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Youth Suicide Statistics

Youth Suicide Statistics

While the rate of youth suicide has decreased slightly for the third year in a row, too many young New Zealanders are still taking their own lives.

Suicide is the second leading cause of death in the 15 to 24 year age group, following motor vehicle crashes.

Provisional statistics for 1998 show youth suicide statistics are very similar to the previous two years. There were 138 young people aged between 15 and 24 years of age who took their own life. Of these, 35 were female and 103 were male. There was an increase in the number of those under 15 who died by suicide, 13 in total and, of these, nine were Maori.

In 1997, a total of 142 people aged between 15 and 24 years of age died by suicide. In 1996, the total was 143 and in 1995 it was 156.

The figures are provisional as there are still a few 1998 deaths before the coroners court. Suicide statistics can take some time to finalise because a coroner's inquiry is necessary to establish the cause of death and this can be a lengthy and complex process.

Deputy Director-General Maori Health Ria Earp said the number of young people dying by suicide was a tragedy and the Ministry was particularly concerned with the increase in young Maori taking their own lives.

Ministry senior analyst Maria Cotter said the reasons behind suicide were extremely complex.

"This means there are no easy answers. There is no one cause and no one way to address it. The community as a whole, as well as the Ministry and other agencies involved in young people's welfare, have to take ownership of the problem and work together to reduce suicide," she said.

"We all need to take responsibility to improve our own attitude and understanding of emotional problems and suicidal behaviour, to know where to seek help for someone in crisis and how to support them.

"We need to empower young people to seek help when they face emotional crisis and show them that there are positive options for dealing with problems."

Ms Earp said the Government put the New Zealand Youth Suicide Prevention Strategy into action in 1998. The Maori strategy, Kia Piki te Ora o te Taitamariki, was developed with Maori communities and complements the mainstream strategy. Such strategies are necessary to reduce the suicide rates in young Maori and young New Zealanders as a whole.

"The issue is serious and urgent. All agencies need to focus attention on reducing the rates. We need to ensure that effective approaches which support whanau and communities are maintained and actively encouraged. The loss of such potential in our young people simply must be changed," Ms Earp said.

END

For more information contact Annie Coughlan, Media Advisor, 04 496 2067 or 025 495 989. website address: http://www.moh.govt.nz/media.html

Factsheet attached. The Ministry has a youth suicide web page at the following address: www.moh.govt.nz/youthsuicide.html

Further contacts. Dr Peter Watson, Paediatrician, Centre for Youth Health, tel (09) 263-7209, fax (09) 263-7218.

Adrian Te Patu, Project Co-ordinator, Project Mana, tel (03) 379-9480 ext 756, or (03) 353-2325, or (025) 314-755. E-mail: TPAA@cpublichealth.co.nz or mana@cpublichealth.co.nz

Josie Keelan, Consultant, Rangatahi Maori Development Project, Tel 09) 307-9999 ext 6104, Fax(09) 307-9971, e-mail: josie.keelan@aut.ac.nz

Dr Annette Beautrais. Principal Investigator. Canterbury Suicide Project, Christchurch School of Medicine, PO Box 4345, Christchurch. Tel (03) 372-0408, fax (03) 372-0405, e-mail: suicide@chmeds.ac.nz

1

(Embedded image moved to file: pic19718.pcx) The New Zealand Youth Suicide Prevention Strategy

Youth Suicide Facts Provisional 1998 Statistics

(July 2000)

Key Points · Suicide is the second leading cause of death in the 15-24 year age group, following motor vehicle crashes.

· Youth suicide totals have reduced slightly for the third year in a row.

· Suicide prevention requires a range of interventions across a number of settings and the co-operation of Government, service providers, communities and families. These are outlined in the New Zealand Youth Suicide Prevention Strategy.

What is the most recent data available on suicide? · We have provisional 1998 data on all youth suicides . These figures are still considered provisional because there are a small number of deaths that are subject to coroners' findings, for which a cause of death has not yet been assigned. For this reason we are unable to say they are final. Data becomes official once it is published by the New Zealand Health Information Service (NZHIS).

