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Issue 4

 

SPINZ News

Summer 2006 Issue
www.spinz.org.nz

Contents

2003 provisional suicide statistics released

"A rise in the latest suicide rates reinforces the need to continue efforts to tackle this complex issue, Associate Minister of Health, Hon. Jim Anderton said. Mr Anderton made the comments while releasing the latest suicide figures. They show that 515 people died from suicide in New Zealand in 2003, (a rate of 11.5 deaths per 100,000 population), compared to 465 people in 2002 (a rate of 10.8 deaths per 100,000 population)."

For more information

New Postvention resources

Government has released two new postvention resources

After a suicide: practical information for people bereaved by suicide Guidance for community organisations involved in suicide postvention

After a suicide: practical information for people bereaved by suicide (prepared by the NZ Guidelines Group and skylight, for the Ministry of Youth Development, 26 page booklet). This resource is divided into chapters:

  • After a suicide
  • Dealing with the practical
  • Informing other agencies
  • Answering difficult questions
  • Coping with grief
  • Caring for yourself
  • Coping with suicidal thoughts
  • Getting ongoing help and support
  • Finding further information

Guidance for community organisations involved in suicide postvention (by Lewis Rivers, for the Ministry of Youth Development, 12 pages), contents:

  • Guidance for community organisations
  • Establishing a community initiative
  • Flow chart
  • Guiding principles
  • Suicide and bereavement
  • Information sources

New Zealand All-Ages Suicide Prevention Strategy and Action Plan

This is due for release in June this year. Recently the Analysis of the submissions on the draft strategy was published. In December the Ministry of Health released a number of research reports:

  • Social Explanations for suicide in NZ: A suite of five reports, and a sixth summary report, part of a contract the Ministry of Health held with the Wellington School of Medicine and Health Sciences between 2001 and 2004
  • Cost of suicide report
  • Related Press releases from Associate Health Minister, Hon Jim Anderton

Upcoming events

  • Fourth National Mental Health Promotion Hui, 24-25 May 2006, Palmerston North, A Holistic Approach to Mental Health Promotion: "Mind, Body, Spirit and Physical Acitivity" Organised by the Mental Health Foundation, Public Health Services MidCentral DHB and Regional Public Health, Palmerston North Convention Centre. For more information marika@mentalhealth.org.nz
  • World Suicide Prevention Day 10 Sept 2006, "with understanding, new hope"
  • 2nd Asia Pacific Suicide Prevention Conference 2006, 10-12 March, Singapore

More New Zealand resources: an update

  • Beautrais A. L., Fergusson D. M., Horwood L. J., (2006). Firearms legislation and reductions in firearm-related suicide deaths in New Zealand. Australian & NZ Journal of Psychiatry, 40(3), 253-9
    Examines the impact of introducing more restrictive firearms legislation (Amendment to the Arms Act, 1992) in New Zealand on suicides involving firearms, and shows a significant reduction of suicides using guns - University of Otago press release
  • Fergusson, David M., and others (2006). Cannabis and psychosis. BMJ, 332, 172-175 "evidence suggests a causal relation in which frequent use of cannabis leads to a greater risk of psychotic symptoms"
  • Family violence & Pacific health research
    in the 27 Jan 2006 issue of the NZ Medical Journal
    • Editorial: Family violence in New Zealand: we can do better / Ian Hassall, Janet Fanslow
    • Original Articles:
      On the receiving end: young adults describe their parents' use of physical punishment and other disciplinary measures during childhood / Jane Millichamp, Judy Martin, John Langley
    • Domestic violence as witnessed by New Zealand children / Judy Martin, John Langley, Jane Millichamp
    • Contraceptive use by Māori youth in New Zealand: associated risk and protective factors / Terryann Clark, Elizabeth Robinson, Sue Crengle, Peter Watson
    • Pacific healthcare workers and their treatment interventions for Pacific clients with alcohol and drug issues in New Zealand / Gail Robinson, Helen Warren, Kathleen Samu, Amanda Wheeler, Havila Matangi-Karsten, Francis Agnew
    • Pacific Islands Families: First Two Years of Life Study—design and methodology /Janis Paterson, Colin Tukuitonga, Max Abbott, Michael Feehan, Phil Silva, Teuila Percival, Sarnia Carter, Esther Cowley-Malcolm, Jim Borrows, Maynard Williams, Philip Schluter
  • Out of the Blue/Kia Marama depression awareness campaign
    Latest newsletter, issue 2, is now online
    Also, as a side note, Hubbards Fruitful Lite cereal boxes are scheduled to have information about depression and Out of the Blue/Kia Marama on the side of their boxes shortly.
  • Wairarapa DHB releases "Health Priority publications"
    • Our Children, Their Health
    • Aging Well, Living well
    • Life2Go - Youth health in the Wairarapa
    • Mind You - Health minds, Healthy lives

Dr Nicole Coupe completes study on Māori suicide prevention

Dr Nicole Coupe (Kai Tahu, Te Atiawa, Ngati Toa, Rangitane, Raukawa), recently received her doctorate Philosophy in Māori Studies, which focuses on Māori suicide prevention.

