Issue 13
| SPINZ news |
In this issue:
- Suicide Prevention Action Plan 2008 to 2012 released
- Irish Minister for Mental Health and Disabilities visits SPINZ
- New Zealand news
- New Zealand research
- International research and resources
If you would like a copy of any of the resources or research articles listed, for your personal research, please make a request through our information service. In some cases a charge may apply due to interloan costs. Email info "at" spinz.org.nz, ph 09 300 7035.
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Suicide Prevention Action Plan 2008-2012 released
There is no quick fix in suicide prevention. Rather it requires long term and co-ordinated action across society. This is the message of a new Suicide Prevention Action Plan released on 17 March.
Background: The New Zealand Suicide Prevention Strategy 2006-2016
The New Zealand Suicide Prevention Strategy 2006-2016 (the Strategy) was launched in 2006. It provides a national framework for suicide prevention and has the following seven goals:
- Promote mental health and well-being, and prevent mental health problems.
- Improve the care of people who are experiencing mental disorders associated with suicidal behaviour.
- Improve the care of people who make non-fatal suicide attempts.
- Reduce access to the means of suicide.
- Promote the safe reporting and portrayal of suicidal behaviour by the media.
- Support families/whþnau, friends and others affected by a suicide or suicide attempt.
- Expand the evidence about the rates, causes and effective interventions.
The New Zealand Suicide Prevention Action Plan 2008-2012
The New Zealand Suicide Prevention Action Plan 2008-2012 (the Action Plan) builds on the Strategy and provides more detail about how the high level goals of the Strategy can be achieved over the next five years.
The Action Plan is made up of two companion documents, which are best read together.
- The Summary for Action outlines what the actions are, who will do them and by when.
- The Evidence for Action discusses the evidence and context underlying the actions.
No single initiative on its own will lower the rate of suicide. Rather an approach is needed that involves many initiatives at different points in the continuum and in a variety of sectors.
New Zealand already has a range of initiatives underway contributing to suicide prevention, and there are many people with expertise and commitment working across the country - researchers, policy makers, funders, community organisations and professional groups. The Ministry of Health will continue to be the government agency responsible for the co-ordination of suicide prevention activities.
Examples of current suicide prevention initiatives
- Raising awareness about depression and encouraging help-seeking
- Improving the care and follow-up of people who have made a suicide attempt
- Reducing the risk of suicide for at risk children and young people
- Supporting families, friends and communities following a suicide
- Professional development for teachers to improve the mental health of the whole school
- Improving co-ordination of suicide prevention activities within district health board regions
- Providing information about suicide and suicide prevention
- Maori community development for suicide prevention
- Skills-based training in suicide intervention
While it is important that communities are involved and committed to suicide prevention, it is also essential that all activities are safe and guided by evidence. That is why considerable effort has been put into producing The Evidence for Action, which ensures the actions in the companion document The Summary for Action are evidence-based.
It is encouraging to know that New Zealand's suicide rate has reduced by about 19 percent since the late 1990s, but there are still too many New Zealanders taking their own lives and still much more we need to do. The Strategy and the Action Plan together will help us work together and know where to target out efforts.
The Action Plan is available online and hard copies are available from SPINZ at info "at" spinz.org.nz
Contributed by Jenny Skinner, Analyst Non Communicable Diseases Policy, Population Health Directorate, Ministry of Health.
Read Hon Jim Anderton's speech at the launch of the Action Plan Monday 17 March
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Irish Minister for Mental Health and Disabilities visits SPINZ
Pictured from left: Minister Jimmy Devins; Merryn Statham, Director of SPINZ;
Sonja Tepavac, SPINZ Development Manager; Rodney Walshe, Honorary Consul General for Ireland
In March, SPINZ were delighted to have a visit from Dr Jimmy Devins, T. D. Dr Devins is the Minister for Mental Health and Disabilities, in Ireland. He was accompanied by the Honorary Consul General of Ireland, Rodney Walshe.
The Minister was in New Zealand to meet with various health officials with a view to progressing models of community care for those experiencing mental illness. Dr Devins also has a particular interest in suicide prevention and wanted to see how the SPINZ service operated.
