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1999 Suicide Statistics Lowest Since 1994

23 April 2002

The Ministry of Health says new figures released today showing a decline in suicide deaths in 1999 are encouraging but New Zealand's suicide rate is still too high.

Provisional 1999 suicide statistics for all ages show 514 people died by suicide in 1999, compared with 577 in 1998 and 561 in 1997. The 1999 total is the lowest since 1994 (512), said Ministry spokesperson Maria Cotter.

"It's encouraging to know these rates can come down but the figures are still too high," Ms Cotter said.

"Every suicide is a personal tragedy and devastates families, friends, colleagues and communities. While the decrease in suicide is encouraging, we must all try to create an environment where people are supported enough to value their own lives."

Suicide deaths have reduced among both Mäori and non-Mäori. The overall rate of suicide among Mäori was the same as for non-Mäori in 1999.

Preventing suicide and suicide attempts across all age groups is a priority under the New Zealand Health Strategy. It involves cooperative efforts from Government, service providers, communities and families.

"Suicide is not only an issue for the health system, it's an issue for New Zealand society. Although there is no one cause and no single way to address the issue of suicide, Government and the community need to continue working together to reduce and prevent suicide," said Ms Cotter.

"These latest figures still make New Zealand's youth suicide rate the highest among selected OECD countries, although international comparisons are difficult as countries have different reporting methods," said Ms Cotter.

Youth suicide rates are still significantly higher among Mäori than non-Mäori.

The New Zealand Youth Suicide Prevention Strategy involves a wide range of initiatives aimed at reducing youth suicide, with a specific focus on addressing suicide among taitamariki (Mäori youth).

This strategy, launched in 1998, is now led by the Ministry of Youth Affairs and involves a number of government agencies. Many initiatives under the strategy impact on all age groups. These include expansion of mental health services, primary health care, mental health and emergency department guidelines. Another important focus is the prevention, recognition and management of depression across all age groups.

The 1999 statistics are currently only provisional as there are a small number of outstanding deaths awaiting a coroner's finding.

"Suicide statistics take some time to collate as it is important to assign an accurate cause of death to the majority of deaths before the figures are released. We expect the youth suicide statistics for 2000 to be available around mid year."

The provisional 1999 suicide statistics are available from the New Zealand Health Information web site: www.nzhis.govt.nz


For more information contact: Zoe Priestley Media Advisor ph: 04-496-2483 or 025-277 5411 http://www.moh.govt.nz/media.html

Julie Allan Senior Communications Advisor Ministry of Youth Affairs ph: 04-914-4866 http://www.youthaffairs.govt.nz

The Ministry of Health has published a resource to help with the reporting and portrayal of suicide in the media. For copies of Suicide and the Media - The reporting and portrayal of suicide in the media, a resource contact Wickliffe Press on 0800 226 440 or see the Ministry's website under publications www.moh.govt.nz

Other contacts on suicide/suicide prevention:

Dr Peter Watson Specialist Adolescent Physician Centre for Youth Health ph: (09) 279-5110 or 021-863-426

Dr Annette Beautrais Principal Investigator Canterbury Suicide Project Christchurch School of Medicine ph: (03) 372-0408

Keri Lawson-Te Aho Researcher Suicide among Mäori ph: 025-207-1955


Suicide Facts Provisional 1999 Statistics (all ages)

For graphs to illustrate suicide statistics and more detailed information, see the NZHIS website www.nzhis.govt.nz |------------------------------------------------------------------------- -------------------------------------------------------------------------- --| |Key Points | | | |The total number of suicides has reduced to 514 from 577 in 1998 and 561 in 1997. This is the lowest total number since 1994 (512) and the lowest | |rate since 1993. | | | |Total suicide deaths and rates have reduced among males in recent years, but there has been a slight increase in numbers and rates among females. | | | |In 1999 a total of 120 young people aged 15?24 years died by suicide, compared with 140 in 1998, and 142 in 1997. Youth still have higher rates of | |suicide than other age groups. | | | |Suicide deaths have reduced among both Mäori and non-Mäori. In 1999 the rate of suicide among both Mäori and non-Mäori was almost identical (12.0 to| |12.2 per 100,000). However, Mäori continue to have higher rates of suicide among youth. | | | |The hospitalisation rate for suicide attempt and self inflicted injury in 1999/2000 has increased slightly for the total population compared to | |1998/1999 and 1997/1998 (but is identical to the 1995/1996 rate). Hospitalisation rates for youth (15-24 years) in 1999/2000 have also increased | |slightly on 1998/1999 but are lower than the 1995/1996 rate. | | | |There is some variation in regional suicide rates for the total population but there is no apparent trend. There is more variation among youth rates| |but still no emergent regional trends. | | | |The New Zealand Health Strategy has identified reducing suicide and suicide attempts across all ages as a priority health objective. | | | |Suicide prevention requires a range of interventions across a number of settings and the cooperation of Government, service providers, communities | |and families. | |------------------------------------------------------------------------- -------------------------------------------------------------------------- --|

What is the most recent data available on suicide? Provisional 1999 all ages statistics are available on the New Zealand Health Information web site: www.nzhis.govt.nz 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).

