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Issue 3

 

SPINZ News

Spring 2005 Issue
www.spinz.org.nz

Contents

SPINZ Symposium

SPINZ Symposium: Males and suicide – Pathways Forward (13 & 14 October 2005): a review

Lucia Tibre, SPINZ Resource Development and Community Liaison Coordinator

- selected proceedings are now available online

Two days in an interesting, and sunny venue (Christchurch's Riccarton Park Racecourse), were a constant reminder of the subjects tackled.

Richard Tankersley (paemanawa@paradise.net.nz) did a fine job as Master of Ceremonies, and facilitator, and provided excellent feedback at the conclusion of each day.

The symposium was opened by Tim Barnett, MP for Christchurch Central, who presented himself as a "40 something" gay man, with a Maori partner. He was born in England, with a father who suffered from recurrent mental illness. Tim paid tribute to the passion and work of Jim Anderton in the areas of suicide prevention and mental health. He spoke of

  • the difficulty in cross-sector working within Government
  • recognition of the risk demographics including men, and lesbians and gay men
  • invisibility issues leading to difficulty in collecting statistics
  • constructive and positive ways of dealing with men's issues

Barry Taylor followed with a passionate presentation "Not feeling the best; men's narratives on suicide and depression". We shouldn't focus on males, Barry Taylor said, but on gendered behaviours in society:

"A priest is called to a house where a son died by suicide, following the mother's worries related to the father's refusal to grieve. The priest finds the father crying out in the field in his truck – the place where he has chosen to grieve because in his wife's presence… he has to be strong."

How do we unpack these behaviours in a changed society with biological gender losing its meaning for gender role concept? A society that lost the rites of passage that helped young men to understand a sense of mortality, a sense of living within a social system? Through mental health messages that are careful not to denigrate men and masculinity, for what we see as barriers to become solutions.

Looking at the statistics, Maori are at the top for prison and suicide, voiced Carmen Hetaraka. Perhaps the answer lies in spirituality. Everything has its own whakapapa (whaka = to cause; papa=ground), and to do things right we have to go to the whakapapa of things. Drugs, alcohol, gangs do not belong to Maori whakapapa, they need to be replaced with the original, real whakapapa: genealogy, love and nurture, kura wananga, mentors. "We have the answer for our people and we have to walk this korero around".

There are four major influences on our youth life today, identified NZ Police and Youth Officer Nick Tuitasi

  1. family, whanau;
  2. the 2 E (education and employment);
  3. the 2 C (community rules and culture) and
  4. peers ("not to be confused with beers which also have a strong influence on our youth today").

When these pillars broke down, gangs may offer to replace them, changing tragically a life path. The Uncle Nick programme was there to interrupt this course of events and this Uncle Nick was keen, enthusiastic, and charmed the audience, followed by the Pacifika feedback: "today we are no longer part of the problem, we are the solution". Moli Fiso was nominated as a Pacific mandated member of SPINZ Reference Group.

We had interesting approaches like Pareire Huata's linguistical quest: if you would ask a Pakeha what is suicide, he will give you a definition. If you would ask a Maori, he would give you a concept. Speaking about words, why you wouldn't find the word "love" in a report?

Associate Professor Sandy Simpson gave an overview of "Suicide and Suicidal Behaviour in New Zealand Prisons". There are approximately 7,500 prisoners in New Zealand (183 inmates per 100,000 population), a mean age of just under 30 and half of them are of Maori ethnicity. Being young, male, of unstable personal background, substance abusing, impulsive and antisocial to which we can add the experience of imprisonment and the reasons for it, all are risk factors for suicidality. "We are, after all, trying to help a group of people who, not infrequently, feel there is nothing left for them".

An estimate that 20% of those diagnosed with Pathological Gambling Disorder will attempt suicide, revealed Dr. Sean Sullivan in his presentation, "Behavioural addictions and suicide, an under-estimated relationship? The only differences between addictions and behaviours may be the absence of an external chemical introduced into person's system and less acute withdrawal effects. The consequences often lead to depression and anxiety, some behavioural addictions, particularly gambling, having higher risk for suicide than chemical addictions.

"A Patient Preference Trial of Problem Solving Therapy After Self Harm – The Male View" was the subject of Dr. Simon Hatcher's presentation. The Problem Solving Therapy would be short term, would capitalise on the crises and would enhance the following process: list the problems (10-20% of self-harmers are problem gamblers and 12% have a significant alcohol problem); choose a problem to work on, brainstorm solutions; define steps review and start again. The solutions looked for should be SMART (specific, measurable, achievable, realistic, time-based). The pilot completed within Waitemata DHB had included 40 clients and opened the Problem Solving Therapy for another future 500 participants.