· Suicide figures for those aged 25 and over are not yet available because there are still many cause of death verdicts outstanding. This means that the most recent total population figures are for 1997.

(Provisional 1998 youth/1997 all ages statistics are available on the New Zealand Health Information web site: www.nzhis.govt.nz )

How is a death deemed to be a suicide? · Only a coroner can classify a death to be a suicide. A coroner will inquire into all suspicious deaths and make the decision after they have all the facts. In some cases the inquest will be heard over a year after the death, particularly if there are other factors surrounding the death which need to be investigated first.

How many young people died by suicide in 1998? · In 1998 a total of 138 people aged 15?24 years died by suicide, compared with 142 in 1997, 143 in 1996, and 156 in 1995. · Of these 138 people, 35 were female and 103 were male.

What is the rate of youth suicide in New Zealand? · The rate of youth suicide for males (aged 15?24) in 1998 was 37.8 per 100,000, compared with 37.9 per 100,000 in 1989. · The rate of youth suicide for females (aged 15?24) in 1998 was 13.3 per 100,000, compared with 7.0 per 100,000 in 1989. · The total rate of youth suicide in 1998 was 25.7 per 100,000 compared to 22.6 per 100,000 in 1989.

What is the difference between number and rate? · The number of suicide deaths is exactly that; the actual number of people who have died by suicide. · The age-specific rate of suicide is the frequency with which it occurs relative to the number of people in a defined population. In this case, the population of 15?24 year-olds.

Figure 1: Youth suicide rates (aged 15?24), 1979 ? 98 (rates per 100,000)* (Embedded image moved to file: pic19895.pcx) **1991 rates onwards calculated with the estimated usually resident population Rates prior to 1991 calculated with the estimated defacto population.

Why do more males die by suicide than females? · The youth suicide (15-24) ratio in New Zealand is about 3 male suicides to every female suicide. This appears to be a common pattern in most countries. There are a number of theories for this pattern, for example, men tend to be more reluctant to seek help for emotional problems (or even express their distress to friends and family), they tend to use more lethal methods of suicide, and are generally more impulsive than women. · Females, however, make more non-fatal suicide attempts.

How do youth suicide numbers compare with the rest of the population? · As noted above, while we have provisional youth suicide data for 1998 we currently only have 1997 total population data for comparison purposes. · For all ages there were a total of 561 people who died by suicide in 1997. · Youth suicides represented 25 percent of total suicides in 1997, despite youth aged 15?24 making up only 14 percent of the population. Most suicides (75 percent) occur over the age of 25. · Total suicide deaths increased by 3.9 percent from 1996 to 1997. · Of all ages, the highest number of suicides for males in 1997 is in the 25?29 year age group, followed by those in the 20?24 year age group. This differs from 1996 when deaths were highest in the 20-24 age group. · For females, the highest number of deaths both in 1997 and 1998 was in the 15?19 year age group. · In 1997, the highest age-specific rate for males was in the 25-29 year age group. The highest for females in both 1997 and 1998 was in the 15-19 year age group. · In 1998, there were 13 deaths in the 10?14 age group compared with 8 in 1997. · Although males aged 80 to 85 had the third to highest suicide rate in 1997 (42.7 per 100,000), the actual numbers are low (9 deaths) compared to 70 deaths in the 25 to 29 year age group, and 60 deaths in the 20 to 24 year age group.

Figure 2: Suicide rates by age-group, 1997 (rates per 100,000) (Embedded image moved to file: pic05447.pcx)

How many Mäori youth die by suicide? · In 1998, 42 Mäori youth aged 15?24 died by suicide, compared with 96 non-Mäori. There were 13 Mäori female and 29 Mäori male deaths, compared with 22 non-Mäori female and 74 non-Mäori male deaths. · The rate of Mäori youth suicide in 1998 (39.4 per 100,000) was higher than the corresponding non-Mäori rate (22.3 per 100,000).

