Counting The Toll - On And Off The Road
Counting the toll - on and off the road
By Dr Rory Truell
"The road toll this holiday season is____" Sadly, the number in that sentence is reported in news bulletins as routinely as the 'outlook for Tuesday' in a weather bulletin.
Tragically at this time of year, every year, the deaths on our roads are all but an expected fact. Even with all the annual campaigns, the high impact advertising, the spending on better roading and policing, we have a long way to go to reduce the carnage that comes with combining people with cars.
What we don't hear on the radio are bulletins that begin: "The suicide toll is ...". The latest figure - released in November - put the suicide toll in 2005 at 502, while the figure for deaths on the road that year was 405.
We clearly have a long way to go in acknowledging those untold tragedies off the road, and a lot to learn about being more open as a society about the deaths that we could collectively be doing more to prevent.
In 2008 the government's programme for suicide prevention is being ramped up, and promises have been made that there will be more consistent information about people who die by suicide as well as improved gathering of information about the thousands of cases of hospitalisation for self-harm each year, a disproportionate number of whom are young women and Māori.
Politician Jim Anderton is to be commended for calling for social support structures strong enough to deliver real change and for pushing for more collaboration between organisations that had not been working together closely enough. Yet only five of the 21 District Health Boards around New Zealand will begin piloting suicide prevention co-ordinator positions in 2008 - is that going to be enough to bring real change, sooner than later?
Suicide, the intentional killing of oneself, occurs not only as a result of personal breakdown but also because of the deterioration of a person's social context - people combined with people. A good social context makes people safe, be it within an integrated extended family or a community where people watch out for one another. Safety nets that stop people falling too far at times of personal crisis.
Speaking from experience the role of the caring-services is to guide and facilitate such family and community supports and when needed offer additional expert counselling. Yet little emphasis seems to have been placed on building community responses and ensuring that the helping services work dynamically within communities to support vulnerable people.
The gaps in the caring
services and breakdown of wider community support are major
indicators as to why New Zealand has such a significant
youth suicide problem.
From a social service perspective it is not good enough for people in personal crisis to be directed to their GP as an isolated measure. Community doctors are not equipped to provide the counselling and family integration work needed to support people through a crisis. Most often a GP can only offer practical advice, medication and a referral to an under-funded counselling agency with non or semi-qualified staff. Mental health services are not resourced to provide focused care to persons until they are already an active danger to themselves, others or until the person has a chronic mental illness. Nor are those services adequately linked to community care.
When we're counting the toll at the end of 2008, a year from now, my hope is that we are talking about suicide prevention more openly, and that the suicide toll is as prominently placed on the public radar as the road toll.
* Road toll statistics
* Suicide figures http://www.moh.govt.nz/moh.nsf/indexmh/suicide-facts-2005-2006-nov07
Dr Rory Truell is head of the national industry training organisation for social services, Te Kaiāwhina Ahumahi, responsible for training people in social services. He holds a Doctorate of Health Sciences as well as qualifications in Social Work, Community Welfare, Clinical Supervision and Psychotherapy