More smiles, laughter and communication and two shows sold out for two hours public performance in Municipal Theatre were some of the outcomes of "Livin it up Rangatahi Stylez", developed by Kia Piki Te Ora o Te Taitamariki (Maori Youth Suicide Prevention Strategy) and presented at the Symposium by Sally Rye and Pahia Turia.

The second day of the Symposium began with Dr. John Wren, the Ministry of Health's project leader for suicide prevention who announced a release date for the new All-Age Suicide Prevention Strategy: mid-June 2006. The Strategy will be accompanied by an Action Plan outlining detailed action points relating to all objectives and will involve Government Agencies as well as NGO's and community groups in its implementation.

The longitudinal study "Hopelessness and Low Self-Esteem in Childhood and Suicidal Thoughts in Early Adulthood" coordinated by Dr. Rob McGee identified different paths for girls and boys living in families with low social economic status or/and with poor parent-child interaction. For girls, low SES (social economic status) can generate low self-esteem, while poor parent-child interaction could enhance hopelessness and thoughts of self-harm with no connection between thoughts of self harm and suicidal ideation. For boys low SES will drive low self-esteem and hopelessness while poor parent-child interaction will drive thoughts of self harm. For boys, there is a strong connection between thoughts of self harm and suicidal ideation. Hope was defined as expectations that people might have about the future.

Adding to the picture, Dr. Shyamala Nada-Raja presented results from the longitudinal study "How do early events, attachment, happiness, and having a sense of meaning in life relate to self-harm in adulthood?"

"How do I get her back?" is an often asked question for Denis Bunbury, Mensline manager. Mensline offers men in crises an opportunity to connect with their inner feelings in a male-appropriate way and provides for men a model of strong emotional masculinity.

Posters displays:

  • "Young gay Males – Sexuality, Gender and Suicide" – Sarah Helm from Out There, New Zealand Aids Foundation;
  • "The Power of Validation Through Comparable Experience" – Colin Slade, Manager and Consumer Advocate for the Psychiatric Consumers Trust, Christchurch
  • And skylight – Peter Tia

Opinions added to the content, in workshops settings

  • He Waka Tapu – Daryl Gregory; "Suicide Prevention Working across Mental Health, Maori Health and Emergency Departments";
  • "A New Initiative" – Emma Sutich and Nicole Coupe;
  • "Strengthening Protective Factors and Preventing Suicide in Older Men" – Marie Hull-Brown

or in open discussions encouraged after every presentation. Certainly colour from Maori tikanga, Pacific flowers and songs, diverse expressions towards a unique aim: valuing life.

We definitely came back to our various homes with more knowledge, ideas, networks in our kite. And awareness: Males and Suicide, a concern expressed in and from statistics, added, rather than minimised the significance of "Suicide is everybody's business" – the core message of the Suicide Prevention International Day, 2005.

SPINZ Symposium

SPINZ Symposium: All Age Suicide Prevention Strategy and Action Plan – presentation by Dr John Wren – a report

John Wren, Senior Policy analyst at the Ministry of Health (MOH), and Project Leader for the All Age Strategy, presented at the recent SPINZ symposium . This is a report on his speech and presentation.

The draft strategy was released in April this year and consultations followed in May and June. John talked about where the All Age Strategy was currently at.

He backgrounded the consultation process where 20 meetings had been held throughout the country, including hui and fono in Auckland, Wellington and Christchurch. One hundred and six written submissions were also received. Submissions were independently analysed, and a report on them will be shortly available on the Ministry of Health website www.moh.govt.nz/suicideprevention

Feedback showed general support for the draft strategy, with useful suggestions for improvement.

The main point of difference lay in the approach to suicide prevention. Three streams or approaches emerged

  • A clinical / psychiatric approach
  • a public health approach
  • a non health sector approach

John pointed out that the draft strategy was a high level document and much evidence-based work included in earlier drafts had been taken out to keep the draft concise. However, this evidence work will now be reinserted and updated.

He said, there was good support for the whole of population and community focused approach, and a need to focus both on the high risk groups and society more broadly. There was a need to highlight the links between mental illness and suicide.

A Suicide Prevention External Advisory Group has been established to revise the strategy and develop its action plan. Chaired by Dr David Chaplow, Director Mental Health, Ministry of Health, the group met in Wellington for the first time on 11 November. Members were appointed by Government for their knowledge and expertise, and include both clinicans and non-clinicians. Another meeting is planned before Christmas and another in mid-late February 2006.

