Dunne: Australian National Suicide Prevention Conference
Hon Peter Dunne
Associate Minister of Health
Address to the
Australian National Suicide Prevention Conference
Friday, 12 October 2012
And thank you for inviting me to speak to you today.
I appreciate this opportunity to share with you New Zealand’s experiences in suicide prevention.
Indeed, it is particularly timely, given that it is Mental Health Awareness Week at present.
I believe that together we can be successful in reducing the number of Aussies and Kiwis who die as a result of suicide and that is a goal worth pursuing on both sides of the Tasman.
All of us here today are evidence of the important theme of this conference – we are all ‘bringing it together’.
We have speakers from Australia, New Zealand, the United States, and the United Kingdom.
We have researchers, policy makers, community representatives, service providers, and people who have personal experience of suicide in their own lives.
This group is a good illustration of the reality that suicide affects us all, and knows nothing of national boundaries.
In coming together to share our experiences, knowledge and ideas we are taking an important step in tackling suicide in our communities.
Suicide can affect any of us.
Gender, race, age, sexuality, religion, income – suicide does not discriminate.
As such, any attempts to prevent suicide in our communities need the support of everyone.
While governments can put suicide prevention on their agendas, and that is fine, real change will occur only when there is full community support.
Families, friends, workmates, church groups, book clubs, community groups, rugby clubs, and organisations like your Suicide Prevention Australia, all need to ‘bring it together’ to ensure suicide prevention is on everyone’s agenda.
Collectively these groups can make a real effort to prevent suicide in our countries.
This morning, I would like to talk about New Zealand’s suicide rates, the action we have taken so far to address these, and the future directions of suicide prevention in New Zealand.
The situation in New Zealand
My starting point is stark - we have some work to do in New Zealand.
In August, our Ministry of Health released our 2012 suicide figures, which showed that overall we are sustaining patterns of decline.
Since the peak in the late 1990s, suicide rates have decreased by 23.6 percent.
This is good news and cause to reflect and build on the successes we have had in achieving this result.
But our suicide rates are still too high.
In 2010, 522 New Zealanders died by suicide.
That is 11.5 deaths for every 100,000 people – and about twice the number that die on our roads annually.
Of particular concern are young people.
For every 100,000 young New Zealanders – those between the ages of fifteen and twenty-four – 17.7 died as a result of suicide.
Yes, we have seen improvement since the 1990s, but our youth suicide rates are still among the highest for OECD countries.
We need to continue to work to get these rates down.
New Zealand also needs to address the issue of suicide in our Māori communities.
There were 104 Māori suicide deaths in 2010, 16 deaths for every 100,000 New Zealanders.
Twenty percent of all who die by suicide in New Zealand are Māori, yet they make up only around 14 or 15 percent of our overall population.
Even more concerning is that Māori youth suicide rates are 2.5 times higher than those for non-Māori youth.
These numbers are concerning, especially given that the decreases seen in overall New Zealand suicide rates are not reflected in corresponding decreases in Māori suicide rates.
For Māori, culture is a strong source of identity, and a positive attitude toward this identity is important for wellbeing.
Links between whānau (family), iwi (tribe), and hapu (a smaller, sub-tribe) are important in addressing Māori suicide prevention, as is acknowledging the importance of whakapapa, that is genealogy and family history.
However, it is important to remember that the reasons for Māori suicide are complex, just as they are for non-Māori, and there is no single solution that will reduce the rates of suicide in the Māori community.
Suicide Prevention Strategy and Action Plan
The New Zealand Government’s approach to suicide prevention is set out in the New Zealand Suicide Prevention Strategy 2006–2016 and the New Zealand Suicide Prevention Action Plan 2008–2012 (the Action Plan).
The Action Plan brings together activity across a range of government agencies and includes goals and actions that, combined, are likely to prevent suicides.
It spells out how each action will be achieved, which agency is responsible for it, and when it will happen.
Clear goals, and actions to achieve them, have been important in the progress we have made so far.
The Action Plan and the Suicide Prevention Strategy reflect that suicide is on the agenda of a number of Ministers across government.
I chair a Ministerial Committee which oversees the implementation of the Strategy, and includes Ministers holding portfolios such as Social Development, Police, Education, Corrections, Justice, Health, Māori Affairs, and Pacific Island Affairs.
