Issue 7
| SPINZ news Spring 2006 |
In this issue:
- SPINZ Symposium, 28 & 29 November, in Dunedin
- Mental Health Awareness Week 9 to 15 October
- Journeys of despair, journeys of hope new study
- Research Award for Ass. Prof. Annette Beautrais
- Te Rau Hinengaro: The NZ Mental Health Survey released
- Suicide trends publication withdrawn
- New Coroners' Act
- Manawaora o Nga Taiohi Project
- Involve 06
- New research
Australian research & resource news
International research & resource news
- Important Warning Signs for Suicide research
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4th National Suicide Prevention Symposium, St David's Conference Centre, University of Otago, Dunedin, 28 & 29 November 2006, 'Understanding Suicidal Behaviour - update your knowledge and practice' This year, the SPINZ Symposium is organised in collaboration with Otago University and Public Health South.
Click here for details.
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Mental Health Awareness Week 9 to 15 October
This year's theme is Happiness - what does it mean to you? When do you have moments of happiness? We believe happiness can happen in an environment where we:
Accept each other - accept diversity and have an inclusive society. This ties in well with human rights and the Like Minds Like Mine key messages.
Belong - be, or become, part of a community, family, whanau or group of friends. Belonging helps us feel valued. Know who you are and your culture.
Connect with others - communicate, ask for and offering help, be a good friend, access community groups and activities.
Links between Mental Health Awareness week theme and suicide prevention research by Fi McAlevey, SPINZ South Island Community Liaison.
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Journeys of despair, journeys of hope: young adults talk about severe mental distress, mental health services and recovery by Heather Harnett and Hilary Lapsley, Mental Health Commission
Research Report, 2006 (online, 112 pages)
"This study is based on in-depth interviews with 40 young people. Every year around 18,000 young adults between the ages of 18 and 29 use New Zealand's mental health services – they are one of the largest groups of service users. Participants in the study talked about child abuse and other stressors leading to later mental health difficulties. They often felt that they had no one to talk to, and they thought that parents need greater awareness of children's emotional issues. This research suggests that the next big challenge for New Zealand is to ensure services are able to respond as soon as a person or their family indicates that they need help, rather than waiting until there is a crisis." – Mental Health Commission.
Also see the report's Backgrounder (online, 21 pages)
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Edwin Shneidman Award for 2006
Associate Professor Annette Beautrais, Head of the Canterbury Suicide Project at the Christchurch School of Medicine, has been awarded this annual award by the American Association of Suicidology (AAS). The award recognises outstanding contributions in the field of suicidology. Associate Professor Beautrais is the first person from New Zealand and Australia to receive the award, which was first presented in 1973. She received the award at the AAS annual conference held from 28 April 1 May 2006 in Seattle, USA.
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Te Rau Hinengaro: The New Zealand Mental Health Survey – a nationally representative household survey conducted from October 2003 to December 2004 in a sample of 12,992 participants aged 16 years and over. The report is now available on the Ministry of Health website. Click on the link above.
Chapter 7 examines suicidal behaviour.
The latest Australian and New Zealand Journal of Psychiatry (October 2006), includes research papers from the survey including:
- Beautrais, A. and others. Suicidal behaviour in Te Rau Hinengaro: The New Zealand Mental Health Survey, 40(10), 896.
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Suicide trends 1983-2003, Ministry of Health report withdrawn.
This publication which came out in August last month has been withdrawn from distribution and is no longer online.