Membership:

  • Dr Nick Baker, Community Paediatrician, Nelson Hospital
  • Assoc Prof Annette Beautrais, Christchurch School of Medicine & Health Sciences
  • Sara Bennett, Group Manager Population Strategies, Alcohol Advisory Council NZ
  • Judi Clements, CEO, Mental Health Foundation NZ
  • Dr Sunny Collings, Snr Lecturer, Consultant Psychiatrist, Otago University
  • Prof David Fergusson, Christchurch School of Medicine & Health Sciences
  • Molly Fiso, National Manager, Pacific Islands Women's Project Aotearoa
  • Simon Hatcher, Senior Lecturer in Psychiatry, Consultant Psychiatrist, Auckland University
  • Mark Jacobs, Senior Policy Analyst, Mental Health Commission
  • Materoa Mar, Mental Health Consultant, Yesterday, Today, & Tomorrow
  • Assoc Prof Richie Poulton, Dunedin School of Medicine
  • Dr Shaymala Naja-Raja, Senior Research Fellow, IPRU, Otago University
  • Lewis Rivers, Psychologist, Lewis Rivers Consulting
  • Ana Sokratov, Consumer Consultant, Mental Health, North Shore Hospital
  • Dr Jemaima Tiatia, Hibiscus Research Ltd
  • Bryan Wilshire, CEO, Lifeline Auckland
  • Dr Janice Wilson, Deputy Director Mental Health, Ministry of Health

Five international experts have been invited to review the draft strategy. The final strategy and action plan to implement it should be ready by mid-June 2006.

The Action Plan will have detailed actions relating to all objectives and based on available evidence, the stocktake of Government activities, written and oral submissions as well as international input. Government agencies, NGO's and community groups will all have responsibility for implementing the stategy.

Upcoming reports and resources:

  • Report of submissions on the Draft Strategy will be posted shortly on www.moh.govt.nz/suicideprevention
  • Five Wellington School of Medicine and Health Sciences based reports will soon be available
    • (2002) Caroline Maskill et al. Explaining Patterns of Suicide: A selective review of studies examining social, economic, cultural and other population-level influences
    • (2002) Stuart Ferguson et al. Suicide Rates in New Zealand: Exploring associations with social and economic factors
    • (2004) Paul Hirini & Dr Sunny Collings Whakamomori: He whakaaro, he korero noa. A collection of contemporary views on M?ori and suicide
    • (2003) Assc Prof Philippa Howden-Chapman et al. The Impact of Economic Recession on Youth Suicide: A comparison of New Zealand and Finland
    • (2004)Dr Sunny Collings et al. Suicide Trends and Social Factors in New Zealand 1981–1999: Analyses from the New Zealand Census-Mortality Study
    • A Cost of Suicide to New Zealand Society report

      Support for families resources
    • Having suicidal thoughts? – already published
    • Available soon:
      • Support for those bereaved by suicide
      • Support after a suicide attempt

Menslines

SPINZ symposium: Mensline presentation by Denis Bunbury - "the possibility of possibility" – a report

Mensline began in 1995, and celebrated its 10th anniversary this year. Denis first joined Mensline as a volunteer in 1999, and became manager in 2002. Mensline is part of the Lifeline Auckland service. In that time Mensline has trained over 150 male counsellors. It's rationale Denis said was to provide "a counselling service for men specifically by men".

"Mensline is an opportunity for men to experience men in a nurturing and emotionally articulate role helping to break the male stereotype of isolation, competition, and conflict".

Denis said Mensline did not mean to imply that women counsellors cannot help male clients, but he said, there is "something irreplaceable that men can offer men in their emotional health".

It is important that "men can foster their emotional lives albeit in a masculine and strong male way and be informed by their own inner selves, that when we're hurting, we can say so, and take steps to find solutions".

Mensline's largest group of callers are in the 30-60 age group, and are largely European. Although Mensline does have some Maori and Pacific Island counsellors, Denis noted these cultures were under-respresented amongst their callers. Different cultures do have different needs, he said, and counselling may not be the answer for all cultures and indeed, for all age groups.

Most of the callers were single men or separated or divorced. The issues they "spontaneously raised" concerned (not in any order): communication, depression, anxiety and stress, loneliness, lack of confidence, and relationship breakup. Denis said this connected with the research literature that men on their own or having been through a relationship breakup, are emotionally at risk. With regard to suicidality, he noted that 4% of callers had threatened suicide or had attempted suicide, and 28% had acknowledged suicidal thoughts, though Mensline believed this figure was much higher in reality.

Denis went on to discuss, in more depth, Mensline's philosophy. The vision driving us, he said, was to "model in ourselves the naming and expression of emotionality".

Quoting from Philip Culbertson's book "Counseling men" (1994), Denis said men's conversation patterns were generally limited to covering sport, politics, women, professional successes, and big boys' toys. Men did not feel safe to talk about deeper personal issues.