When he arrived at the Mental Health Foundation on Friday afternoon, the organisation was in celebratory mode with a farewell for a staff member who is having a baby. They joined in the celebrations and we shared a mihi and a waiata before we left to have a focused discussion session about suicide prevention and show him our resources.
Dr Devins spoke about the recent increase of young male suicide in Ireland and the comparison of budgets and suicide prevention infrastructure in our respective countries. He was particularly impressed by the National Depression Initiative and Like Minds Like Mine television advertisements. We described the recent launch of the Low Down website as part of an initiative to reach young people through use of the internet.
One of the other challenges the Minister described was that of how best to engage those bereaved by suicide in safe and effective activities. He talked about the concerns he had about some of the approaches taken by bereaved people after a suicide. This is a shared issue across countries. One of the examples he gave was of the setting up of local help lines after a suicide or suicides. These were staffed by well meaning but untrained volunteers and over a short space of time, became unsustainable. This created frustration in communities about a perceived lack of support from government agencies.
We discussed the use of well developed resources to engage communities before suicide behaviour occurs. This increased the connection to current policies and best practice, connected people and services and could improve the sustainability of any activities undertaken through a more careful considered course of action.
The Minister was bid farewell with a large bundle of resources as examples to take back to Ireland. He was extremely grateful for these and the time he had spent with us.
Contributed by Merryn Statham, Director of SPINZ
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Deliberate Self-Harm Among Adolescents
The Director of the Centre for Suicide Research at the University of Oxford, Professor Keith Hawton visited New Zealand recently on a lecture tour. He talked about deliberate self-harm in adolescence with Kathryn Ryan on Nine to Noon, Radio NZ National, Tuesday 26 Feb.
Hear audio (20 minutes)
Media release, University of Otago, Christchurch
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NZ Ministerial Committee on Suicide Prevention
Terms of Reference and latest meeting minutes now on Ministry of Health Suicide Prevention website.
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Postdoctoral Fellowship: The importance of culture in indigenous mental health
"Dr Lynne Pere from the Health Services Research Centre at Victoria University of Wellington plans to investigate the influence of culture on the meanings that indigenous peoples from New Zealand, Australia and Canada, who have experienced mental illness, impart to their illness."
Read more - Health Research Council Panui
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School-Based Health Teams Equipped To Deal With Self Harm
"With concerns over the escalating numbers of North Island high school students presenting with self-harm behaviours, Waikato Primary Health launched a pilot scheme in three Waikato high schools aimed at supporting the school-based health team. The 'Secondary School Targeted Staff Support Programme' was developed by a consultant clinical psychologist and implemented in Terms 3 and 4 of 2007."
Read more
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2008 Postgraduate course: Suicidal behaviours, research and prevention, second semester, University of Otago at Christchurch, convenor Associate Professor Annette Beautrais
Read more
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Award for Associate Professor Annette Beautrais
The American Foundation for Suicide Prevention has awarded its 2008 Research Award to from the University of Otago, Christchurch in recognition of her contributions to suicide research. It will be presented at the AFSP's annual fundraising dinner in New York in May.
Read more in Otago University Bulletin, 20 March, page 10.
"Suicide prevention and supporting families" presentation from Associate Professor Annette Beautrais to Balance New Zealand Conference in November 2007 is online, link here.
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New Zealand Published Research
Andriessen K., Beautrais A., Grad O.T., Brockmann E., Simkin S., (2007). Current understandings of suicide survivor issues: research, practice, and plans. Report of the 1st International Suicide Postvention Seminar, September 8, 2006, Portoroz, Slovenia, Crisis, 28(4),211-3.
Report from the Postvention Taskforce of the International Association for Suicide Prevention (IASP)
Read abstract
Blakely, T., M. Tobias, et al. (2008). Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies. British Medical Journal, 11 pages, Health Inequalities Research Programme, University of Otago, Wellington.
"To determine whether disparities between income and mortality changed during a period of major structural and macroeconomic reform and to estimate the changing contribution of different diseases to these disparities... During and after restructuring of the economy disparities in mortality between income groups in New Zealand increased in relative terms (but not in absolute terms), but it is difficult to confidently draw a causal link with structural reforms. The contribution of different causes of death to this inequality changed over time, indicating a need to re-prioritise health policy accordingly." - from abstract
Article in full online
Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2008). Cigarette smoking and suicidal behaviour: results from a 25-year longitudinal study. Psychological Medicine, 38(3), 433-439.