A Massey University researcher, Dr Coupe's 5 year study looked at reasons for suicidal behaviour among Māori, whose rate of suicide and suicide attempts far exceeds that of non-Māori.

Her study found that not being connected to Māoritanga (Māori culture) is a key risk factor associated with attempted suicide among Māori. Among the group that attempted suicide there were higher numbers for those who were not connected to things Māori. "They didn't have a secure identity."

"Interestingly, the majority could actually say who their iwi were but they couldn't tell us much more than that. They were much less likely to speak te reo than the group from the wider community."

Other factors included poor general health, cannabis use, and being a victim of others' abuse.

Dr Coupe was recently awarded a postdoctoral fellowship from Nga Pae o te Maramatanga (Māori CoRE) to continue her research in Whakamomori: Māori suicide prevention in the primary care setting.

She is also working with the NZ Guidelines Group implementing guidelines for people at risk of suicide in emergency departments, mental health services and Māori health services.

Massey University study:

  • 250 Māori who were treated at Auckland hospitals after attempting suicide were interviewed. They were compared with a control group of 250 Māori randomly selected from the same communities.
  • Each participant was asked 400 questions about his or her personal circumstances, background, health, employment, drug and alcohol use and whether they suffered depression and anxiety.
  • Those connected with Māori culture were three times less likely to have attempted suicide than those who were not connected.
  • Cultural connection included being able to speak Māori, name their iwi, ancestors and marae, having visited their marae and having access to their whanau.

Reference: Coupe, Nicole Michelle (2005). "Whakamomori: Māori suicide prevention": a thesis presented in partial fulfilment of the requirements for the degree of Dr of Philosophy in Māori Studies at Massey University [Turitea Campus].

School-based suicide prevention

A recent invitation to SPINZ, to work with a primary school provided an interesting insight into how important planning is for safe practice. While many in education see the focus of suicide prevention sitting predominantly in secondary schools, the same approaches and guidance are recommended for all schools in New Zealand. It was encouraging to see the number of supports that were made available to this particular school. A Child Youth and Family social worker, a Ministry of Education representative, Group Special Education Traumatic Incident Response team, the Resource Teacher of Learning and Behaviour (RTLB) and SPINZ staff all met together with the Principal to discuss the appropriate management of a situation in the school. The observation and reporting of warning signs by school staff ensured a comprehensive response, both within the school and for those families identified. Referrals to the local Child and Adolescent Mental Health Service were made, support was provided to family members and SPINZ provided two information workshops for all school staff. On-going support for school staff and management was set in place.

The need for a Traumatic Incident Response Plan can be overlooked in the busy day to day life of schools. SPINZ encourages all schools to not only have this policy in place but to ensure:

  • it is reviewed and updated by the Board of Trustess annually
  • staff are aware of their responsibilites as part of this policy
  • good connections are maintained with the agencies/individuals that contribute support
  • a good understanding of the Guidelines that cover management of suicide risk and suicide attempt in schools- The Prevention, Detection and Management of Young People at Risk of Suicide: Development of Guidelines for Schools (1997, 52 pages) or contact SPINZ for a printed copy.

Preventing Suicide – Restricting Access to Means

A new SPINZ resource information sheet will be soon be available.

"It's important to realise that suicide is preventable. And that the means of suicide is both an important risk factor and determinant of suicide"
- Prof. Lars Mehlum, former IASP (International Association for Suicide Prevention) President (2003-5).

The World Health Organization has placed strong emphasis on restricting access to means of suicide as a major approach to suicide prevention.

Of the six basic steps for the prevention of suicide identified by WHO, four relate to means restriction (guns possession control, detoxification of domestic gas, detoxification of car emission, control of toxic substances availability).

Restricting access to means in suicide prevention requires people from various fields (policy making, industry, health, pharmaceutical, community leaders) working together. As a community, we can support and advocate for legislation restricting access to means like gun control, safety barriers around hot-spots, access to particular medicines, catalytic converters for vehicles, and mass-media responsibility. As a family member or mental health professional or other professional living/working directly with suicidal persons, we strive to ensure a safe environment for those that we care for. Key actions should include safe storage of medication and toxic substances, removal of all hazards, control/removal of objects that might be used for cutting or for hanging, monitoring access to information regarding lethal suicide methods and on-going support and supervision of a suicidal person.