Mensline, in the counselling context, said Denis, was seeking for "empathic attunement with the caller, leading to a clear, tested and reflected insight, leading on to change".

He is also spoke about the transferencial issue of men's relationship with their father and how this could become subconscious in their dealings with other men. Denis said there was an overdependency by men on women for emotional fluency on personal issues and that a crisis like a separation or divorce could mean that that emotional connection was then lost. For men to find emotional health, this should be seen as a public issue as well as requiring change at the individual level.

With regard to suicidality, Denis said, not only do men have problems asking for help, but may also encounter difficulties in receiving help, even when they ask for it.

Mensline was modelling men counsellors to try to pick up the signals. Quoting Clapham and Peters, men were perceived more negatively for helplessness, hopelessness, self deprecation, and passivity, and so more positively, for acting on their feelings rather than communicating them. Whiting in "Preventive strategies on suicide" (1995) edited by Kerkhof et al. spoke of the minimal power differential of non professionals befriending men asking for help, and so in this regard, said Denis, Mensline provides important assistance.

Finally, Denis, asked "Is Mensline successful?". There was no empirical evidence one way or the other as to whether suicide prevention centres do make a difference, but quoting Kerkhof above, the conviction of these centres and of organisations like Mensline, was that yes, they do help. He said counselling involved a rich change, from despair and helplessness, to a feeling that change can happen, and life can be more fruitful. Denis described the process as a "kind of descent" or "more dramatically, disintegration" and an awakening of hope and a new identity. This movement into grief and pain, and into hope, is very challenging both for the man and the counsellor. This new identity arises through:

  • interacting with others
  • our own inner experiences
  • inhabiting a wide range of roles (Arnold Mindel)
  • and crucially, our own personal and communal memory

Most of all, ended Denis, "the possibility of possibility"

denisb@lifeline.org.nz
0800 MENSLINE (0800 636 754) 7 nights a week
www.mensline.org.nz

related site: Mensline Australia

Lifeline brings Dr Frank Campbell, international traumatic loss and postvention expert, to New Zealand as part of its 40th anniversary

In August, Dr Campbell spoke at a workshop in Auckland about "sudden and traumatic loss – the aftermath of suicide, the benefits of an active postvention approach". He was also interviewed on National Radio's Nine to Noon show (26 August), by host Maggie Barry. Dr Campbell is the executive director of the Baton Rouge Crisis Intervention Center, and a past president of the American Association of Suicidology.

Speaking with Maggie Barry, he said suicide was a global problem, and the number two cause of death on the planet, and that society needs to look at reducing suicide and supporting those bereaved.

As a way of explaining postvention as also being prevention work, Dr Campbell spoke about there being three sections to suicide: prevention; intervention; and postvention. The latter he sees as "interrupting what could be a legacy" of suicidal behaviour in the family and amongst peers and friends of those left behind. In other words, breaking what could be seen as "role modelling" suicidal behaviour. Postvention is prevention work.

He says there is a real need for survivors to be able to process the loss, to talk about it, and when talking with children to use "appropriate words at a child's developmental stage." If the child asks that "most challenging question" why did it happen, one of the best answers he says is "I don't know", honesty is very important, and to explain the suicide in terms of the person's inability to cope. That can lead into talking about ways of coping and problem solving.

Survivors have four dimensions which are compromised says Dr Campbell: physical, mental, emotional, and spiritual dilemmas. A safe open envionment is needed. Grief he says is so very personal. Talking to others who have been through similar experiences, whether they be mental health/trauma workers or those bereaved, without giving advice or making judgment is so important.

He sees intervention within 60 days as best, there being a real need to reduce "maladaptive coping" such as addictions or poor eating and sleeping. He said there is a much higher suicide risk within the first few months of the suicide due to the intensity of the grief and over identification with the deceased. As survivors try to understand why, they are ambivalent about being left behind. There is a strong need to "normalise things" and to "be there for them".

"Listening is a very power intervention" and society tends to minimise its benefit, said Dr Campbell.

Victoria University of Wellington (VUW) introduces Suicide Prevention Plan

Victoria University Vice-Chancellor announced October 6, that as part of their Healthy Campus Strategy and its Mental Health Promotion strand, a Suicide Prevention Plan will be introduced next year to ensure all students "displaying suicidal and self harm behaviour receive immediate assistance".

"A key requirement of the Responding to Suicidal Behaviour by Students' policy is that general and academic staff must notify the suicide prevention team [at the Counselling Service] of at-risk students, who will then be assessed." Staff will contact the University's Counselling Service and will complete a brief online Suicide Incident Report Form. Students identified as being at risk through the process will be required to attend four assessment sessions with a counsellor.