By working in these areas we can make a practical difference for communities, families and individuals who are grappling with suicide and suicidal behaviour.
The Ministerial Committee is supported by an inter-agency committee, which brings together officials from a wide range of government departments.
This collective approach allows for different perspectives to be brought forward, discussed, and acted on.
It supports government agencies to work collaboratively to develop policy, to fund complementary initiatives, avoids the duplication of costs, and ultimately helps to deliver better public services.
These committees show the importance of sharing knowledge and working together to prevent suicide in our communities.
Current Suicide Prevention Initiatives
People usually take their own lives as a result of a complex range of factors.
Because these risk factors are so wide-ranging, actions to prevent suicide need to be similarly wide-ranging.
They need to have multiple components and work at the level of individuals, as well as at a population-wide level.
I would now like to take the opportunity to discuss a number of innovative initiatives underway in New Zealand to ensure this multi-level approach.
We know that mental illness is a strong risk factor for suicide, and we are working to address this.
The National Depression Initiative is a campaign aimed at reducing the impact of depression on the lives of New Zealanders.
It focuses on aiding early recognition, appropriate treatment and recovery.
An important and successful part of this programme is The Lowdown, a website that provides information and fact sheets for young people suffering from depression.
It allows them to access help by phone, email, text, and instant messaging.
Another website, The Journal, provides a self-help programme to coach those with depression and help them develop the skills they need to get though.
Together, these initiatives show the importance of using new technologies to reach the public – and especially young people – and reduce the impact mental illness has on our population.
A particular success has been the Like Minds Like Mine campaign, which aims to reduce the negative perceptions, stigma, and discrimination associated with mental illness.
Through this campaign we aim to remove one of the biggest barriers to recovery, and make sure that people are not afraid to ask for help, nor provide help.
Surveys carried out during the implementation of the programme have shown positive changes in people’s perception and understanding of mental illness.
De-stigmatising mental illness in our communities is no easy feat.
Maintaining the momentum of these changes is crucial if we are to have the support of all New Zealanders in preventing suicide in our communities.
A person’s first contact with the health system is often through the primary care system.
Therefore, we have a significant focus on making primary mental health services and resources more accessible.
Increased funding has allowed greater access to talking therapies and co-ordinated packages of care for patients.
Since February 2011, people with mild and moderate mental health problems have also been using e-therapy tools, such as the computerised cognitive behavioural therapy tool, Beating the Blues.
In helping people in the primary care system we can ensure New Zealanders have the support they need early on.
Another area of innovation is the Kia Piki te Ora National Suicide Prevention Programme, which promotes health and wellbeing of Māori.
It focuses on community action to improve the co-ordination and delivery of services to improve the mental health of those in the Māori community.
It includes training and resource development to improve the knowledge and skills of the community and workforce.
Providers have also worked together to create Te Whakaururoa, a resource designed to help Māori communities prevent suicide.
Kia Piki te Ora is important in engaging our communities with suicide prevention, and working to reduce suicide rates in our Māori communities.
It is important to ensure people have correct and helpful information about suicide.
Suicide Prevention Information New Zealand provides a national service by making suicide information accessible for the public.
Similarly, the Government funds training programmes to increase mental health and suicide prevention literacy.
Mental Health 101, a mental health literacy programme, aims to increase knowledge about mental health, and reduce the stigma associated with it.
Mental Health 101 targets frontline workers, such as primary health care providers and non-governmental organisations, especially Māori and Pacific organisations.
Applied Suicide Intervention Skills Training, ASIST, is a skills-based workshop that equips people for ‘suicide first aid’.
This programme focuses on increasing awareness of signs of suicidal ideation and behaviours.
It is particularly aimed at those who are often in contact with vulnerable people, such as nurses, social workers, youth workers, and teachers.
The programme is also delivered in both English and Māori.
Similarly, the Department of Corrections has undertaken staff training to help prison staff identify signs of suicidal behaviour among prisoners.
These training and information programmes are crucial in increasing the public’s understanding of mental illness to ensure communities, families, and organisations can support each other and reduce our suicide rates.
Our Government is also working to ensure we have effective postvention initiatives in place.
Victim Support provides immediate 24/7 practical and emotional support for people who have been bereaved by suicide.
We fund a National Community Postvention Response Service that provides professional postvention support for communities affected by suicide contagion or ‘clusters.’
