22 November, 2007
Suicide statistics released
Suicide rates have remained stable over recent years, the latest suicide statistics published today show.
Between 2003-2005 a rate of 13.2 people in every 100,000 died by suicide compared to13.1 deaths per 100,000 people in 2002-2004. This is a decrease of about 19 percent from the 1996-1998 peak of 16.3 deaths per 100,000.
Releasing the statistics at the 5th National Suicide Prevention Symposium in Wellington today, Associate Health Minister Jim Anderton said suicide rates remained steady, but the number of people who died by suicide in 2005 was slightly higher than the previous year.
"While it is encouraging to see suicide rates have dropped since the peak in the late 1990s there is no room for complacency.
“Any suicide remains a serious concern and is a tragedy for family and friends. In 2005, 502 people died by suicide. Those who had particularly high rates were those aged between 15 and 44, along with Mâori and those living in the most deprived areas of New Zealand. Men also had higher rates than women – for every three male suicides there was one female suicide’’.
Suicide Facts:2005-2006 data shows that the rate of suicide is higher for Mâori (17.9 per 100,000) than non-Mâori (12.0 per 100,000). This disparity has increased over the past nine years.
“While fewer Mâori people died by suicide in 2005 than in 2004, the three year moving average rates - a more robust measure of what’s happening over time – show the Mâori suicide rate has increased by 5.2 percent from 2002-2004 to 2003-2005,’’ Jim Anderton said.
“I am concerned about the suicide rates among Mâori. One of three main focuses of the New Zealand Suicide Prevention Strategy is to reduce inequalities in suicide and suicidal behaviour. All Government-funded suicide prevention policies and initiatives must consider how to specifically address those groups with high rates of suicide and suicide behaviours.”
Jim Anderton said there were many causes of suicide, and therefore a range of agencies needed to be involved in its prevention.
“Collaboration – the theme for this year’s National Suicide Prevention Symposium – is essential to try to prevent and reduce the number of suicides, and lessen the impact on family and friends. For example, this means people in research, policy and service provision working together, primary and secondary health services working together, and health services and social services working together. That way, everyone’s efforts in the range of areas that are needed to prevent suicide will be more likely to make a difference ’’.
The publication shows the number of hospitalisations for intentional self harm has increased. In 2006 there were 5400 hospitalisations for intentional self-harm - the equivalent of 151.7 hospitalisations per 100,000 people. This was a 7.5 per cent increase on the previous year when there were 4992 hospitalisations (a rate of 141.1 per 100,000).
Jim Anderton said it was not known whether this represented an actual increase in the number of people being admitted to hospital who have self-harmed or if it was partially the result of better reporting methods by district health boards.
“What we do know is more females are admitted to hospital for self-harm than males – in 2006 there were two females admitted for every male. Mâori are nearly 1.5 times more likely to be admitted than non-Mâori and those who self-harm tend to be aged between 15 and 24.’’
Suicide Facts: 2005-2006 data is available on the Ministry of Health’s website: http://www.moh.govt.nz
NB: There is evidence that some types of media coverage of suicide can increase suicide rates. Responsible media reporting of suicide is encouraged. For information see Suicide and the Media: The reporting and portrayal of suicide in the media at www.moh.govt.nz/suicideprevention)
QUESTIONS AND ANSWERS
Why is collaboration, the theme of the 5th National Suicide Prevention Symposium, important for the prevention of suicide?
The causes of suicidal behaviours are broad and complex - there is never just one reason why someone takes, or attempts to take, their own life. This means that there needs to be a range of approaches to prevent suicidal behaviours, which requires collaboration and commitment from a variety of people working in many sectors. This includes collaboration with other agencies, services and institutions, for example linking up research, policy and practice. It also includes collaboration between agencies, services or institutions, for example between schools, GPs and mental health services.
What is being released at the Symposium today?
Suicide Facts: 2005–2006 data is the latest annual update of New Zealand suicide data. The previous annual publication, Suicide Facts: 2004-2005, was released in November 2006.
Suicide Facts: 2005-2006 data describes provisional 2005 suicide death data and 2006 hospitalisation for intentional self-harm events data by total population and key population groups (gender, ethnicity, age, deprivation and DHB region). It does not provide an explanation of the causes of suicidal behaviour.
What is a three-year moving average and why is it used?
Three-year moving averages are the average age-standardised rates for three-year periods (ie, 1983–1985, 1984–1986, 1985–1987 etc). The three-year moving averages are plotted on the mid-point year, for example, the 2001–2003 three-year moving average is plotted on the year 2002.
Three-year moving averages are used because rates based on individual years often contain small numbers and therefore tend to show bigger fluctuations and unstable rates. This means that three-year moving averages are more robust measures for looking at trends over time.
What is the definition of intentional self-harm hospitalisations used in Suicide Facts: 2005-2006 data?
Hospitalisation for intentional self-harm is defined as first admission (inpatient or day patient) to hospital for an intentional self-harm event. The data represent unique ‘events’ of self-harm, rather than the number of ‘people’ who have been hospitalised for a self-harm. This is because a single person could be admitted to hospital for more than one self-harm event in any given year.
In New Zealand, hospitalisation for intentional self-harm is a recognised proxy measure for attempted suicide. The motivation for intentional self-harm varies, and while hospitalisation data is unable to adequately capture those with an intent to die, it does provide a good indication of the level of serious suicide attempts.