In its background paper "Mental Health promotion and Suicide Prevention Framework", the VUW Suicide Prevention Working Group, outlines five key objectives:

  • promote protective factors in the VUW community
  • improve early identification and intervention
  • improve crisis support, treatment and care
  • provide support after suicide and incidents of suicidal behaviour
  • build the evidence base – research, information and evaluation

"A key component of the Plan is for VUW to respond to suicidal behaviour in a compassionate but assertive manner…"

The Policy has the support of SPINZ, and Assoc Prof. Annette Beautrais of the Canterbury Suicide Project. It is based on a similar effective University of Illinois programme. See the study by Paul Joffe (36 pages)

A Suicide Preventing Planning Group will implement the policy and prepare a funding proposal. Sarah Lee, SPINZ Wellington-based community liaison and SPINZ national workshop co-ordinator, has been part of the group.

Chris Bowden, suicide researcher, VUW School of Education Studies led the initiative for the Plan.

A brochure Identifying and assisting students at risk: advice for staff has been produced.

More VUW information

Brischke, G., (2005). Breaking a silence. Salient, issue 23
Victoria academic Chris Bowden talks about his personal experience with suicide, in this article in the Victoria University Students' Association newspaper.

Over 60s Movement

by SPINZ Director Merryn Statham

With work well underway on the New Zealand Suicide Prevention Strategy for all age groups, opportunities to build closer connections to groups and networks catering to older people are timely. One such network is the 60's Up Club that operates branches throughout New Zealand.

I was invited to address both the Howick Pakuranga and the Pukekohe branches in the last 3 months. While initially interested in youth suicide as a focus for the address, the coordinators quickly appreciated the need to address suicide prevention in the broader context.

The warmth and hospitality of these two groups was matched by their genuine interest in issues that affect their families and communities. Many shared stories of their own grief and concerns for family members. Many expressed surprise at the rate of suicidal behaviour amongst older people.

It was very rewarding to be congratulating the organizers and participants of these clubs for providing what I viewed as fantastic mental health promotion in action. The connectedness amongst the group was obvious. If people who usually attended were not there, someone agreed to call or visit them. Coming events that were being promoted were looked forward to. And, despite the seriousness of the topic being presented, they were very willing to have a laugh.

Evidence points to social connectedness and inclusion as protective factors for suicide amongst older people. In my opinion, 60's Up Clubs are making a very positive contribution to their communities.

Report from IASP (International Association for Suicide Prevention) World Congress, Durban South Africa

SPINZ Director Merryn Statham, and researcher Terry Fleming, presented on behalf of SPINZ at the conference in September this year.

Terry writes about two interesting presentations she attended, both by Dr Morton Silverman. He is from the Suicide Prevention Resource Center (SPRC – www.sprc.org) in the United States. The reviews were limited by the same things that limit other evidence based reviews, that is, they don't tend to include small, un-evaluated, longer term or more multidimensional programmes, or those that are not overtly suicide prevention. Thus health promotion, community/whanau development programmes may not feature.

  • A review of the effectiveness of suicide prevention programmes.
    Together with the American Foundation for Suicide Prevention, SPRC has developed an online registry of the evidence for various suicide prevention programmes. They have taken a rigorous evidence based approach. The website lists programmes which have evidence that show their effectiveness. If a programme has not been rigorously evaluated it will not be listed even though it could be effective. Morton pointed to other websites which compiled evidence of what works.

He suggested suicide prevention programmes typically target one or more of these areas:

  • Attitudes, knowledge, beliefs or values about suicide
  • Risk factors
  • Protective factoys
  • Suicide ideation, plans or intent
  • Suicide attempts or deliberate self-harm
  • Completed suicide

And most programmes are either:

  • Training programmes (training gatekeepers or mental health service providers)
  • Clinical interventions (psychotherapies or drugs)
  • Public health (school-based, media, crisis centres/hotlines, access to means, access to health care, community or family based programmes

For details of how the programmes rated see the website.

  • A review of the effectiveness of national suicide preventation strategies.
    This information has also just been published in JAMA (Journal of the American Medical Association), in their 26 October issue.
    The information came mainly from a Salisburg workshop in 2004 which was a meeting of 15 countries and the World Health Organisation, reviewing the effectiveness of specific components of national strategies. They examined only rigorous studies and only considered effects on suicide rates. They found that evidence is strongest for prevention or treatment of psychiatric illness and approaches that tackle risk factors.
    • Public awareness and education campaigns: The study concluded there is no evidence available that these decrease suicide rates.
    • Gate keeper training: shown to be evidence of effectiveness, two studies from the United States Airforce, and the Norwegian army show 33-40% decreases in rates.
    • Screening programmes: No clear evidence.
    • Physician education in depression/suicide management: good evidence showing this does decrease suicide rates.
    • Treatment of psychiatric discorders: Concludes that increase in antidepressant treatments is associated with a decline in suicide rates, but causality is not established and the use of other medications also show trends.
    • Access to means: showed evidence of effectiveness for guns, gas and barbiturates, but not yet for analgesics and vehicle emissions.
    • Media reporting: evidence not available to show decrease in rates.