"The Ministry of Health is withdrawing its publication Suicide Trends New Zealand 1983-2003 due to the way in which hospitalisation data was reported in the document. The suicide-related hospitalisation data refers to intentional self harm events. In Suicide Trends each individual person hospitalised for a self-harm event was counted once. However where a person was hospitalised more than once for a separate self-harm event, the additional events were not counted when they should have been. This situation resulted in an undercounting of the number of self-harm events. The Ministry is taking the opportunity to add some additional data to the Suicide Trends report that was not available at the time of publication. This will make this a more useful suicide reference report for New Zealand. As a result of the changes to the hospitalisation data and the inclusion of new data the Ministry will re-publish the complete report under the title: New Zealand Suicide Trends: Mortality 1921-2003, hospitalisations for intentional self-harm 1978-2004. The expected publication date of this is early November"
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New Coroners' Act
Parliament has passed the Coroners' Bill, replacing the Coroners Act 1988 and reforming the coronial system. A body of up to 20 legally qualified, mostly full time Coroners will be established, taking the place of the current approximately 55 mostly part-time Coroners. A chief coroner will also be appointed. The new coronial structure will be operational by 1 July 2007. The legislation continues the existing restrictions on making public details of self-inflicted deaths, but takes a more flexible approach. Details of a self-inflicted death cannot be made public (beyond the name, address, occupation, and the finding of self-inflicted death), unless authorised by the coroner. Details can only be made public where the making public of those details is unlikely to be detrimental to public safety.
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Carter, M., McGee, R., Taylor, B., Williams, S. (2006). Health outcomes in adolescence: associations with family, friends and school engagement, Journal of adolescence, article in press, (12 pages).
The authors, from the Dunedin School of Medicine, University of Otago, surveyed 643 students from Dunedin high schools.
"School engagement showed the strongest and most pervasive associations across both health compromising and promoting behaviours"
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Beautrais, A. (2006). Suicide in Asia. Crisis : the journal of crisis intervention and suicide prevention, 27(2), 55 (editorial)
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Towards Wellbeing (TWB) suicide prevention programme
Smith, D., Ellis, P. (2006). Surveying social workers. Social work now, August 2006, 34, 4-10. Full article online.
The authors (from the Department of Psychological Medicine at the Wellington School of Medicine and Health Sciences) discuss the Towards Wellbeing suicide prevention programme from the viewpoint of social workers involved. The programme assists in managing young people at risk of suicide, most of whom are current clients of the Dept. of Child, Youth and Family.
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Manawaora o Nga Taiohi project.
An initiative of the Mental Health Foundation and Te Tohu o Tu Trust this project is targeted at making a real difference in the lives of young men and their whanau whanui, who may be at risk of suicide. The project, led by Temairiki Williams, is working in Canterbury and the West Coast. See In Touch, Spring 2006, for more details.
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SPINZ Library catalogue now online
The SPINZ Library Catalogue is now available online on the SPINZ website.
Library records are progressively being updated and reviewed, and new features added and planned e.g. monthly new additions lists, subject lists, etc.
The library sits within the Mental Health Foundation Resource & Information Centre on level 1, 81 New North Road, Eden Terrace, Auckland, opening hours 9am-4.30pm weekdays (please ring if you need to come outside of those hours).
While borrowing is currently restricted to Auckland residents, except for videos and dvds which can be lent nationally, our information service is nationwide. All enquiries welcome.
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Involve 06 is a national conference that aims to reflect and connect the diversity of people who work with and for young people. It is being held from November 1-3 at Lincoln University in Christchurch. It is being organised by the New Zealand Association for Adolescent Health and Development with support from the Ministry of Youth Development, and in partnership with the National Youth Workers Network.
This promises to be an inspiring, informative conference that encourages and challenges everyone who attends. It will bring together hundreds of diverse people from the youth health and development sectors, including: youth health and development providers, practitioners, clinicians, researchers, policy-makers, educators, youth workers, social workers, peer support workers and more.
The conference will:
- put you in touch with other people in the youth sector,
- give you the chance to hear from leading youth health and development researchers, policy-makers and grassroots practitioners,
- provide you with the chance to hear from leading international experts,
- an optional full-day workshop on motivational interviewing,
- and provide you with an opportunity to share your experiences in working with young people; or present new research and information.
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Recent Australian Research and Resources
Robinson, J., McGorry, P., Harris, M. G., Pirkis, J., Burgess, P., Hickie, I., et al. (2006). Australia's National Suicide Prevention Strategy: the next chapter. Australian Health Review, 30(3), 271-276.
ORYGEN Research Centre, University of Melbourne
"Australia's National Suicide Prevention Strategy (NSPS) is about to move into a new funding phase. In this context this paper considers the emphasis of the NSPS since its inception in 1999. Certain high-risk groups (particularly people with mental illness and people who have self-harmed) have been relatively neglected, and some promising approaches (particularly selective and indicated interventions) have been under-emphasised" - from abstract.