Figure 3: Youth suicide rates (aged 15-24) by ethnic group, 1996-1998* (rates per 100,000). (Embedded image moved to file: pic21726.pcx) *Note: 1998 data are provisional.

How many Pacific youth die by suicide? · In 1998, there were 6 male and 2 female Pacific youth suicides reported.

How has the classification of ethnicity changed? · In September 1995, the methods used for recording ethnicity for all mortality changed from a system of biological concept (50 percent or more ancestry) to one of self-identification. This was to match with census changes and is a more reliable method. · The changes have had a significant impact on the relative rates of all mortality for Mäori and non-Mäori.

Can we still compare ethnicity data across years? · No ? 1996 data was the start of a new time series for ethnic specific mortality data and is only comparable with data from 1997 onwards. · Comparison with previous years is misleading as the method of collecting ethnicity data changed part way through 1995. · This is the case for all ethnic specific mortality data, not just suicide statistics. · It is necessary to exercise caution when interpreting ethnic specific data because of variations in collection across different providers.

Is the overall rate of youth suicide still increasing? · No. The 1996 to 1998 rates are very similar and down from 1995. The 1998 rate for all females was lower than the 1996 rate, while the 1998 male rate was slightly lower than in 1997. · The Mäori rate of youth suicide for both males and females has increased from 1997 to 1998 as a proportion of total youth suicides. · Because in statistical terms suicide is a relatively rare event and rates vary from year to year, it is better to look at the total pattern of suicide rates over several years.

Why has New Zealand's youth suicide rate increased in the past 20 years? · We don't really know why. There are many factors that may have some level of influence, such as increasing rates of depression and alcohol and drug abuse, rising rates of violence and abuse, cultural alienation, changes in family structure and in society as a whole, reduced influence of religion, high unemployment, and trends towards a more risk-taking and individualistic society. There is also a greater awareness of suicide and suicide is portrayed in the media more than before. Some researchers argue that suicide has become "normalised" leading to some people perceiving suicide as an "acceptable" solution to an emotional crisis.

How does New Zealand's youth suicide rate compare internationally? · In comparison with selected OECD countries New Zealand's 1998 youth suicide rate still appears to be highest. · The increase in youth suicide appears to be a global trend, particularly amongst developed countries. · Suicide trends appear to differ across cultures, for example, while New Zealand has a high rate of young male suicide, China has a high rate for females.

(OECD countries compared with are, Finland, Australia, Canada, USA, Norway, France, Sweden, Germany Japan, UK and Netherlands.)

How accurate are international comparisons? · Comparing international rates of suicide is inherently problematic given that different methods are used to classify suicide, and because the classification of suicide is, to some degree, culturally determined.

How many young people attempt suicide? · In 1998, there were 416 male (rate of 152.5 per 100,000) and 676 female (rate of 256.4 per 100,000) hospitalisations for self-inflicted injury for the 15?24 year age group. · Male hospitalisations are slightly up on 1997 from 401 (rate of 145.7 per 100,000) and female hospitalisations are down from 779 (rate of 290.8 per 100,000). · In 1998, the hospitalisation rate for Mäori females was 217.8 per 100,000, below the non-Mäori female rate of 266.1 per 100,000. In 1998, the hospitalisation rate for Mäori males was 174.1 per 100,000, higher than the non-Mäori male rate of 147.3 per 100,000). · More females are hospitalised for attempted suicide than males. This is mainly due to females more often choosing methods such as self-poisoning, which generally are less-fatal, but still serious enough to require hospitalisation.

Figure 4: Youth (aged 15-24) hospitalisation rates for self-inflicted injury, total population by sex, 1989-1998* (rates per 100,000).

(Embedded image moved to file: pic14771.pcx)

Figure 5: Youth hospitalisation (aged 15-24) rates for self-inflicted injury, by sex and ethnicity, 1991-1998* (rates per 100,000).