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 people died by suicide in 1999? A total of 514 people died by suicide, compared with 577 in 1998, and 561 in 1997. 383 males died by suicide, compared with 445 in 1998, and 440 in 1997. 131 females died by suicide, compared with 132 in 1998, and 121 in 1997.

What is the rate of suicide in New Zealand? The suicide rate for the total population was 12.5 per 100,000 in 1999, compared to 12.1 per 100,000 in 1990. This is the lowest rate since 1993. The rate of suicide for males was 18.9 per 100,000 in 1999, compared with 19.7 per 100,000 in 1990. The rate of suicide for females was 6.4 per 100,000 in 1999, compared to 4.7 per 100,000 in 1990.

Suicides by age group In 1999 the highest rates of suicide were among males 20-39 years (20-24 ? 41.2 per 100,000, 25-29 - 41.5 per 100,000, 30-34 ? 36.0 per 100,000 and 35-39 - 29.1 per 100,000). Among females 15-19 year olds (14.5 per 100,000) and 20-24 year olds (14.0 per 100,000) have the highest rates.

How many Mäori died by suicide in 1999? In 1999, 77 Mäori died by suicide, compared to 112 in 1998 and 103 in 1997. In 1999, 57 Mäori males died by suicide compared to 87 in 1998, 77 in 1997. In 1999, 20 Mäori females died by suicide compared to 25 in 1998, 26 in 1997. The rate of suicide for Mäori was 12.0 per 100,000, compared to the non-Mäori rate of 12.2 per 100,000. In 1999, the rate of suicide for Mäori males was 18.2 per 100, 000, compared to the non-Mäori rate of 18.4 per 100,000. In 1999, the rate of suicide for Mäori females was 6.1 per 100, 000, compared to the non-Mäori rate of 6.2 per 100,000.

How many Pacific people died by suicide in 1999? In 1999 14 Pacific people died by suicide (8 males and 6 females), compared to 24 deaths in 1998.

How has the classification of ethnicity changed? And can we still compare ethnicity data across years? In September 1995, the method 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 considered to be a more reliable method. The changes have had a major impact on the relative rates of all mortality for Mäori and non-Mäori. Ethnicity data can now only be compared as far as 1996. This is the case for all ethnic specific mortality data.

Why do more males die by suicide than females? The all ages gender ratio for suicide in New Zealand is 3:1 male suicides to every female suicide. The youth suicide (15-24 years) ratio is 2:1 males suicides to every female suicide. Research suggests that the difference in male and female suicide may be associated with choice of methods. Females, however, make more non-fatal suicide attempts.

SUICIDE ? YOUTH (15-24 years)

How many young people (15-24 years) died by suicide in 1999? In 1999 a total of 120 young people aged 15?24 years died by suicide, compared with 140 in 1998, and 142 in 1997. Of these 120 young people, 83 were male and 37 were female.

What is the rate of youth suicide (15-24 years) in New Zealand? The total rate of youth suicide in 1999 was 22.6 per 100,000 compared to 22.5 per 100,000 in 1990. The rate of youth suicide for males (aged 15?24) in 1999 was 30.6 per 100,000, compared with 38.0 per 100,000 in 1990. The rate of youth suicide for females (aged 15?24) in 1999 was 14.2 per 100,000, compared with 6.7 per 100,000 in 1990.

How many Mäori youth (15-24 years) died by suicide in 1999? In 1999, 33 Mäori young people (15-24 years) died by suicide (23 males, 10 females), compared to 43 in 1998, and 36 in 1997. In 1999, the rate of suicide for Mäori youth was 30.6 per 100,000, compared to the non-Mäori rate of 20.5 per 100,000. In 1999, the rate of suicide for young Mäori males was 42.4 per 100, 000, compared to the non-Mäori rate of 27.7 per 100,000. In 1999, the rate of suicide for young Mäori females was 18.7 per 100, 000, compared to the non-Mäori rate of 13.1 per 100,000.