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Suicide risk assessment and intervention: men at risk e-learning tool available at Mensline Australia, "a resource for professionals working with men who may be at risk of harming themselves, to equip them with the knowledge and skills to assess and respond to suicide risk".
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Abelson, J., Lambevski, S., Crawford, J., Bartos, M., & Kippax, S. (2006). Factors associated with 'feeling suicidal': the role of sexual identity. Journal of Homosexuality, 51(1), 59-80.
University of New South Wales.
"Examines factors associated with feeling suicidal in a large sample of urban men in Sydney and Melbourne, aged 18-50, including heterosexual, gay and bisexual men, HIV antibody positive and HIV antibody negative. As in previous research, sexuality (being homosexual or bisexual) was found to be a major predictor of suicidality" - from abstract.
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Bridge, S. (2006). Suicide prevention - targeting the patient at risk. Australian Family Physician, 35(5), 335-338.
James Cook University.
Full article online.
"Suicide is a major cause of death from adolescence upward. While there has been a concentrated effort to educate families and health workers to be aware of warning signs of pending suicide, there has been limited information or practical strategies available for people at risk of suicide or for those who have suicidal thoughts." - from abstract.
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Goldney, R.D. (2006). Suicide in Australia: some good news. Medical Journal of Australia (MJA), 185(6), 18 Sept., 304.
Article online.
"Since 1997, when the number of Australians committing suicide peaked at 2720, there has been a sustained reduction in the number of suicides each year."
The latest Australian statistics (for 2004) are available on the LIFE website.
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Measey, M-A. L. and others (2006). Suicide in the Northern Territory, 1981-2002. Medical Journal of Australia (MJA), 185(6), 18 Sept., 315-319.
Article online.
Discusses the rising rate of suicide in the Northern Territory, including the major indigenous issue.
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Trauma Assist online, Monash University. A module-based educative tool to understand the nature of trauma, and how it can be managed.
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Sydney Statement of the National Forum on Men & Suicide, Sydney, 2-3 May 2006 - "Meeting the Challenge". This 5 page document was written by delegates attending the National Forum on Men & Suicide and contains 26 recommendations. Actions for government, media, the corporate and community sector to reach the forum's long term goal, that by 2030, all Australians will know what actions to take to prevent suicide. Currently around 80% of suicides in Australia are men, and 50% are men aged 25-44.
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Recent International Research and Resources
Rudd, M. D., Berman, A. L., Joiner, T. E., Jr., Nock, M. K., Silverman, M. M., Mandrusiak, M., et al. (2006). Warning signs for suicide: theory, research, and clinical applications. Suicide and Life Threatening Behavior, 36(3), 255-262. Article free access online.
This is a major piece of research from a working group of the American Association of Suicidology (AAS). In it they determine the foundations for a standard set of warning signs for suicide, see table 2 below. This includes a two-tier model, the first is for high risk, the second for lower risk.
The basic rationale for warning signs is that improved public education and awareness promotes early detection and intervention. The authors' note that to some degree warning signs are both signs (ie. Something observed in another), and symptoms (what an individual tells another). The low rate of completed suicide in the general population is a significant problem in the ability to predict it. In the editorial to this issue of the journal, Morton Silverman, observes that warning signs for suicide "are intended to predominately inform the observers of suicidal behaviors in others, not the individuals themselves" unlike other public health warning signs e.g. for lung cancer, which are for the individuals themselves.
This article is one of four in this issue, in a Special Section: Warning Signs for Suicide.
TABLE 2
Consensus Warning Signs for Suicide
Are you or someone you love at risk for suicide? Get the facts and take action.