There was also a WHO presentation on effective public health interventions for suicide prevention which emphasised the importance of treating mental disorder, controlling access to means, and deglamorising media reports, as key interventions.

Other noted presentations included Annette Beautrais on gender and suicide; some work on the importance of reading disability for later suicidality; national strategies in England and other countries; developments in suicide prevention training, the role of crisis centres and volunteers (this was very positive), work on developing nations and South Africa.

New Postgraduate paper to be offered at Christchurch School of Medicine and Health Sciences

"An Introduction to Suicidal Behaviours, Research and Prevention" is being introduced next year, in 4 x 2 day block courses from July to October 2006.

"To our knowledge this is the first postgraduate academic course in suicidal behaviours, research and prevention to be offered in New Zealand. The proposed course will provide a critical approach to the complex and often emotive issue of suicide. The course will centre around three themes: the epidemiology of suicidal behaviour; suicide research and prevention; assessment, treatment and management of suicidal individuals." [information for students]

In brief

  • Suicide Statistics 2003 (provisional)
    These are expected to be released in late January 2006, earlier than the usual April release time (source: John Wren, Ministry Of Health)
  • Hon Jim Anderton retains Suicide Prevention role in Govt
    As Associate Minister of Health, he is responsible for government policy in the areas of drugs, alcohol and suicide prevention.

Please contact Russell Tuffery, SPINZ Information Officer, at info@spinz.org.nz, or ph 09 300 7035, for more information on any of the resources. Copies of individual articles may be able to be supplied, provided this is within copyright.

New Zealand Research noted 2005

Click here.

Recent NZ resources : a selection

Cochrane Library now available free on the Ministry of Health website. "All New Zealand residents now have free access to reliable up-to-date evidence on medical interventions from the Cochrane Library. The Cochrane Library is a collection of regularly updated evidence-based healthcare databases that can help clinicians and consumers make decisions about appropriate and effective health care. The Library brings together in one place research which looks at the effectiveness of different health care treatments and interventions."

Discriminating times?: a re-survey of NZ print media reporting on mental health. Mental Health Commission, June 2005 (12 pages)

Safe Communities Foundation NZ
fact sheets:

1. The NZ Injury Burden (Dec. 2004)
2. Profile of injury deaths 2001 by age and ethnic group (Feb. 2005)
3. Profile of injury hospitalisations (2001-2003) by age and ethnic group (Sept. 2005)
9. Injury fatalities by territorial local authority regions in NZ (Sept. 2005)
10. Injury hospitalisations by territorial local authority regions in NZ (Sept. 2005)

Stocktake of Government initiatives (more than 90 detailed) of the NZ Youth Suicide Prevention Strategy, June 2005

Tumataroa, P.(2005). "Fathering the future". Te Karaka: the Ngai Tahu magazine, 27, 34-37
Looks at raising boys in New Zealand, including the contributions of Steve Biddulph and Celia Lashlie.

Recently added to SPINZ library collection:

Curtis, Cate (University of Auckland)

  • Sexual abuse and subsequent suicidal behavior: exacerbating factors and implications for recovery (29 pages)
  • Suicide contagion: the impact of "real life" experience of others' suicidal behaviour (PowerPoint)
  • Female self-destructive behaviour: the relationship between self-mutilation and suicidal behaviour (PowerPoint)

Dafoe, B., Monk, L., (2005). Suicide postvention is prevention: a proactive planning workbook for communities affected by youth suicide. Vancouver, Canada: BC Council for Families. (82 pages)

Skylight brochures

  • Helping someone after a suicide
  • Helping ourselves through grief
  • Helping a friend who is grieving

Leenaars, A. A., (2005). National suicide prevention strategy and Canada: researchers and all of us. Lecture presented at Research Day, Canadian Association for Suicide Prevention Conference, Ottawa, Oct. 16-19 (88 pages)

Overseas recent research and resource news

Specialist journals: click here for updates on these:

  • Suicide and life-threatening behavior journal
  • Crisis: the journal of crisis intervention and suicide prevention
  • Archives of suicide research

New peer-reviewed journal: The International journal of men's health and gender
two recent articles:

  • Depression in men: communication, diagnosis and therapy, vol 2(1)
  • The effects of fatherhood on the health of men: a review of the literature, vol 1(2-3)

Assessment

Framework for suicide risk assessment and management for NSW health staff (40 pages) NSW Dept of Health, 2004
Provides detailed information on conducting suicide risk assessments and specific information on the roles and responsibilities of generalist and mental health services to guide the suicide risk assessment and management process.