Pacific Youth Development Strategy

In June 2005 the Ministry of Pacific Island Affairs presented the Pacific Youth Development Strategy to the Pacific communities of Counties Manukau, Auckland and Waitakere cities. The aim of the strategy is to deliver positive life-changing programmes and affirmation for all Pacific youth in Auckland (focusing the Pacific Youth Development Strategy in Auckland region will enable it to most effectively respond to needs of the greatest number of Pacific young people both now, and in the future).

The strategy draws on three fundamental elements that are important in a Pacific young person's life: family, church and youth.

The Ministry of Social Development (MSD) has now taken the lead in developing the strategy for Auckland. The two goals that the strategy hopes to achieve are:

  • to improve the social well-being of Pacific youth
  • ensure effective collaboration between the Ministy of Social Development, and other government organizations in partnership with community and Pacific Young people to effectively implement the strategy.

To find out the needs of Pacific young people the Ministry of Social Development used the process of Talanoa (conversation) to explore issues and ideas in relation to the Pacific youth population. There were three forums in which the proposal for the strategy was presented to Pacific youth. These included schools, churches and community-based groups in the Auckland region. Through the extensive consultation the strategy has had strong support from those who participated in its development.

The strategy identifies family, church and education as important areas for Pacific youth to develop socially and economically. It is in these three areas that the strategy will aim to:

  • Create parents as first role models- Having parents as role models will help influence and develop Pacific young people. Examples that the strategy has identified of ways that parents can be role models are having job security, a stability of income, and a supportive and healthy home environment.
  • Empower Pacific young people through education- An issue for Pacific youth is the capability to achieve academically. This part of the strategy looks at how the education system can respond to needs by providing opportunities to achieve. Some of these opportunities are having services that provide mentoring, career planning and counseling, alliance with training institutions, and pedagogy training and development.
  • Enhance community and family through the church- the church plays an important role in Pacific Island culture, especially spirituality in Pacific youth. The strategy sees the church as a place where youth can be connected to their culture, and develop new leaders.

Following the consultation process with Pacific young people, action projects were created to meet the identified needs. The Pacific family intervention and Pacific parenting model aims to develop a programme and framework for an early intervention service to help create a healthy supportive home environment. This project also aims to ensure that primary healthcare organistations are working with Pacific communities to be actively involved in changing attitudes.

The Pacific mentoring model aims to mentor Pacific youth through an education framework that will support and empower youth to make education and career decisions. The pedagogy, training and development focuses on a teacher training model with Pacific involvement in the education delivery process. The Pacific reconciliation model recognizes the importance of the church as a central place where cultural identity, language and sense of community are maintained. The aim of this model is to connect Pacific youth to their culture through the church. The final action project is partnered outreach services that will enable the church and community to support healthy economic and social growth for Pacific youth and people as a whole.

The Pacific Youth Development Strategy supports The New Zealand Youth Suicide Prevention Strategy "In Our Hands/Kia Piki te Ora o te Taitamariki" It aims to promote wellbeing by strengthening families/aiga, young people and communities. Pacific young people have been involved in the development of this strategy, with this involvement giving them meaning and purpose.

Links:
Pacific Youth Development Strategy Launched
Ala Fou – New Pathways: Strategic Directions for Pacific Youth in New Zealand

Canterbury Bereaved by Suicide Phone Line

The Canterbury Bereaved By Suicide Support Group went into recess in 2005. Although the group no longer meets, their support phone line still exists. The phone number is the same (03) 3777 233 and is listed under 'Personal Help Services' (page 6) in the Christchurch White Pages Directory. Resources are also offered on the Canterbury Bereaved By Suicide Support Group website. The website has not been updated since the group folded, so no new information is offered.

Lifeline Christchurch is maintaining the Bereaved by Suicide phone line. They hope to further develop the service in consultation with community groups in Canterbury. It is hoped they will be able to offer more support to families/whanau bereaved by suicide in the future.

For more information about resources for those bereaved by suicide, please visit the SPINZ website.

International Resource Update

  • New issue of Suicide & Life-threatening behavior journal (December 2005) – articles include:
    • The Usefulness of Coroners' Data on Suicides for Providing Information Relevant to Prevention
    • Suicidality in African American Men: The Roles of Southern Residence, Religiosity, and Social Support
    • Perceptions Concerning College Student Suicide: Data from Four Universities
    • Predicting the Suicide Attempts of Lesbian, Gay, and Bisexual Youth
    • Siblings After Suicide— "The Forgotten Bereaved"
  • New issue of Advancing Suicide Prevention (January 2006) – full issue online – focus is on Youth and suicide
  • Visions: BC's Mental Health and Addictions journal (Canada) – Fall 2005 issue (40 pages) is devoted to a range of articles on suicide. Online in full.