"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."
Read abstract
Gallagher, L.M., Kliem, C., Beautrais, A.L., Stallones, L. (2008). Suicide and occupation in New Zealand, 2001-2005. International Journal of Occupational and Environmental Health, 14, 45-50.
Full text free online (register first - free)
A total of 2,024 suicide deaths were reviewed. Being non-waged was seen as being a risk factor for suicide and those working in farming, fisheries, forestry and the trades had higher suicide rates. The article discusses the reasons including the depressive effect of chronic pesticide exposure and toxic chemicals amongst farmers and trades-people.
Marie, D., Fergusson, D.M., Boden, J.M., (2008). Ethnic identification, social disadvantage, and mental health in adolescence/young adulthood: results of a 25 year longitudinal study. Australian and New Zealand Journal of Psychiatry, 42(4), 293 - 300.
Abstract
"Data were gathered on mental health, cultural identification, socioeconomic factors and childhood adversity as part of the longitudinal Christchurch Health and Development Study"
"Within these limitations [of the study] the present results suggest that although social adversity is the principal contributing factor leading to the higher rate of mental health problems experienced by MÄori, cultural identity may also play an important role" in "being a [protective] factor that may mitigate the effect of exposure to adversity"
Nock, M.K., Borges, G., Bromet, E.J., Alonso, J., Angermeyer, M., Beautrais, A., et al. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192, 98-105.
"The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. Interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries."
Abstract
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International Research & Resources
Kelly, C.M., Jorm, A.F., Kitchener, B.A., Langlands, R.L. (2008). Development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study, BMC Psychiatry, 8,17
ORYGEN Research Centre, University of Melbourne, Australia.
Full article online
"These guidelines will be useful in revision of curriculum of mental health first aid and suicide intervention training programs. They can also be used by members of the public who want immediate information about how to assist a suicidal person."
New from Suicide and life-threatening behavior journal (American Association of Suicidology)
In vol 38 no 1 February 2008 issue, read abstracts
Three articles on survivors and bereavement:
Johnson, J. G., Zhang, B., & Prigerson, H. G. (2008). Investigation of a developmental model of risk for depression and suicidality following spousal bereavement. Suicide Life Threat Behav, 38(1), 1-12.
Sveen, C. A., & Walby, F. A. (2008). Suicide survivors' mental health and grief reactions: a systematic review of controlled studies. Suicide Life Threat Behav, 38(1), 13-29.
"Considering specific grief variables, suicide survivors report higher levels of rejection, shame, stigma, need for concealing the cause of death, and blaming than all other survivor groups."
Cerel, J., & Campbell, F. R. (2008). Suicide survivors seeking mental health services: a preliminary examination of the role of an active postvention model. Suicide Life Threat Behav, 38(1), 30-34. "Archival data from suicide survivors presenting for treatment from 1999-2005 at the Baton Rouge Crisis Intervention Center (BRCIC) were used to examine differences in those who received an active model of postvention (APM; n=150) compared to those who received a traditional passive postvention (PP, n=206)"
Related resource:
Coping after a suicide by Families for Depression Awareness, USA, brochure online here
In vol 37, no 6, 2007
Articles on Alcohol abuse and suicidal risk
Read abstracts
Rossow, I., Ystgaard, M., Hawton, K., Madge, N., van Heeringen, K., de Wilde, E. J., et al. (2007). Cross-national comparisons of the association between alcohol consumption and deliberate self-harm in adolescents. Suicide Life Threat Behav, 37(6), 605-615.
Pfaff, J. J., Almeida, O. P., Witte, T. K., Waesche, M. C., & Joiner, T. E., Jr. (2007). Relationship between quantity and frequency of alcohol use and indices of suicidal behavior in an elderly Australian sample. Suicide Life Threat Behav, 37(6), 616-626.