Call 1-1-1 or seek immediate help from a mental health provider when you hear, say or see any one of these behaviors:
- Someone threatening to hurt or kill themselves
- Someone looking for ways to kill themselves: seeking access to pills, weapons, or other means
- Someone talking or writing about death, dying, or suicide
Seek help by contacting a mental health professional for a referral should you witness, hear, or see anyone exhibiting any one or more of these behaviors:
- Hopelessness
- Rage, anger, seeking revenge
- Acting reckless or engaging in risky activities, seemingly without thinking
- Feeling trapped—like there's no way out
- Increasing alcohol or drug use
- Withdrawing from friends, family, or society
- Anxiety, agitation, unable to sleep, or sleeping all the time
- Dramatic changes in mood
- No reason for living; no sense of purpose in life
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Phongsavan, P. et al. (2005). Health behaviour and lifestyle of Pacific youth surveys: a resource for capacity building, Health promotion international, 20(3), 238-248.
Full article online.
"This paper describes the development, implementation and major findings of the Health Behaviour and Lifestyle of Pacific Youth (HBLPY) surveys, a regional initiative to obtain representative data about health-related behaviour and needs of adolescents in Vanuatu, Tonga and the Federated States of Micronesia. The Pacific HBLPY is modelled on the WHO Europe Health Behaviour in School-aged Children (HBSC) surveys." – from abstract.
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Brock, A., Baker, A., Griffiths, C., Jackson, G., Fegan, G., & Marshall, D. (2006). Suicide trends and geographical variations in the United Kingdom, 1991-2004. Health Statistics Quarterly(31), 6-22.
Office for National Statistics, UK.
Full article online.
"The UK suicide rate peaked in men in 1998 but has since fallen, whilst the suicide rate in women was stable between 1991 and 2004. The highest suicide rates in the UK were seen in young men aged 15–44 from 1998 onwards, and in elderly women aged 75 and over across the period"
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The High level of suicide in Irish society, July 2006
A report from the Joint Committee on Health & Children, Republic of Ireland Parliament (83 pages)
"The sharp increase in rates of suicide in Ireland of the past two decades demands decisive action by Government. This rise is particularly stark in males aged less than 35 years but an emerging trend in young female suicides of those aged less than 25 years is also now apparent."
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Access to Means
Ajdacic-Gross, V., Killias, M., Hepp, U., Gadola, E., Bopp, M., Lauber, C., et al. (2006). Changing Times: A Longitudinal Analysis of International Firearm Suicide Data. American Journal of Public Health.
University of Zurich.
"Changes in the proportion of firearm suicides in Western countries since the 1980s and the relation of these changes to the change in the proportion of households owning firearms. Several countries had an obvious decline in firearm suicides: Norway, United Kingdom, Canada, Australia, and New Zealand. Multilevel modeling of longitudinal data confirmed the effect of the proportion of households owning firearms. Legislation and regulatory measures reducing the availability of firearms in private households can distinctly strengthen the prevention of firearm suicides" - abstract.
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Elderly Suicide
National Guidelines for seniors' mental health:The assessment of suicide risk and prevention of suicide, May 2006 (Canadian Coalition for Seniors' Mental Health, 34 pages)
Manthorpe, J., & Iliffe, S. (2006). Suicide among older people. Nursing Older People, 17(10), 25-29.
King's College, London
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Media Reporting
Pirkis, J., Blood, R. W., Beautrais, A., Burgess, P., & Skehan, J. (2006). Media guidelines on the reporting of suicide. Crisis : the journal of crisis intervention and suicide prevention, 27(2), 82-87.
Examines media guidelines in various countries, and evaluates their effectiveness
Romer, D., Jamieson, P. E., Jamieson, K. H. (2006). Are news reports of suicide contagious? a stringent test in six U.S. cities. Journal of Communication, 56, 253.
University of Pennsylvania
"The results support theories of media contagion but also suggest that media depiction can inhibit suicide among some audience members."
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Prison Suicide
Pratt, D., Piper, M., Appleby, L., Webb, R., & Shaw, J. (2006). Suicide in recently released prisoners: a population-based cohort study. Lancet, 368(9530), 119-123.
Centre for Suicide Prevention, University of Manchester, UK
"Recently released prisoners are at a much greater risk of suicide than the general population, especially in the first few weeks after release. The risk of suicide in recently released prisoners is approaching that seen in discharged psychiatric patients. A shared responsibility lies with the prison, probation, health, and social services to develop more collaborative practices in providing services for this high-risk group" – from abstract.
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Youth Suicide
Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47(3-4), 372-394.
