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Peter Dunne at launch of ASIST Suicide Prevention Programme

Hon Peter Dunne
Associate Minister of Health


Address at launch of Bicultural ASIST
Suicide Prevention Education Programme
Orakei Marae, Bastion Point
1pm, Thursday 11 August 2011

Kia ora Koutou.

Thank you for inviting me to be here today to celebrate developing the world’s first bicultural ASIST tool and the launch of Lifeline’s new SafeTALK campaign.

This is an exciting day for you all as it sees the culmination of a great deal of hard work!

But, more importantly your hard work will contribute to improving they way we address the issue of suicide in New Zealand.

This is crucial given New Zealand continues to experience significant harm as a result of suicide within our families, whanau and communities.

While suicide rates have declined since their peak in the late 90s, they still represent a serious loss to our society and it is vital that we do not lose sight of this or ease up on efforts to combat such tragic losses.

Sometimes, I think we do not pay sufficient heed to the incidence of suicide in our society.

More people now die each year through suicide, than on the roads, a reality not often appreciated when it comes to the level of public attention we pay to suicide.

This is a major health issue – for all of us – and we have to do all we can to ensure that, without sensationalising its impacts, our public attitudes and policy responses reflect the serious situation we face with regard to the incidence of suicide in New Zealand.

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The most recent confirmed numbers we have are for 2008, when a total of 497 people died by suicide.

82 of these people were Maori.

In 2008 the rate of suicide deaths among Maori was 13.3 deaths per 100,000 Maori which was higher than that for general population at 11.2 deaths per 100,000 people.

This difference was not statistically significant but it remains concerning to me that the Maori suicide rate is persistently higher.

Most Maori suicides are aged 15 to 45 years, with Maori men being at higher risk. We also know that in 2008 the suicide rate for rangatahi was about 70 percent higher than that of non-Maori youth.

These statistics are striking and tell us that it is essential for New Zealand to develop tools and adopt approaches for reducing our suicide rate that are culturally appropriate for Maori.

I would also like to note that while Pacific peoples do have lower suicide rates than Maori or the general population, we know that New Zealand born Pacific people have higher rates of suicide planning and attempts than Pacific people who migrated to New Zealand as adults.

In particular, Pacific young people experience very high rates of attempted suicide.

This means we must not forget about this potentially vulnerable group and continue to look at where efforts can be focussed to prevent harm in Pacific communities.

The overarching aim of the New Zealand Suicide Prevention Strategy 2006-2016 is to reduce the rate of suicidal behaviour and its effects on the lives of New Zealanders, while taking into account that suicide affects certain groups more than others.

The strategy commits the Ministry of Health to suicide prevention activities that are evidence-based, safe and effective, responsive to Maori, and recognise and reflect diversity.

Some of the work underway as part of the Strategy includes:

• establishing suicide prevention coordinators in some DHBs,

• developing suicide postvention response services,

• establishing local Child and Youth Mortality Review groups,

• a focus on addressing depression through the National Depression Initiative, which I believe has had a huge impact on how we talk about mental health issues in New Zealand

• developing Te Whakauruora, a Maori suicide prevention resource, which is proving to be successful and I know my colleague Minister Turia supports this as a particularly powerful tool

• and the reason we are here today, which is the work to adapt ASIST, a Canadian suicide prevention education model, to meet the needs of New Zealand.

I am told that Lifeline Aotearoa (previously Lifeline Auckland), has a 41 year history of experience in suicide intervention and prevention.

Through its freephone service, Lifeline offers free anonymous confidential helpline counselling services 24 hours a day, 7 days a week.

Lifeline Aotearoa also delivers ‘The Lowdown’ and ‘The Journal’ telephone, text and email services.

These are fantastic resources that are easily accessible and help to prevent and support people with depression

As such, they play an important role in suicide prevention.

The ongoing contribution of Lifeline Aotearoa’s volunteers and workers to the mental health of New Zealanders is greatly valued both by me and the Government.

As well as counselling services that address individual need, Lifeline Aotearoa also takes a population approach through the delivery of suicide prevention education, including the internationally recognised ASIST programme.