Attempted suicide

Guides to support people after attempted suicide (USA) – from NAMI (National Alliance on Mental Illness)

  • Suicide:Taking Care of Yourself After an Attempt (Consumer guide)
  • Suicide: Taking Care of Yourself & Your Family After an Attempt (Family guide)
  • Suicide: Helping Patients & Their Families (Physician/provider guide)

Behaviour

De Leo D., Cerin E., Spathonis K., Burgis S., (2005). Lifetime risk of suicide ideation and attempts in an Australian community: prevalence, suicidal process, and help-seeking behaviour. Journal of affective disorders, 86(2-3), 215-24.
"This survey provides a reliable picture of suicide ideation and behaviour in the general population. Information on the development of suicidal process, recklessness, and help-seeking attitudes may be valuable for future prevention strategies"

Postvention / crises

Support Group Leader tips & hints for a long-lasting group by LaRita Archibald - article in Surviving suicide, Fall 2005 (American Association of Suicidology) re Bereaved by Suicide Support Groups

Coping with Grief at Christmas (NALAG New South Wales)

Donnelly, M., Rowling, L. (2005). Impact of critical incidents on counsellors in school communities. 7th International Conference on Grief and Bereavement in Contemporary Society, 12-15 July 2005. PowerPoint. University of Sydney.

Prevention

The Australian National Suicide Prevention Strategy is being evaluated by Urbis Keys Young on behalf of the Australian Government, Dept of Health and Ageing. The evaluation is due to be completed in December 2005

Brown, G. K., Brown G.K., Ten Have T., Henriques G.R., Xie S.X., Hollander J. E., Beck A.T. (2005). Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. JAMA, 294(5), 563-70
Concludes cognitive therapy is effective in preventing suicide attempts by up to 50 percent, in this randomised control trial of adults. Also see press release from National Institute of Mental Health (USA)

Kaleveld, L., English, B. (2005). Evaluating a suicide prevention program: a question of impact. Health promotion journal of Australia, 16(2), 129-133.

Lee, J. B., Bartlett, M. L. (2005). Suicide prevention: critical elements for managing suicidal clients and counselor liability without the use of a no-suicide contract. Death studies, 29, 847-865.
"Despite its entrenchment as a standard of practice, no-suicide contracts fail to achieve their purpose as an effective part of treatment or as an effective method of inoculating counselors against potential lawsuits should a client commit suicide. Critical elements for managing suicidal clients and counselor liability without reliance on the no-suicide contract are presented. Therapeutic considerations include evaluating clients to determine (a) no referral for hospitalization needed, (b) referral for voluntary hospitalization, or (c) referral for involuntary hospitalization".

Lifeforce Suicide Prevention Program (Wesley Mission, Australia)

Martin, G. (2005). On evaluation. Australian e-journal for the advancement of mental health (AeJAMH), 4(1), [editorial]

Wilson, C. J., Deane, F. P., Ciarrochi, J. (2005). Can hopelessness and adolescents' beliefs and attitudes about seeking help account for help negation? Journal of clinical psychology, 61(12), 1525-39.

Woodhouse, R., Kemp, R. (2005). Tasmanian Suicide Prevention Steering Committee Report 2002-2004. Tasmanian Department of Health and Human Services. Community Support. Hobart.

Republic of Ireland releases Suicide Prevention Strategy (84 pages)

Prison suicide

Fazel S., Benning R., Danesh J. (2005). Suicides in male prisoners in England and Wales, 1978-2003. Lancet, 366(9493), 1301-02
"The number of suicides in English and Welsh prisons is increasing, but the excess compared with the general population has not been reliably quantified…the proportional excess of suicides of male prisoners has been increasing during the past quarter of a century, which underscores the need for substantial improvements in suicide prevention in prisons."

Protective factors

Birndorf, S., Ryan, S., Auinger, P., Aten, M., (2005). High self-esteem among adolescents: longitudinal trends, sex differences, and protective factors. Journal of adolescent health, 37(3), 194-201.
"Fewer adolescent girls than boys report high self-esteem. Adults may foster self-esteem in adolescents by providing positive communication through supportive and caring relationships"

Risk factors

Abuse of paracetamol in young people – from Kids Help Line, Australia, October 2005 newsletter

Agerbo, E. (2005). Midlife suicide risk, partner's psychiatric illness, spouse and child bereavement by suicide or other modes of death: a gender specific study. Journal of epidemiology and community health, 59(5), 407-12.
"The suicide risk is associated with partner psychiatric illness. Conjugal bereavement is particularly indicative of suicide in men, and spousal suicide is particularly indicative of suicide. Child bereavement is associated with parental suicide, while being a parent is protective against suicide in women."