Media Reporting

  • Mind Over Matter: Improving Media Reporting of Mental Health. From the UK, this report "finds public understanding of mental health has improved enormously over recent years, as has media reporting. But prejudiced attitudes still remain deeply ingrained in society - and in the media"
  • Pirkis, J. E., and others. (forthcoming). The relationship between media reporting of suicide and actual suicide in Australia. Social Science and medicine.
    University of Melbourne
    "Further research on this topic is required, but in the meantime there is a need to remain vigilant about how suicide news is reported. Mental health professionals and suicide experts should collaborate with media professionals to try to balance 'public interest' against the risk of harm"

Males

  • The male perspective: young men's outlook on life from the National Suicide Research Foundation Ireland, a 50 page study

Prevention

  • The Ministerial Council for Suicide Prevention in Western Australia has developed a new community website, which provides evidence-based information for family members, friends and others who are concerned about someone who is in distressed (in crisis) and potentially suicidal; or if they are currently supporting someone who is suicidal.
  • LIFE: the National Suicide Prevention website managed by Auseinet (Australia) is now putting out a monthly email update.

Risk Factors

  • Hall, W. D., (2006). Cannabis use and the mental health of young people. Australian and New Zealand Journal of Psychiatry, 40(2), 105-13.
    University of Queensland
    Reviews the evidence on the mental health and psychosocial consequences of rising rates of cannabis use among young people in developed countries. "We face major challenges in communicating with young people about the most probable risks of cannabis use (dependence, educational underachievement and psychosis) given uncertainties about these risks and polarized community views about the policies that should be adopted to reduce them"
  • Judd, Fiona and others (2006). Rural suicide – people or places effects? Australian and NZ Journal of psychiatry, 40, 208-16.
  • Mann, J.J., and others (2006). ACNP Task Force Report on SSRIs and Suicidal Behavior in Youth. Neuropsychopharmacology. 31(3), 473-92 [full article online]
    Columbia University/New York State Psychiatric Institute
    A very useful summary on this topic.
    "Three other lines of evidence in youth, epidemiology, and autopsy studies, and recent cohort surveys (Valuck et al, 2004; Simon et al, 2005), do not support the hypothesis that SSRIs induce suicidal acts and suicide, instead indicating a possible beneficial effect, and that a negligible number of youth suicides are taking antidepressants at the time of death"
  • Rehkopf, D. H., Buka, S. L., (2006). The association between suicide and the socio-economic characteristics of geographical areas: a systematic review. Psychological medicine, 36(2), 145-57
    Department of Society, Human Development and Health, Harvard School of Public Health
    "Resources for suicide prevention should be targeted to high poverty/deprivation and high unemployment areas."
  • Rey, J. M., Martin, A., (2006). Selective serotonin reuptake inhibitors and suicidality in juveniles: review of the evidence and implications for clinical practice. Child & Adolescent Psychiatric Clinics of North America, 15(1), 221-37.
    University of Sydney. "reviews the existing evidence regarding whether selective serotonin reuptake inhibitors increase suicidal behaviors in children and examines the implications of the findings for clinical practice and research."
    "When balanced against the fact that depression in the young is a serious, recurring condition that produces personal suffering and can lead to suicide, the overall weight of the evidence favors pharmacologic treatment over nontreatment in moderate to severe depression. Nevertheless, the need for careful clinical monitoring of suicidality and attention to behavioral activation, manic switching, and medication compliance or withdrawal are clearly warranted."
  • Supporting life: suicide prevention for mental healthcare service users, Schizophrenia Ireland Lucia Foundation (Occasional Paper No. 2, 35 pages, 2005)
  • Tang, N. K., Crane, C. (2006). Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychological medicine, 18 Jan. 1-12
    Department of Psychology, Institute of Psychiatry, King's College London.

Resources

Information Request Form

SPINZ e-news is edited by Russell Tuffery, SPINZ Information Officer. Contact Russell for any of the resources here or on the SPINZ website, phone 09 300 3075 or email info@spinz.org.nz

SPINZ can supply many of these, but we are constrained by copyright in some cases. Also try your organisation's library or your public library. Many resources can be obtained for a small fee via interlibrary loan (interloan) - ask at your local library.

Please contact Russell if you are having difficulty obtaining a resource.

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