Is the overall rate of youth suicide still increasing? No. The youth suicide rate has now decreased for four consecutive years. The 1999 numbers and rates are the lowest for many years. Total youth suicide deaths are the lowest since 1987 and the total rate is the lowest since 1991. Youth suicide numbers and rates have dropped for both Mäori and non-Mäori. There was a slight increase for females (due to an increase among non-Mäori females). Because suicide is, in statistical terms, an uncommon event and rates vary from year to year, it is better to look at the total pattern of suicide rates over several years.


How many people attempted suicide (1999/2000 from mid year to mid year)

All ages The rate of hospitalisation for 1999/2000 was 95.7 per 100,00, compared to 92.9 per 100,000 in 1998/1999, and 94.8 per 100,000 in 1997. In 1999/2000, there were a total of 3767 hospitalisations for self-inflicted injury compared to 3631 in 1998/1999. The rate of hospitalisation in 1999/2000 was the same as 1995/1996 (five years ago). In 1999/2000 there were 1389 male hospitalisations (rate of 70.4 per 100,000) compared to 1427 hospitalisations in 1998/1999 (rate of 73.1 per 100,000). In 1999/2000 there were 2378 female hospitalisations (rate of 121.2 per 100,000), up from 2204 in 1998/1999 (rate of 112.3 per 100,000). Among Mäori in 1999/2000 there were a total of 556 hospitalisations at a rate of 89.5 per 100,000 (213 male at a rate of 70.4 per 100,000, and 343 female at a rate of 108.0 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.

Youth (15-24 years)

Youth have the highest hospitalisation rates. The hospitalisation rate for young people (15-24 years) in 1999/2000 is 198.5 per 100,000 (1054 hospitalisations) compared to 195.2 per 100,000 in 1998/1999 (1047 hospitalisations) and 215.8 per 100,000 in 1997/1998 (1172 hospitalisations). The hospitalisation rate in 1995/1996 was 238.4 per 100,000 (five years ago). In 1999/2000 there were 356 male hospitalisations (rate of 131.4 per 100,000) compared to 402 hospitalisations (rate of 147.4 per 100,000) in 1998/1999. In 1999/2000 there were 698 female hospitalisations (rate of 268.3 per 100,000) compared to 645 hospitalisations (rate of 244.6 per 100,000) in 1998/1999. In 1999/2000, the hospitalisation rate for Mäori females was 224.4 per 100,000, lower than the non-Mäori female rate of 279.6 per 100,000. For Mäori males the hospitalisation rate was 158.6 per 100,000, higher than the non-Mäori male rate of 124.6 per 100,000).

Are there problems with the accuracy of suicide attempt data? Yes. It is important to be cautious about the interpretation of suicide attempt data. We don't have accurate data on all suicide attempts because records are only kept on those who are admitted to hospital as inpatients or daypatients. Data are not collected on people treated in Accident and Emergency 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 overdoses 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 may 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 dying by suicide, so it is important that such people get effective follow-up support and treatment.


Key points (total population): Although there is variation at the District Health Board level, no overall trend in suicide rates is apparent. Bay of Plenty, Whanganui, West Coast and Canterbury District Health Boards have suicide rates significantly higher than the national rate. No District Health Board has suicide rates significantly lower than the national rate.

Key points (Youth): While the magnitude of regional variation amongst youth suicide rates is greater, the number of District Health Boards reaching levels of significance is less than for the total population. The lower levels of significance are due to the smaller populations involved in calculating youth suicide rates. Bay of Plenty and Whanganui District Health Board have significantly higher youth suicide rates while only Auckland District Health Board had a significantly lower youth suicide rate than the national rate.

General points: Whanganui and Bay of Plenty have significantly higher suicide rates for both youth and the general population.


How does New Zealand's suicide rate compare internationally? In comparison with selected OECD countries New Zealand's 1999 suicide rates are high, particularly among youth. In 1999, New Zealand's all age suicide rates for males and females were the fourth highest among selected OECD countries. For youth aged 15-24 years New Zealand has the highest rates of suicide for both males and females among selected OECD 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. The increase in youth suicide over the last 20 years appears to be a global trend, particularly amongst developed countries.


What causes people to want to take their own life? Because each person is unique, there is no single reason why people choose to end their life. However, from research we know that there are several factors that may contribute to a person engaging in suicidal behaviour. Mental disorder, most commonly depression, appears to be the most important risk factor for suicide and suicide attempts. Research from the Canterbury Suicide Project has found that young 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 die by suicide or make suicide attempts will have one or more recognisable psychiatric disorders at the time. The most common are: depression; substance-use disorders (alcohol, cannabis and other drug abuse); and significant behavioural problems.