(Embedded image moved to file: pic11538.pcx)

Are there problems with the accuracy of suicide attempt data? · Yes. We don't have accurate figures on all suicide attempts because records are only kept on those who are admitted to hospital as inpatients or daypatients. Statistics are not collected on people treated in Accident & Emergency (A&E) as outpatients, people treated by GPs, and those who do not seek medical treatment. · Also, changing treatment methods make comparisons across years difficult. For example improving treatments for overdose has meant more people can be treated on an outpatient basis, and will not appear in hospitalisation suicide attempt figures. · The suicide attempt data (above) are for self-inflicted injury and include cases of deliberate self-harm where the intent was not death. · Hospitalisation figures include people who are admitted more than once during that year, and also include those who died while in hospital.

What is the relationship between suicide and attempted suicide? · People who have already made one suicide attempt are at greater risk of completing suicide so it is important that such people get effective follow-up support and treatment.

What causes people to want to take their own life? · Because each person is unique, there is no single reason why people commit suicide. However, from research we know that there are several factors that may contribute to a person engaging in suicidal behaviour. · Research from the Canterbury Suicide Project in Christchurch has found that people who have died by suicide or who have made a serious suicide attempt often have shared circumstances, such as: * they have some underlying psychological distress or mental illness * they display some recognisable mental health or adjustment difficulty prior to the suicide attempt * immediately prior to the suicide attempt they may face a severe stress or life crisis that often centres around the breakdown of an emotional or supportive relationship * they tend to come from disturbed or unhappy family and childhood backgrounds * they tend to come from socially and educationally disadvantaged backgrounds.

· Research from this study also found that approximately 90 percent of people who commit suicide or make suicide attempts will have one or more recognisable psychiatric disorders at the time. The most common ones are; depression; substance-use disorders (alcohol, cannabis and other drug abuse); and significant behavioural problems.

Are there protective factors for suicide? · Yes. A range of factors appear to have the capacity to protect people who might otherwise be at risk of suicide. These include good coping skills and problem-solving behaviours, positive beliefs and values, feelings of self-esteem and belonging, connections to family or school, secure cultural identity, supportive family/whänau, hapü and iwi, responsibility for children, social support, and holding attitudes against suicide.

Where can people go for help? If you are concerned about someone who may be suicidal or is very distressed you can approach the following people for advice: · family doctor (GP) or practice nurse · community mental health service · Marae based health clinics · Mäori community health workers · counsellor (including school guidance counsellor) or Mäori health/counselling services · phone counselling services such as Lifeline, Samaritans or Youthline.

If the situation is critical try to ensure the person is safe and contact your nearest hospital emergency department or psychiatric emergency team.

How can suicide be prevented? · Just as there is no one reason which brings someone to take their own life, there is no one answer. Rather, a range of initiatives need to be in place across a number of settings supported by Government, service providers, communities and families. Such interventions are generally aimed at promoting protective factors and reducing risk factors for suicide.

What are some examples of where we can focus suicide prevention initiatives? · Support communities, families and whänau to provide emotionally safe and nurturing environments for children and young people. · Expand family support and early intervention services to help keep children and young people safe and healthy. · Promote positive mental health for young people (such as in schools). · Improve services for young people (both mental health, emergency and general health services). · Promote awareness of mental health issues at the community level. · Increase public understanding of what to do if someone is suicidal. · Improve the support and treatment of those who have already attempted suicide. · Implement measures to restrict access to the means of suicide. · Provide guidance to the media about the reporting and publicity of suicide to minimise the potential of imitative suicides. · Improve our knowledge and information systems so we can better target suicide prevention strategies for the best outcomes.

What is the New Zealand Youth Suicide Prevention Strategy? · In March 1998, the Government released The New Zealand Youth Suicide Prevention Strategy. This Strategy provides a framework for understanding what suicide prevention is, and signals the steps a range of government agencies, communities, service providers, Mäori whänau, hapü and iwi must take to reduce suicide. · Through the Strategy all suicide prevention initiatives should become increasingly co-ordinated and any service gaps identified and addressed. · The Strategy has two components. In Our Hands is the general population strategy. Kia Piki te Ora o te Taitamariki takes an approach based on whänau, hapü, iwi and Mäori community development and encourages mainstream services to be more responsive to Mäori. · The Ministry of Health has the leadership role for promoting, co-ordinating and communicating the implementation of the strategy. · A Ministerial and Inter-Agency Committee have also been formed to oversee the government-level implementation of the Strategy.