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, USA.
Review examining the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior.
Horowitz, J. L., & Garber, J. (2006). The prevention of depressive symptoms in children and adolescents: A meta-analytic review. Journal of Consulting and Clinical Psychology, 74(3), 401-415.
Vanderbilt University, Nashville, USA.
"Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention" – from abstract.
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By their own young hand: deliberate self-harm and suicidal ideas in adolescents by Keith Hawton and Karen Rodham, with Emma Evans, Jessica Kingsley Publishers, London, 2006 (264 pages) US$34.95
Written by leading experts from the Centre for Suicide Research, University of Oxford, this book explores the findings of the first large-scale survey of deliberate self-harm and suicidal thinking in adolescents in the UK, and draws out the implications for prevention strategies and mental health promotion.
Part one looks at the nature of deliberate self harm in adolescents, and part two looks at prevention and treatment.
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By Lucia Tibre, SPINZ Resource Co-ordinator/Community Liaison
In many countries there are restrictions (respected or not) on media reporting of suicide. But there exist very few legal, technical or financial obstacles to those who wish to provide the millions of internet users with detailed information on how to complete suicide (Mehlum).
Searching the Internet using search term such "suicide" opens thousands of sites. Keith Hawton and Kathryn Williams group them into four categories (Hawton 2005).
The first category is concerned with provisions of constructive and useful information aimed at providing greater understanding of the reasons for suicidal behaviour.
The second category provide advice and information for people seeking help with dealing with suicidal thoughts.
A third category is the "chat rooms" (allowing discussions between individuals) or newsgroups (enabling people to post messages on electronic news boards to which anybody may respond).
Finally, there are sites that encourage suicides and/or provide instructions on suicide methods.
For many people, especially for those concerned with self help, the internet sites that offer quality, constructive, research-based information about risk factors, protective factors, advice and information for people seeking help in dealing with suicidal thoughts may be helpful. But for people who enter sites encouraging suicide, the risk may be increased, either directly or indirectly.
Directly, such as by providing information about choice of methods or by putting suicidal individuals in touch with each other as a means of supporting and encouraging suicidal impulses. Or, indirectly, by exposure to their content. It is likely that isolated individuals are more vulnerable to such influences from the internet (Hawton, 2005). This may come about because these particular sites may present suicide as a solution, rather than encouraging help seeking or problem solving.
Lars Mehlum (2000) was the first to report about the relationship between the Internet, suicide and suicide prevention. He used the example of a famous Norwegian case where two people (a 17 year old girl from a town in the southern part of Austria and a man in his twenties from a town in western Norway) made contact through one of several Internet discussion groups on the subject of suicide. They met and ended their lives on the West Coast of Norway.
Two years later, in 2002, the German Society of Suicide Prevention chose the theme "New media and suicidality" for their biannual meeting. Good opportunities in suicide prevention came out of it: email, chat and SMS counselling, websites in the form of a suicide prevention program, online-therapy, antidepressive psychotherapy via the internet (Bronisch, 2004).
"If used appropriately, the internet is a powerful communication tool that can be used to benefit suicidal patients”"(Adekola).
References:
Adekola, O. A., Soderberg, M., Pohl, E. L., & Alao, A. L. (2006). Cybersuicide: review of the role of the internet on suicide. Cyberpsychology and Behavior, 9(4), 489-493.
SUNY Upstate Medical University, Syracuse, New York.
Bronisch, T. (2004). Book review of: New media and suicidaity: perils and possibilities of intervention (2003) / Etzersdorfer, E., Fiedler, G. and Witte, M. (eds.), Goettingen: Vandenhoeck & Ruprecht, in Archives of Suicide Research, vol. 8, number 4, 2004 (no English translation of book at time of review)
Hawton, K. & Williams, K. (2005). Media influences on suicidal behaviour: evidence and prevention , ch. 17 in Prevention and treatment of suicidal behaviour: from science to practice / edited by Keith Hawton, Oxford University Press
Mehlum, L. (2000). The internet, suicide, and suicide prevention. Crisis, 21(4), 186-188.
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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.
To order New Zealand Suicide Prevention Resources click here