This is one of a suite of suicide prevention programmes developed by the Canadian organisation, LivingWorks Education Inc.

I understand that ASIST has had great success in a range of countries including Canada, Australia, USA and Europe, which led the Ministry of Health to contract Lifeline Aotearoa to deliver it in New Zealand.

ASIST raises awareness and promotes a community response to suicide prevention built on evidence-based approaches.

ASIST has been taught in New Zealand since 2005 and evaluation has shown that the programme enhances the skills of participants to proactively help in situations where there is an imminent risk of suicide.

The interactive two day suicide intervention skills workshop trains participants to recognise and respond effectively when there are concerns for people’s safety.

The training is provided to community groups, government and non-government organisations, whanau, hapu and iwi organisations.

These groups are commonly referred to as ‘gatekeepers’.

‘Gatekeepers’ are people who, in their day to day routine, come into contact with vulnerable populations and are in the position to respond to someone with suicide on their mind.

ASIST helps these community gatekeepers recognise when suicide is an issue and to be better able to provide assistance.

In order to maximise the benefit of the ASIST tool in New Zealand, the Ministry of Health also contracted Lifeline Aotearoa to take the international generic version of ASIST and tailor it for the New Zealand context.

The objectives for this were to:

• make ASIST culturally appropriate and relevant for New Zealand populations, in particular, for Maori and Pacific people, and

• ensure ASIST is safe, effective and evidence-based.

The adaptation project was a comprehensive exercise involving many people, including a Cultural Reference Group, a Clinical Reference Group and the project Working Group and I would just like to acknowledge the contribution and commitment of all those involved.

Cultural considerations were the driving force for the project.

Alienation from your culture can increase the risk of suicide and the opposite is also true - culture can provide a sense of belonging and self-worth that acts as a protective factor for suicide.

With this in mind, the priority areas for cultural adaptation were to:

• Include New Zealand data

• Include New Zealand language, New Zealand specific cultural references, signs and signals and reflect New Zealand’s cultural diversity

• Incorporate Maori and Pacific protocols

• Develop and use teaching methodologies suited to a variety of cultural styles of learning; and

• Recruit Maori and Pacific training facilitators.

Bicultural ASIST has been primarily adapted to meet the needs of Maori, which is important given Maori continue to have the highest rates of suicide.

It includes Maori tikanga and matauranga (knowledge) and incorporates a set of skills and a body of knowledge which Maori can make their own and apply within their own communities.

Among the improvements to the programme is a bilingual Maori and English version of the ASIST workbook.

A new cross–cultural handbook complete with New Zealand data and information will also be introduced.

One of the recommendations for implementing the programme is that ASIST training be held on marae with Kaumatua present.

This is good common sense and I expect that Lifeline Aotearoa will work hard to facilitate this.

I am advised that Lifeline Aotearoa will shortly appoint a Kaiwhakahaere or Bicultural manager, part of whose role will be to develop a Maori health plan, a bicultural policy, and also to promote services to Maori communities and agencies nationwide.

This appointment will go some way to ensuring the programme is implemented appropriately.

I am also told that Lifeline Aotearoa plan to work with Kia Piki Te Ora sites to promote the bicultural training and that they have begun a conversation with Te Wananga o Aotearoa in Mangere about training their social work students with the bicultural ASIST tool.

This is great news – it is essential for the success of any resource that the right connections are made early on so that it is actually implemented and not consigned to the bookshelf.

With the roll out of the programme about to get underway, I encourage Lifeline Aotearoa to continue to look for opportunities to work with providers and communities so that the effectiveness of the programme is maximised.

I will be watching with interest.

Taking a proven suicide prevention model, like the ASIST programme, and adapting it to make it more appropriate for New Zealand is a recipe for success.

I hope that all future ASIST trainers and trainees will be better equipped to contribute to continued reduction in the rate of suicide in New Zealand, especially among Maori.

Thank you for inviting me to be here today, I am heartened by the commitment and passion of all those who have been involved in this work.

I have no doubt that this will help to ensure the success of the programme and that the tool will play a key role in future efforts to reduce our rates of suicide.

Nō reira, tēnā koutou, tēnā koutou

Tēnā koutou katoa

Noho ora mai


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