Two important articles on the relationship between alcohol abuse and suicidal risk, in particular, patterns of drinking behaviour. "Overall, the findings of the [Rossow and others] study underline the importance of alcohol consumption, especially heavy drinking and intoxication, as a contributory factor to deliberate self-harm in adolescents". The differences between the heavy drinking patterns in Nordic countries compared to Mediterranean countries are also discussed. Data from schools in Australia, Belgium, England, Hungary, Ireland, the Netherlands, and Norway were surveyed, sample size 30,532.
The second article looks at 1,000 elderly Australians and alcohol abuse "the interaction between quantity and frequency of alcohol use was significant, suggesting that those who use alcohol less frequently but in greater quantities (ie. binge drinking) are more likely to have a history of suicide attempts".
Also in this issue:
Nordentoft, M., Qin, P., Helweg-Larsen, K., & Juel, K. (2007). Restrictions in means for suicide: an effective tool in preventing suicide: the Danish experience. Suicide Life Threat Behav, 37(6), 688-697.
"Restrictions on availability of household gas, with carbon monoxide content and barbiturates, was associated with a decline in the number of suicides and suicides by self-poisoning with these compounds after controlling for the effect of calendar year. Restricted access occurred concomittantly with a 55 percent decrease in suicide rate."
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In the current issue of Crisis journal (volume 29, no 1, 2008)
Read abstracts
Brian Mishara, President of the International Association for Suicide Prevention, in an editorial discusses "Reconciling Clinical Experience with Evidence-Based Knowledge in Suicide Prevention Policy and Practice" based on his previous research and also raised in his presentations to the SPINZ symposium in Wellington last year. Discusses the debate between scientific research based suicide prevention knowledge and that derived from clinical and community experiences, in particular, his crisis helpline research.
Also in this issue:
Hawton, K., Harriss, L. (2008). The changing gender ratio in occurrence of deliberate self-harm across the lifecycle: category research trends. Crisis, 29(1), 4-10.
"Statements in the research literature about the overall gender ratio for DSH across all ages, while accurate, may also be misleading. Close examination of the gender ratio at different ages reveals remarkable variation. This probably reflects the different pace of development of the two genders in early adolescence, changes in motivation for DSH at different ages, and the closer resemblance of DSH to suicide in older age groups. These findings are not only relevant to understanding the factors that contribute to DSH but also to planning clinical services to meet patients' needs across the life-cycle"
Cerel, J., Jordan, J.R., Duberstein, P.R. (2008). The impact of suicide on the family. Crisis, 29(1), 38-44.
"In this article, we review and summarize the research on the impact of suicide on individuals within families and on family and social networks"
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3rd Asia Pacific Regional Conference of International Association for Suicide Prevention, 31 Oct to 3 Nov 2008, Hong Kong
Guest speakers to include: Dr Annette Beautrais, Prof. Diego De Leo, Prof. Keith Hawton, Prof. Brian Mishara, Prof. Kees van Heeringen.
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Krysinska, K. E. and D. De Leo (2007). Telecommunication and suicide prevention: hopes and challenges for the new century. Omega (Westport), 55(3): 237-53.
Griffith University, Brisbane
"presents an overview of the wide range of telecommunication-based suicide prevention approaches. Interventions using the Internet, telephone, and videoconferencing are discussed, including crisis intervention, referral, and support, suicide risk assessment, psychotherapy for individuals at risk, and online-based suicide prevention training and education."
Read abstract
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Wyman, P. A., C. H. Brown, et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1): 104-15.
Department of Psychiatry, University of Rochester School of Medicine and Dentistry, USA
"Gatekeeper-training programs, designed to increase identification and referral of suicidal individuals, are widespread but largely untested. A group-based randomized trial with 32 schools examined impact of Question, Persuade, Refer (QPR) training on a stratified random sample of 249 staff with 1-year average follow-up. To test QPR impact, the authors introduced and contrasted 2 models of gatekeeper-training effects in a population: gatekeeper surveillance and gatekeeper communication... Skill training for staff serving as "natural gatekeepers" plus interventions that modify students' help-seeking behaviors are recommended to supplement universal gatekeeper training."
Read abstract
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SPINZ e-news is compiled by Russell Tuffery, Information Officer, Resource and Information Service, Mental Health Foundation of NZ. 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
