Issue 12
| SPINZ news Summer 2007/2008 |
In this issue:
- From the 5th National Suicide Prevention Symposium
- New suicide facts released
- SF Auckland
- Report from the IASP conference 'Suicide Prevention across the Lifespan: Dreams and Realities'
- Research and resource news
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5TH National Suicide Prevention Symposium
SPINZ, in collaboration with Regional Public Health Wellington, and the University of Otago, held a symposium in Wellington, November 21 and 22. Around 180 delegates attended.
The international keynote speaker was Professor Brian Mishara.
Brian Mishara is Professor of Psychology and Director of the Centre for Research and Intervention on Suicide and Euthanasia (CRISE) at the University of Quebec at Montreal. He is also President of the International Association for Suicide Prevention (IASP).
His keynote address concerned "Challenges in suicide prevention for policy, practice and programme evaluation". Despite his subject Brian Mishara spoke to his audience in a highly personable and informative way, with some good Canadian humour.
He spoke about how suicide was different from other problems. It was a rare event, multi-determined with no simple solutions. There were, however, numerous opportunities for prevention activities. It was an important global problem, but not universally recognized, and suicide prevention is not sufficiently supported or funded (if you compare the attention given to preventing traffic accidents, terroism, homicide, wars).
Professor Mishara said lessons learned from programmes like Zippy's friends and Canada's "I'm fed up" were that good goals and well conceived programmes which proved highly popular, did not guarantee positive results.
Speaking about the use of research knowledge he referred to "relationship capital", how research carried out by their Centre in Montreal, showed that clinicians and community workers best took on new knowledge through positive relationships with the researchers themselves.
Some of his key conclusions were:
- "The evaluation of effects is useful, but it is better to link effects to process variables to better understand what is essential for the programme to be effective
- Measures of client satisfaction are great for convincing funding agencies to give money, but are useless for determining programme quality or effects
- The more homogeneous the target population and the more intense the activities, the more likely you are to identify changes in suicide rates"
Professor Mishara's presentation is available online.
He also presented at a parallel session on the second day "Helplines: what are the effective methods of helping callers in suicidal crises?" Helplines presentation.
His key findings:
- The more directive collaborative problem solving approach was related to positive outcomes
- The active listening approach is not related to positive outcomes
- Empathy, respect, supportive attitude and establishing a good contact are related to positive outcomes
The research behind this is available in Suicide and life-threatening behaviour journal, vol 37 issue 3, 2007 - for a number of articles on crisis hotlines including research by Brian Mishara. This issue is available free online.
Centre for Research and Intervention on Suicide and Euthanasia website
Pictured:The SPINZ team, with international keynote speaker, Brian Mishara (4th from left) ?
From left: Sarah Lee (this year's symposium organiser, and SPINZ workshops coordinator/Community liaison),
Magnum Tuipulotu (Community Liaison) , Merryn Statham (Director), Fiona McAlevey (Community Liaison),
Sonja Tepavac (Development Manager), Russell Tuffery (Information Officer).
Absent: Lucia Davis (Community liaison, on maternity leave)
Leading day two was an address from Associate Health Minister, the Hon. Jim Anderton, who also released the latest Suicide statistics 2005-2006, he said "This is a very important issue. It's important because five hundred lives a year - nearly ten a week - end in New Zealand through suicide. We have made progress in bringing down suicide rates from their peak in the late nineties. But there is a lot more to do.
Today I am releasing the facts that show we have a lot more to do: the latest annual suicide statistics publication, "Suicide Facts". It contains 2005 suicide data and the 2006 hospitalisation admissions for intentional self-harm data.
The document shows our suicide rate has dropped nineteen percent from the 1990s, but on the most recent figures it has stopped coming down. The figures show that the rate of hospitalisation for intentional self-harm has actually increased... A five-year Suicide Prevention Action Plan to implement the suicide prevention strategy has been developed... The Action Plan sets out the actions over the next five years; who will be responsible for leading them; and when things will get done. I expect to release it early next year."
Read the Minister's speech in full here.
Check for more presentations from the symposium at the SPINZ website. They will be loaded as they become available, and permission is granted by the presenter.
Russell Tuffery at the Symposium Resource Table
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Suicide facts 2005-2006 published
- Detailed report
- Media statement from Associate Health Minister Hon. Jim Anderton
- Mental Health Foundation media release
Ministry of Health summary: Suicide deaths in 2005
A total of 502 people died by suicide in 2005, compared with 488 in 2004. The three-year moving average rate of suicide for 2003?2005 was 13.2 deaths per 100,000 population. This rate represents a 19.0% decrease from the 1996-1998 peak (16.3 per 100,000), and continues the downward trend of recent years.
The sub-groups of the population with the highest three-year moving suicide mortality rates in 2003?2005 were males, Maori (as opposed to non- Maori), those in the age group of 15?44 years, and those residing in the most deprived areas (deprivation quintile 5).
It was also evident that Wairarapa, Northland and MidCentral District Health Boards had significantly higher suicide rates than the national average in the 2003-2005 period.