What are some key suicide prevention initiatives already in place? · Guidelines for primary healthcare practitioners on the identification and management of young people at risk of suicide have been developed by the Royal New Zealand College of General Practitioners. The guidelines were funded by the Ministry of Youth Affairs and the Health Funding Authority. · Guidelines for schools on the prevention, recognition and management of young people at risk of suicide have been published by Ministry of Education and the National Health Committee, and training is underway on these guidelines throughout New Zealand. · Guidelines for Department of Child, Youth and Family social workers on the identification and management of young people at risk of suicide have been developed to screen and assess suicide risk in young people. This is part of the Department's Youth Services Strategy. · SPINZ (Suicide Prevention Information New Zealand) is a national service, which is funded by the Ministry of Youth Affairs, and provides advice and information to the community on youth suicide and youth suicide prevention. · The Community Youth Development Fund has been established by the Department of Internal Affairs which funds 7 projects around New Zealand aimed at young people at risk of suicide. · The Crisis Response Fund (as part of the Community Youth Development Fund) has been established by the Department of Internal Affairs to support communities following a suicide. · Suicide and the Media. A Resource on the reporting and portrayal of suicide in the media has been published by the Ministry of Health. · Specialist mental health services for children and young people around the country are being expanded and will continue to grow. · Pamphlets for parents and young people (Helping Troubled Young People and Spin) on suicide prevention awareness and help-seeking for emotional problems have been funded by the Ministry of Youth Affairs. · Te Äwhina I Ngä Rangatahi e Raru nei . Pamphlets for Mäori parents, caregivers and whänau on how to encourage and support rangatahi and seek additional support for their families has been funded by the Ministry of Youth Affairs. · Family Start and Social Workers in Schools pilots are funded through the Strengthening Families programme to help address problems as early as possible. · Like Minds, Like Mine. The national programme to address stigma and discrimination associated with mental illness is being funded by the Health Funding Authority (HFA). · A Practical Guide on Coping with Suicide has been published by the Mental Health Foundation. This community resource provides information on myths and warning signs, how and where to get help, coping after a suicide, resources and background information on youth suicide in new Zealand. · Mental Health Matters, a mental health awareness curriculum for junior secondary schools, is currently being implemented in over 200 secondary schools throughout NZ by the Mental Health Foundation and is funded by the HFA. · The new Health and Physical Education Curriculum has just been revised by the Ministry of Education and includes a leaning module on mental health. · Mentally Healthy Schools is a mental health promotion initiative being piloted in schools in the Northern region schools by the Mental Health Foundation, and is funded by the HFA. · Custodial suicide prevention training is provided to Police and a new training module for Police Youth Aid Officers in now available. · Initiatives to prevent Mäori suicide in prisons are in place such as increasing whänau, hapü, and iwi contact with at-risk inmates and increasing cultural responsiveness of prisons. · Prison officers are trained in the management of suicidal inmates and have procedures to identify and monitor at risk inmates. · Youth Health Centres have been established around the country to provide youth-friendly and youth appropriate health services. · Young People and Depression is a resource for people who work with youth, such as school guidance counsellors, teachers, youth workers, and TOPS Tutors. It is published by the Mental Health Foundation and is funded by the HFA. · Guidelines for General Practitioners on the treatment and management of depression, anxiety disorders and alcohol and drug misuse have been published by the National Health Committee. · Rangatahi Mäori Development Project This project aims to increase the capacity of rangatahi Mäori to fully participate in all aspects of Mäori development (Ministry of Youth Affairs).