Psychologists, nurses, social workers, and cultural advisors with experience in suicide prevention and postvention provide support to communities.
The goal is to build local capacity to respond to suicide safely and effectively, and to reduce further suicide contagion.
This service is important in ensuring that communities have the right strategies in place to work with each other and non-government agencies, supported by local government agencies, to prevent suicide.
The Ministry of Education has also developed resources and held workshops for schools and early childhood centres in responding to emergencies and traumatic events.
They provide the Traumatic Incidents Response Service to help schools create response plans and teams following a traumatic incident.
These initiatives show the cross-government approach being taken.
We have also taken significant steps to promote good media practice in the reporting of suicide.
The Ministerial Committee reviewed how the media reported suicide.
As a result, I convened a special Roundtable that included media and mental health professionals to develop a single set of guidelines for reporting suicide.
That resource provides guidance on good practice in the media, including print, television, film, radio, and the internet, and has now been adopted by our main news agencies in New Zealand.
In working with the media to ensure the safe reporting and portrayal of suicide we can have an influence on New Zealander’s perceptions and ideas about suicide.
Integral to informing action to prevent suicide is the availability of good data.
Last month our Chief Coroner, Judge Neil MacLean, released provisional suicide data for the 2011/12 year.
After the Coroners have finished their investigations, the Ministry of Health compiles suicide statistics in the annual publication ‘Suicide Facts and Intentional Self-harm Hospitalisations’.
As I mentioned earlier, it was not until August this year that we were able to publish this data for 2010.
This lengthy process can be frustrating at times.
I understand that a similar situation exists in other countries, including Australia.
However, since 2009 the Coronial Services Unit and the Ministry have worked together to improve their data-sharing arrangements.
This means that the Ministry can now access more in-depth coronial data sooner.
Similarly, I understand that the Australian Bureau of Statistics and the National Coronial Information System (NCIS) have been working together to make improvements in this regard.
These improvements show the importance of different government agencies working together to understand suicide in both our countries.
They are a positive step forward in the commitment to effective suicide prevention.
New Zealand and Australia are already taking steps to work together in suicide prevention.
Our similar coronial systems and centralised data collection agencies mean we have similar suicide data collation processes.
The New Zealand Coronial Services Unit and the Australian National Coronial Information System are increasingly sharing information.
With the help of the Ministry of Justice, New Zealand coronial data is being added to the Information System.
We are working to ensure that New Zealand data is compatible with Australian data.
Based on our collaboration so far, and many of the similar issues we face, I trust that we can continue to work together in this area and others to help prevent suicide on both sides of the Tasman.
Finally, a process is under way across our government structures to develop a new Suicide Prevention Action Plan for the next four years.
A new, refreshed focus on suicide prevention will help to maintain the momentum in this area and build on gains made over the past 15 years.
The importance of partnerships will be key in underpinning this new action plan.
As I have said, government cannot do it by themselves.
Communities and families have an important role to play.
Some of the most effective prevention methods are strong friendships, healthy, supportive family relationships, and a person’s belief in a positive future.
I understand that Australia has been successful in encouraging communities to get involved in suicide prevention, and highlighting suicide as everyone’s business.
I believe that New Zealand and Australia can learn a lot from each other about the approaches that different communities have taken, and I hope that we can work together to ensure the wellbeing of all communities in our two countries.
Prime Minister’s Youth Mental Health Project
The New Zealand Government knows we need to focus on our young people.
One in five young people will be affected by some form of mental illness in their lives.
In 2010, 113 young New Zealanders died by suicide.
The Government can, and is, playing a key role to ensure that young people are able to lead healthy and fulfilled lives.
Integral to achieving this is the Prime Minister’s Youth Mental Health Project, announced in April this year.
As part of this project, the Government has dedicated $62 million over four years to 22 different initiatives across a number of government agencies.
The project focuses on four key areas to make a difference for young people – in schools, online, among families and communities, and in the health system.
Schools in the three lowest socio-economic stratas in our decile one to ten system will have extra nurses working in them, and many will have youth workers alongside them.
In the online realm, the Government is implementing a number of youth-friendly websites to communicate with our young people, and has dedicated $2.7 million over four years to e-therapy.
To help families and communities tackle suicide, the Government has set up a contestable fund for non-government organisations to provide young people, and their friends and family with the information they need to get help.