Hospitalisations for intentional self-harm in 2006
There were 5400 hospitalisations for intentional self-harm in 2006, equating to a rate of 151.7 per 100,000 population. This represents a 7.5% increase from the rate in 2005 (141.1 per 100,000 or 4,992 hospitalisations).
The sub-groups of the New Zealand population with the highest intentional self-harm hospitalisation rates in 2006 were females, Maori (as opposed to non-Maori), those in the life-cycle stage 15?24 years, and those residing in the most deprived areas (quintile five).
It was also evident that MidCentral, Canterbury, Lakes, Waikato and Otago and significantly higher hospitalisation rates for self-harm than the national average in 2003?2005.
Previous statistics
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By Richard L.A. Moss, Field Work & Admin. Support Officer - SF Auckland
SF exists to enhance the competence and resilience of families and whanau to meet the challenges of mental illness.
SF was established nationally in 1977 and there are now 21 branches all over New Zealand. At SF we understand that families and whanau can often experience grief, powerlessness and isolation when supporting someone they love with a mental illness. Our aim is to build the capacity of families to meet those challenges, maintain their own wellbeing and to support the recovery of the person experiencing the mental illness.
We are a free service and we are able to visit people in their homes or wherever they feel most comfortable. SF provides support and understanding for individual family and whanau members. Our support groups give the families opportunity to link in with other families with similar experiences in a safe environment. We provide education and Information on how a family member might better resource themselves, like skills training to deal more effectively with grief or self care and how to better understand the mental illness their loved one may be experiencing. SF has an extensive library and a bi monthly newsletter available to SF members. In the role of advocacy, SF hopes to empower families to advocate on their own behalf and to become active participants in the mental health system processes.
Families play an important role and people with a mental illness rely on family members for support. It is possible that these relationships will be some of the closest the person with the mental illness has. Families can provide a useful and valuable insight into the onset of the illness and are able to give a depth of understanding that only comes from comparing perspectives. Families provide continuity of care and support, with an in depth knowledge and unique observation of the individual. A wide range of ideas is then generated and when family involvement is successful it creates a more balanced distribution of responsibility.
SF is also nationwide, see www.sfnat.org.nz
Ph 0800 SF AUCK/09 378 9134
www.sfauckland.org.nz
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Report from IASP conference 'Suicide Prevention across the Lifespan: Dreams and Realities' by Terry Fleming, SPINZ Research Adviser
I had the privilege of attending the 24th Biennial Congress of the International Association for Suicide Prevention in Ireland earlier this year. There were several things of particular interest for communities presented there:
The importance of a caring intervention at the critical moment.
The scientific community has been finding increasing evidence for some of the work many members of the community have done for a long time. They are identifying that although depression and problems that increase peoples suicidality may continue for many years, the actual moments where people are ready to kill themselves are typically quite short. If someone can intervene at this moment, suicidal people are often pleased and very few immediately attempt to end their lives again. It was discussed that caring support and contact at these key moments may not necessarily be by highly trained therapists but maybe by friends, family, telephone counsellors or others.
The importance of often simple interventions that include a caring follow up component, after people have attempted suicide.
Many people who have attempted suicide go on to make future attempts and a few do later die from suicide, thus people who attempt suicide have been identified as an important target group to reduce deaths from suicide. One of the themes from this conference was that some quite simple approaches look like they might make a difference for people who have attempted suicide. For example:
- Problem Solving Therapy (Simon Hatcher from New Zealand is a world leader on this, and is running a New Zealand Problem Solving Therapy trial);
- Perhaps brief motivational interventions;
- Some interventions that provide a supportive, regular contact after suicide attempts -e.g. telephone calls/ home visits or even a postcard or letter soon after the suicide attempt with regular follow up contacts. The number and timing of contacts and nature of contacts do vary among different trials. For example perhaps 8 contacts were made over the 18 months following the attempt with most contacts in the first weeks and months after the attempt. The contacts were typically simple and brief friendly supportive messages and included the opportunity to access more help if required. Once these programmes of regular contacts were set up they did not necessarily need to be delivered highly professional persons, and did not need to be particularly expensive programmes.
Suicide prevention among the elderly.
Professor Brian Draper (Australia) presented an overview of suicide prevention issues among older people. He highlighted risk factors such as recent bereavement, low social support and unrecognised depression. Like suicide prevention in younger people no single strategy is likely to be successful on its own in reducing suicide among elderly people. Things that look likely to be helpful in suicide prevention include maintaining strong links between older people and their communities, support of social networks, providing transport opportunities for older people & or regular telephone or visit contacts. Other important strategies highlighted included reducing stigma and preconceptions about older people, GP and other gatekeeper training in recognition and treatment of depression, and funding of services for older people.
Innovative use of technology for suicide prevention.
International research is showing how useful interactive, evidence based web programmes can be in combating depression. New studies are exploring the role of mobile phone technologies in delivering programmes and skills.