Are there reporting differences between DHB regions?
When comparing hospitalisations for suicide and intentional self-harm by DHB region, some of the regional differences may be due to different practices in reporting and patient management. However, reporting differences for deaths by DHB is less likely because classification of a suicide death is subject to a coroner’s inquiry.
Why is there a delay in publishing suicide statistics?
Classification of a death as suicide is subject to a coroner’s inquiry, and only on completion of an inquest can a death be officially classified as suicide. In some cases the inquest will be heard two to three years after the death, and occasionally even later, particularly if there are other factors surrounding the death that need to be investigated first.
What is the explanation for the 7.5 percent increase in hospitalisations for intention self-harm events between 2005 and 2006?
It is difficult to know whether this increase represents an actual increase in the numbers of self-harm events, or is due to improved reporting by DHBs. For example, the Suicide and Self-Harm Collaborative, which is being co-ordinated by the New Zealand Guidelines Group, is an initiative to improve the acute assessment and treatment of people who self-harm and present to emergency departments. The initiative began in 2005, and half of the 21 DHBs are currently participating. One outcome of the Collaborative has been an improvement in recording practices – for example, rather than recording just the physical injuries, the participating DHBs got better at accurately recording that a self-harm event had occurred.
The report shows growing disparity in suicide rates between Mâori and non-Mâori. What is being done to address this?
It is concerning that the disparity between suicide rates for Mâori and non-Mâori has increased. The need to reduce inequalities in suicidal behaviours is one of three purposes of the New Zealand Suicide Prevention Strategy 2006-2016. All suicide prevention initiatives and services must ensure the needs of Mâori are being addressed and must demonstrate how they are appropriate and effective for Mâori.
Addressing the needs of Mâori is particularly important because Mâori also have poorer outcomes in other areas relating to suicide. For example, depression is a major risk factor for suicide. Te Rau Hinengaro: The New Zealand Mental Health Survey shows that Mâori report higher rates of depression than all other ethnic groups, and, with the exception of Pacific peoples, are less likely to access services for a mental health problem.
Disparities between Mâori and non-Mâori will continue to be closely monitored.
What does the New Zealand Suicide Prevention Action Plan hope to achieve and how does it fit with the New Zealand Suicide Prevention Strategy 2006-2016?
The New Zealand Suicide Prevention Strategy 2006-2016 provides a high-level framework for reducing suicidal behaviours, the impact of suicide on others and reducing inequalities. Two 5-year Suicide Prevention Action Plan’s will be developed to translate the goals of the Strategy into action and describe in more detail what will be done, who will be responsible for doing it and when it will happen.
The first 5 year Action Plan will be released early in 2008.
What can be done to prevent suicide?
Suicide prevention is everyone’s concern and responsibility, not just the responsibility of the health and government sectors.
Just as there is no one reason as to why someone would take his or her own life, there is no one answer. Rather, a range of prevention approaches and initiatives are being implemented across a number of settings that are supported by government, service providers, communities and families. Some examples are:
•The National Depression Initiative
The National Depression Initiative was launched in 2006. It is a multimedia campaign that aims to reduce the impact of depression through increasing understanding of the symptoms of depression, increasing public awareness of effective interventions and encouraging people experiencing depression to seek help. It also aims to improve the capability of health providers to respond appropriately to people seeking help for depression. For example, guidelines for primary care providers about depression and other common mental health disorders are being developed and will be implemented over the next few years.
•Mental health literacy programme
The Ministry of Health is currently considering proposals for the development, implementation and evaluation of a community based programme to increase knowledge and improve attitudes about mental health and mental illness. The programme will involve workshops and resources.
•Kia Piki te Ora
Kia Piki te Ora is a Mâori community development initiative to reduce Mâori suicide. The overarching aim of this initiative is to reduce disparities between Mâori and non-Mâori and value cultural diversity through strengthening individual and whânau participation and access to things Mâori. Eight sites across New Zealand are funded to coordinate and facilitate mental health promotion activities within Mâori communities. For example, to develop, in collaboration with the community including key existing services, plans and programmes to promote mental health and wellbeing practices.
Towards WellBeing is a national suicide risk assessment, monitoring and management programme for young people under the care and protection of Child Youth and Family (CYF). Clinical psychologists provide advice and support to CYF social workers to assist them to develop suicide management plans, monitor these plans and identify referral pathways to specialist mental health services, if required. More than 570 young people are managed in this way.
•Whakawhânaungatanga: The Suicide and Self-Harm Collaborative
This initiative aims to improve the acute care given to those who present to emergency departments after a suicide attempt. It includes improving recording practices, providing more timely assessment, providing a best-care mental health and risk assessment, improving discharge planning, and providing follow-up after discharge. Approximately half of all DHBs are currently participating in the initiative. All DHBs will have the opportunity to participate in this initiative by next year.
•The Postvention Initiative
This initiative has multiple components that aim to provide support to those who are bereaved by suicide, to those affected by a suicide attempt, and to communities about how to plan a response to a suicide and how to lead a response when there is a suicide cluster.
•The Suicide Research Fund
The suicide research fund is one of the initiatives announced in this year’s Budget - $1.5 million is available to invest in new suicide research over the next two years.
Where can I go for further information about suicide and suicide prevention?
For further information about suicide and suicide prevention, contact Suicide Prevention Information New Zealand:
PO Box 10051
Phone: 09 300 7035