to be able to... just to see them being able to develop and create something that was special to them.
You know you’ve made a difference, and empowered them to be able to take those steps. And that’s what it’s about.
JUDY BAILEY
The way a suicide is talked about in the community can have a significant effect on the decisions a vulnerable person might make. The way in which a deceased person is remembered can unwittingly provide an endorsement of their choice to take their own life.
MATUA RAWIRI WHAREMATE - CULTURAL ADVISOR, MENTAL HEALTH FOUNDATION OF NEW ZEALAND
We were involved in what we called the service... running a service, church service in the evening, and the great thing about the marae, the subject is open, you speak your mind. And before I got up to speak, I went to speak with the family whom I knew really, really well.
I stood up, I expressed my feelings around the risk of suicide, and dealing with the reality, and then the next kaumatua got up and expressed the same feeling, and we were able to continue to work with the family.
Fortunately for me, I’d been in this particular area for a long period of time, and was able to support and help them to get some understanding around what that meant.
JUDY BAILEY
Every community is different, and postvention in different types of communities present their own challenges.
SANDRA PALMER
When we come into a community there are all these existing politics and relationships which we have to get a... kind of get a handle on when we’re working with a community. And when there is dysfunction and less working together of the community agencies, I guess you’re more at risk of people falling between the gaps and not being screened.
JUDY BAILEY
The effects of suicide at a community level are profound. Just as with natural disasters, an absence of a plan can mean chaos when the unthinkable happens.
ELIZA SNELGAR
One kaumatua said, do you know, I walk up the street and I see aunty so-and-so coming towards me, and I can say to... we can talk now about suicide. Actually talk openly with each other. They haven’t... weren’t able to do that previously, because of the, you know – the hurt, and the grief maybe, and the... and maybe the guilt perhaps may still have been there. So they get that opportunity to be able to share it versus carrying it themselves.
SANDRA PALMER
Once people know what to do, they’re absolutely fine and they feel relieved and they feel in control of the situation. People know that there is risk for other people in the community, and everyone’s aware that screening needs to take place.
JUDY BAILEY
If you’d like more information about suicide prevention in your community, visit SPINZ online at www.spinz.org.nz To find out more about the work of CASA, visit the CASA website.