In summary what are the key things we need to do better to reduce the rate of youth suicide in New Zealand? · We need to support communities, families and whänau to provide emotionally safe and nurturing environments for children and young people.

· We need to empower young people to seek help when they face an emotional crisis, and show them that there are positive options to dealing with problems.

· We all need to take responsibility to improve our own attitude and understanding of emotional problems and suicidal behaviour, to know where to seek help for someone in crisis, and how to support them.

For Further Information on youth suicide or specific projects:

Statistics:

New Zealand Health Information Service, Internet: www.nzhis.govt.nz tel: Shari Mason (04) 922 1800 or fax:(04) 922 1899.

New Zealand Youth Suicide Prevention Strategy

For the Strategy documents contact the Ministry of Health, Internet: www.moh.govt.nz/youthsuicide.html; tel: Maria Cotter or Grant McLean (04) 496-2000 or fax: (04) 496-2340.

Documents/projects under the Strategy

For copies of Suicide and the Media - The reporting and portrayal of suicide in the media. A resource contact Wickliffe tel 0800 226 440.

For copies of Helping Troubled Young People and Spin, Te Äwhina I Ngä Rangatahi e Raru nei contact your local Public Health Service or the Ministry of Youth Affairs tel: Sandra Meredith or Mereana Ruri on (04) 471-2158 or fax: (04) 471-2233.

Suicide Prevention Information New Zealand (SPINZ) www.spinz.org.nz te:l Leora Hirsh (09) 638-7364, fax (09) 630-7190. E-mail: info@spinz.org.nz

For copies of Young People and Depression and A Resource for Coping with Suicide contact the Mental Health Foundation; Leora Hirsh (09) 630-8573 or fax: (09) 630-7190.

Government agency contacts on projects listed on pages 7 and 8

Ministry of Health, PO Box 5013, tel (04) 496-2000, fax (04) 496-2340 Health Funding Authority, Public Health, tel (03) 372-1000, fax (03) 372-1015; Mental Health (03) 372-3025, fax (03) 372-1015. Ministry of Youth Affairs, PO Box 10-300, tel (04) 471-2158, fax (04) 471-2233 Ministry of Education, PO Box 1666, tel (04) 471-6009 Department of Internal Affairs, PO Box 805, tel (04) 494-0587, fax (04) 495-9444 Department of Child, Youth and Family Services, Private Bag 21, tel (04) 918-9242 Department of Corrections, Private Bag 1206, tel (04) 460-3006. Police National Headquarters, PO Box 3017, tel (04) 474-9499, fax (04) 474-9428

Other contacts on suicide/suicide prevention

General

Dr Peter Watson, Paediatrician, Centre for Youth Health, tel (09) 263-7209, fax (09) 263-7218.

Adrian Te Patu, Project Co-ordinator, Project Mana, tel (03) 379-9480 ext 756, or (03) 353-2325, or (025) 314-755. E-mail: TPAA@cpublichealth.co.nz or mana@cpublichealth.co.nz

Josie Keelan, Consultant, Rangatahi Maori Development Project, Tel 09) 307-9999 ext 6104, Fax(09) 307-9971, e-mail: josie.keelan@aut.ac.nz New Zealand Researchers on suicide

Canterbury Suicide Project (Principal Investigator, Dr Annette Beautrais), Christchurch School of Medicine, PO Box 4345, Christchurch. Tel (03) 372-0408, fax (03) 372-0405, e-mail: suicide@chmeds.ac.nz

Injury Prevention Research Centre, Auckland. University of Auckland. Private Bag 92-019, Auckland. Tel (09) 373-7999, fax (09) 373-7503, e-mail: injury@auckland.acnz

Injury Prevention Research Unit, Dunedin. University of Otago. PO Box 913, Dunedin, Auckland. Tel (09) 373-7999, fax (09) 373-7503, e-mail: injury@auckland.acnz

Keri Lawson-Te Aho, Researcher, suicide among Mäori. Tel (03) 353-4370. E-mail: Te.aho@xtra.co.nz.

Updated July 2000

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