Are there protective factors for suicide? Research is continuing to investigate the range of factors that may have the capacity to protect people who might otherwise be at risk of suicide. Suggested protective factors 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.

Key components of suicide prevention

In the absence of conclusive scientific evidence on all aspects of suicide prevention, there is strong agreement internationally of the key components for suicide prevention. The main themes from reports and strategies on suicide prevention, both in New Zealand and internationally, state the need for a comprehensive and intersectoral approach. This approach should use multiple strategies that: address multiple risk and protective factors involve sustained action over a long period involve local, regional and national action involve action across several sectors (e.g. health, education, police, corrections, child, youth and family etc) have a wide view of prevention as requiring interventions to occur at a range of levels including the environment, whole population, specific population groups (eg, Mäori, youth, Pacific peoples, males) and individuals at risk (preferably in the context of the family/whanau) include a focus on improving data, research and evaluation.

Intervention themes

There is general agreement that a comprehensive approach to suicide prevention needs interventions to address the following eight themes: mental health promotion including strengthening social cohesion and providing supportive environments effective, accessible and responsive services for people with mental disorders or suicidal behaviours (including prevention, recognition and treatment of depression) training and skill development on suicide risk assessment and management a managed approach to media and publicity about suicide reducing access to the means of suicide management and support for families and friends following suicide.

What are some examples of where we can focus suicide prevention initiatives? The prevention, recognition and treatment of depression. Promote positive mental health in families, schools, workplaces and the community. Promote awareness of mental health issues at the community level. Improve services (both mental health, emergency and general health services). Support initiatives to reduce the stigma of mental illness (e.g. Like Minds, Like Mine campaign). Increase public understanding of what to do if someone is suicidal. Improve the support and treatment of those who have already attempted suicide, and their families and friends. 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. Support communities, families and whänau to provide emotionally safe and nurturing environments for all people, particularly children and young people. Expand family support and early intervention services to help keep children and young people safe and healthy.

A toolkit has been developed to provide guidance to District Health Boards on the most effective ways in which they can work to reduce the rate of suicide and suicide attempts in their region: www.moh.govt.nz

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 coordinated 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. >From 2001 the Ministry of Youth Affairs has the leadership role for promoting, coordinating 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.

The 2002 implementation plan will be available from May 2002 from the Ministry of Youth Affairs: Ph (04) 471-2158, Website: www.youthaffairs.govt.nz

Help Lines and Services

Refer to page 32 of the telephone book

Help Lines · Youthline · Lifeline · Samaritans

Services for emergencies · Psychiatric emergency services · Community mental health services · General practitioner · Emergency department of the local hospital

General support services · Community mental health services · General practitioner · Lesbian and gay support counselling services · Iwi and other Mäori health/counselling services · Sexual abuse counselling services · Family counselling services · Alcohol and drug services · Other specialist counselling service such as bereavement services, family counsellors, whanau support services, refugee support services etc.) · Victim support · Samaritans/Lifeline/Youthline · School counsellor · Specialist Education Services

General information for the public on mental health · The Mental Health Foundation of New Zealand, Ph (09) 630-8573, Website: www.mentalhealth.org.nz

Anyone seriously concerned about an individual's immediate safety should: · remain with them until appropriate support arrives · remove any obvious means of suicide (guns, medication, cars, knives, rope etc) · contact the nearest hospital or psychiatric emergency service.


For technical queries about provisional data contact the New Zealand Health Information Service. Website: www.nzhis.govt.nz Ph (04) 922-1800, fax:(04) 922 1897, E-mail: inquiries@nzhis.govt.nz

New Zealand Youth Suicide Prevention Strategy

To find out more about the New Zealand Youth Suicide Prevention Strategy contact: Debbie Edwards, National Coordinator, Ministry of Youth Affairs: Ph (04) 914-4863

A stocktake of initiatives that address youth suicide prevention will be available from May 2002 on the Ministry of Youth Affairs website: www.youthaffairs.govt.nz

For New Zealand Youth Suicide Prevention Strategy documents contact Wickliffe Ph 0800 226 440. E-mail pubs@moh.govt.nz

SPINZ (Suicide Prevention Information New Zealand)

For general information for the public about youth suicide and youth suicide prevention contact SPINZ: website: www.spinz.org.nz, contact: Leora Hirsh Ph (09) 638-7364, fax (09) 630-7190, E-mail: info@spinz.org.nz

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