Where these approaches do work for people this is big news in terms of suicide prevention - as it means many people can access these services if they have the technology. Once web or phone services are set up they may be provided at less cost to the consumer and to the service provider than some other options.
These types of approaches look useful for many people. There are some very solid examples including the Australian "Reach Out' programme which offers moderated chat forums, automated email responses and self directed learning programmes. Reach Out is funded and supported by private and public partnerships. Interestingly evaluations suggested that people using Reach Out became MORE likely to talk to others and more likely to seek help from professionals, they were also able to access many more hours of support/ therapy per week than they could through traditional mental health services.
A New Zealand trial of a web based programme to reduce depressive symptoms was presented by Dr Shyamala Nada-Raja. This is a 'recovery via internet from depression' programme and can be viewed at http://www.otago.ac.nz/rid/
Other highlights of the conference included new efforts which target young men in ways that are tailored to them. e.g. the Ireland campaign around 'R U Right in the head?' and positive findings of the effectiveness of strong evidence based national suicide prevention strategies.
IASP Conference website
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For copies please make a request through our information service. Email info@spinz.org.nz
For weekly email news updates subscribe to info@mentalhealth.org.nz and receive the Mental Health Foundation Resource and Information Service weekly bulletin, including SPINZ news updates. This are archived on the SPINZ website.
NEW ZEALAND
Monitoring the health of New Zealand children and young people
- indicator handbook, includes sections on risk and protective factors; individual and whanau health and wellbeing
- literature review and framework development
These reports were released at the Paediatric Society of New Zealand Conference on November 26.
Read more
Boden, J. M., D. M. Fergusson, et al. (2007). Cigarette smoking and suicidal behaviour: results from a 25-year longitudinal study. Psychological Medicine: 1-7.
From the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children (635 males, 630 females). "The findings suggest that the associations between frequency of cigarette smoking and suicidal behaviour may largely be explained by the non-observed background factors and life circumstances that are associated with both cigarette smoking and suicidal behaviour."
Abstract
Fergusson, D. M., J. M. Boden, et al. (2007). Exposure to single parenthood in childhood and later mental health, educational, economic, and criminal behavior outcomes. Archives of General Psychiatry, 64(9), 1089-95.
"The associations between exposure to single parenthood in childhood and outcomes in young adulthood may be explained by the social and contextual factors that are associated with exposure to single parenthood."
In a media release, Professor David Fergusson says: "This research adds to the growing international evidence that suggests the important factors determining a child's later development outcomes relate to the ways in which a family functions, both socially and economically?for this reason it's important that childhood policies place more emphasis on how a family functions, rather than the number of adults, as a determinant of developmental outcomes in children and young adults." This particular study looked at 950 children born in Christchurch in 1977 until the age of 16, examining the links between family history and outcomes in young adulthood between 21 and 25 years.
This study was funded by the Health Research Council of New Zealand.
Fergusson, D. M., J. M. Boden, et al. (2007). Recurrence of major depression in adolescence and early adulthood, and later mental health, educational and economic outcomes. British Journal of Psychiatry, 191, 335-42.
Using data from the Christchurch Health and Development Study concludes "The frequency of depression in adolescence and young adulthood is associated with adverse mental health and economic outcomes in early adulthood."
Abstract
Reith, D. M. and L. Edmonds (2007). "Assessing the role of drugs in suicidal ideation and suicidality." CNS Drugs 21(6): 463-72.
Dunedin School of Medicine
Abstract
Wells, J. E., L. J. Horwood, David. M. Fergusson (2007). Reasons why young adults do or do not seek help for alcohol problems. Australian and N Z Journal of Psychiatry, 41(12), 1005-12.
University of Otago, Christchuirch
"Alcohol-related problems were experienced by approximately one-third of these young adults but treatment contact for these problems was uncommon. Belief in ability to handle problems oneself was often not matched by action."
Abstract
Dominion Post editorial by Tim Pankhurst "Media can help fight this scourge", 27 November. Mr Pankhurst took part in a media panel discussion at the recent Symposium.
Read
WellElder trial commences
The Ministry of Social Development and Capital and Coast District Health Board are jointly funding the $327,000, three-year WellElder trial which will offer counselling for older people going through life changes to try and prevent the onset of more severe depression.
Read more
Depression treatment goes online
Depression treatment is moving into cyberspace in a large-scale trial by University of Otago's Injury Prevention Research Unit.
Lead researcher Dr Shyamala Nada-Raja says the 'Recovery via Internet from Depression' (RID) trial is based on an Australian-developed online programme using cognitive behaviour therapy (CBT).
"It focuses on people's thoughts, feelings and behaviour. It helps them overcome negative thought patterns and turn them around to more positive ways of dealing with life pressures."
Website www.otago.ac.nz/rid/ and Media release
Click here for more research and resource news
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SPINZ e-news is edited by Russell Tuffery, SPINZ Information Officer. Contact Russell to obtain or access any of the resources listed here or on the SPINZ website, phone 09 300 3075, fax 09 300 7020 or email info@spinz.org.nz