The project also uses Whānau Ora, a holistic family and community Māori-centred approach to wellbeing, to help our rangatahi – young people.
Healthcare is also a crucial piece of the puzzle.
The Government has committed $11.3 million to primary mental health care to ensure young people get the support they need.
To make sure vulnerable young people do not fall through the cracks, we are working with child and adolescent mental health services so that our kids get follow-up care.
A review of alcohol and drug education programmes is also under way to make sure that they are having a positive effect in teaching our young people the harm these substances can have.
Together, all of these initiatives will have a positive impact young New Zealanders.
These programmes will not be a quick fix, but they are positive steps – steps closer to a happier and healthier New Zealand.
‘Indirect’ Suicide Prevention
These initiatives give you an idea of the suicide-specific prevention initiatives we have in place in New Zealand.
However, I would now like to talk briefly about a broader range of government policies and programmes.
These are not designed specifically or solely for the purposes of preventing suicide, but they address the same kinds of risk and protective factors.
These programmes have the potential to make an important contribution to suicide prevention.
To be effective in preventing suicide in our societies, we need to minimise the influences that make our people more vulnerable to mental illness and suicide – unemployment, alcohol and drug abuse, lack of education, and childhood vulnerability.
The Government has significant initiatives under way in each of these areas.
We expect that collectively these will make a significant contribution to addressing suicide.
We are reforming the welfare system to reduce welfare dependency and support unemployed New Zealanders to be ready for work.
This reform has a particular emphasis on young people, with a focus on encouraging them to stay in education or training.
For example, the system rewards youth service providers who help young people get into work, education, or training.
Young people themselves will be provided with incentives to attend parenting and budgeting courses.
Such initiatives will ensure young people have the support to remain engaged with their futures and communities.
We are also focusing on reducing alcohol abuse, a significant risk factor for suicide.
The Alcohol Reform Bill, currently before Parliament, aims to promote the safe and responsible sale, supply, and consumption of alcohol, and minimise alcohol-related harm.
The Bill sets out a number of measures to support this objective.
These include restricting supermarkets and grocery stores to displaying alcohol in a single area that is outside the normal thoroughfare of the store, strengthening rules on the types of retail outlets allowed to sell alcohol, and introducing maximum trading hours for licensed premises.
We have also been running a nationwide advertising campaign, ‘Ease up on the drink’, to reduce alcohol-related harm, and work is under way with the wider health sector to encourage greater use of alcohol screening and brief interventions in primary care and emergency departments.
While not specifically designed for suicide prevention, these changes will be significant in targeting alcohol as a risk factor.
To achieve earlier prevention, the Government released yesterday a White Paper on Vulnerable Children focused on making sure all children in New Zealand can thrive, belong, and achieve.
The White Paper sets out ways to deal with the problems that vulnerable children in New Zealand face, and follows a substantial public consultation process in which nearly 10,000 New Zealanders shared their views.
Two days ago, I announced details of our legislation to be introduced later this year to prevent the sales of the so-called “legal highs”, psychoactive substances, synthetic cannabinoids and the like, which will require all such products to be tested for their safety in a regime akin to that for the registration of new medicines before they are allowed to be sold under restricted circumstances in retail outlets.
These are all steps to help our young and most vulnerable.
Together, they will all help reduce our suicide rates through giving all children a positive start to life.
Together, each of these initiatives will undoubtedly have an impact on the wellbeing of New Zealanders by reducing the underlying risk factors for suicide.
This shows the importance of a holistic approach to suicide prevention, and shows the Government’s commitment to ensuring the wellbeing of its people.
There is no denying that preventing suicide is a ‘thorny issue’ and one of the toughest endeavours a country must undertake.
There is no ‘quick fix’, no ‘one size fits all solution’.
It might be complex and challenging, but this provides compelling reasons to get involved and find solutions.
As a government, we owe it to our people to address this matter wholeheartedly and with absolute determination and commitment.
As family members, we owe it to our parents, brothers, sisters, children, and grandparents to offer a helping hand if we see people struggling.
As communities we need to look around, and ask what we can do to help those around us.
Because that, in the end, is what will make a difference – the support and commitment of all New Zealanders and all Australians.
Only by ‘bringing it together’ are we likely to make a difference to the number of lives tragically lost to suicide each year.