Brownhill, S., Wilhelm, K., Barclay, L., Schmied, V. (2005). "Big build": hidden depression in men. Australian and New Zealand Journal of Psychiatry, 39(10), 921-931

Evans E., Hawton K., Rodham K., (2005). Suicidal phenomena and abuse in adolescents: a review of epidemiological studies. Child abuse and neglect, 29(1), 45-58
"There is a clear link between abuse and suicidal phenomena occurring during childhood and adolescence."

Flouri, E. (2005). Psychological and sociological aspects of parenting and their relation to suicidal behavior. Archives of suicide research, 9(4), 373-383.
"Argues that measures (both at the micro and the macro level) that target vulnerable populations such as parents with weak material and social resources, low social and emotional support, mental health problems and few networks, and high-risk children might be beneficial in preventing youth suicidal behaviors."

Hawton, K. et al. (2005). Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. Journal of Clinical Psychiatry, 66(6), 693-704
In this review, the main risk factors for suicide in patients with bipolar disorder, was found to be a previous suicide attempt, and hopelessness. For nonfatal behaviour, the authors identified a family history of suicide, early onset of bipolar, depressive symptoms, severity of affective disorders, substance abuse, amongst others.

Hawton K., Sutton L., Haw C., Sinclair J., Deeks J. J. (2005). Schizophrenia and suicide: systematic review of risk factors. British journal of psychiatry, 187, 9-20.

Healy D., Aldred G., (2005). Antidepressant drug use & the risk of suicide. International Review of Psychiatry, 17(3),163-72.
"we conclude that there is a clear signal that suicides and suicidal acts may be linked to antidepressant usage. It would seem likely that explicit warnings and monitoring in the early stages of treatment could greatly minimize these hazards"

Isacsson G., Rich C. L., (2005). Antidepressant drug use and suicide prevention. International Review of Psychiatry, 17(3), 153-62.
"The number of geographically widespread studies reporting positive results with varying methods leads us to conclude, however, that antidepressants do exert a suicide preventive effect."

Kitts R. L., (2005). Gay adolescents and suicide: understanding the association. Adolescence, 40(159), 621-8.
"This article brings together information garnered from past studies, articles, and experiences to create a more in-depth understanding of why gay adolescents are at a higher risk for suicide"

Sareen J., Cox B. J., Afifi T. O., de Graaf R., Asmundson G. J., ten Have M., Stein M. B., (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Archives of General Psychiatry, 62(11), 1249-57
"This is the first study to demonstrate that a preexisting anxiety disorder is an independent risk factor for subsequent onset of suicidal ideation and attempts. Moreover, the data clearly demonstrate that comorbid anxiety disorders amplify the risk of suicide attempts in persons with mood disorders. Clinicians and policymakers need to be aware of these findings, and further research is required to delineate whether treatment of anxiety disorders reduces the risk of subsequent suicidal behavior."

Self-harm

Burns, J., Dudley M., Hazell, P., Patton, G. (2005). Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition. Australian and New Zealand Journal of Psychiatry, 39(3), 121-128

Cerdorian, K. (2005). The needs of adolescent girls who self-harm. Journal of psychological nursing and mental health services, 43(8), 40-46.

Evans E., Hawton K., Rodham K., (2005). In what ways are adolescents who engage in self-harm or experience thoughts of self-harm different in terms of help-seeking, communication and coping strategies? Journal of adolescence, 28(4), 573-87.
"The findings have important implications for preventive strategies, including educational programmes on emotional health and coping, and for the clinical care of adolescents identified as at risk or having self-harmed"

Fortune, S., Hawton, K. (2005). Deliberate self-harm in children and adolescents: a research update. Current opinion in psychiatry, 18(4), 401-406. Reprinted in Medscape.

Parker, G., Malhi, G., Mitchell, P., Kotze, B., Wilhelm, K., Parker, K. (2005). Self-harming in depressed patients: pattern analysis. Australian and New Zealand Journal of Psychiatry, 39(10), 899-906

Youth

Youth health focused issue of the Medical Journal of Australia (17 October 2005) – full articles online.

"Suicidal thoughts among youths aged 12-17 with major depressive episode". National Survey on Drug Use and Health Report (USA), Sept 9, 2005 (3 pages)

Youth at risk of suicide – new website from the Centre for Suicide Prevention, Calgary, Canada

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Contact Russell Tuffery, SPINZ Information Officer, at info@spinz.org.nz, or ph 09 300 7035, for more information on any of the resources. Copies of individual articles may be able to be supplied, provided this is within copyright.

Top Page last updated: 16 November 2009