Māori suicide rate calls for new strategy

New data shows that suicide rates among Māori people have risen to their highest level in a decade, and the rate among Māori men is double that of non-Māori. Why should this be so? Dale speaks with Matthew Tukaki, executive director of the New Zealand Māori Council and former chair of Suicide Prevention Australia.

 

Tēnā koe, Matthew, nice to catch up with you again. That’s a disturbing kaupapa, isn’t it? More than 600 people took their own lives last year, many of them Māori. Let’s look at the Māori men’s stats. What’s your gut feeling as to why twice as many of Māori men would do that, compared with non-Māori?

The first thing that I’d say is that what I’ve learned over many years is that suicide is very complex, and no two suicides are the same. The data that was released the other day by the Ministry of Health is the 10-year trend data, and it shows that there’s been a steady increase in the number, but it stops at 2016 because that’s the period that they analysed.

But the more recent data is probably the most heartbreaking of all. In the 2018 year, the suicide rate in New Zealand had reached 668 New Zealanders. That in itself is a big number, but the evidence tells us that, for every completed suicide, around 20 other people attempt to take their life. It’s likely that more than 13,000 New Zealanders attempted to take their lives last year.

The Māori suicide rate was 142 deaths, or 23.72 per 100,000 New Zealanders, which is the highest since 2007–2008. The first thing is to understand that this rate has been steadily increasing for more than 10 years, and it seems to be getting worse.

But, from what I’ve learned in suicide, not every suicide death is about mental health problems. People with deep depression, psychosis, anxiety, and that sort of thing are often people that we know about and can help.

But a good number of suicides are people that have never reached out for help, and to be honest, a lot of it has to do with the daily struggle of life: relationship breakdowns, whānau breakdowns, loss of access to children, the failure of a small business, long-term unemployment with no light at the end of the tunnel. All of these things make up what is the tragedy of suicide.

I look at the reaction to road deaths each year. They’re a similar number, and there are all sorts of actions taken to reduce the number: lowering speed limits, widening roads, more frequent breath testing — all of these initiatives to try and curb a trend that we are all disturbed and disappointed by. I can’t see the same level of initiative going in to combat suicide. What are we missing here?

New Zealand had a national suicide prevention strategy that expired in 2016. We currently have no national strategy, and while the government talks about putting money into a wellbeing budget, there’s no specific replacement for the earlier strategy.

You can just throw a lot of money at suicide in New Zealand. It’s actually not the money, it’s the structure of how we deliver services and to whom we’re delivering them.

And you can’t get away from the fact that, with Māori people, it’s not just one thing. There’s a plethora of social barriers and problems that are against us at the moment, such as the recent kaupapa about Oranga Tamariki.

If you read the reports about the number of deaths of young Māori, in particular, you start seeing threads of attachment to the Oranga Tamariki system. These young Māori may have spent a period of their life in state care, and although that may not have been the thing that pushed them over the edge, it’s part of a life that’s being lived tragically.

Take the example of Māori men who are released from prison. Life on the outside is often not what they thought or hoped it would be, even though they were working on reintegration on the inside. So you have all of these different things that go around, and there’s no cohesive strategy around how we work across this plethora of social issues to bring the rate of suicide down.

Is there anything we can learn from what you’ve championed across the Tasman or from other parts of the world?

Yes, there are a significant number of lessons from Australia. The most important thing is to understand the depth of the problem. I’m not convinced that the number of deaths by suicide in New Zealand has been reported accurately, and my fear is that probably the number is greater. Agencies don’t necessarily record the attempts, where they are and what happened in the attempt.

Let’s say a Māori 16-year-old boy is taken to A & E for a drug overdose. The unconscious bias may be that that’s just another Māori boy with a drug problem. But maybe he doesn’t have a drug problem. Maybe he’s struggling with his sexual orientation, or maybe he’s struggling with the fact that the house is wracked with domestic violence, or whatever the case is.

We have to change the perception of those who are entering the system. As a result, we now have a “zero suicides in hospitals” approach in the states of Queensland and Western Australia, and the approach is growing in Victoria and New South Wales as well.

The idea behind that is that suicide deaths for people who are under the care of a hospital or other healthcare provider are preventable, so it takes a systems approach and looks at how things like procedures can be redesigned so people don’t fall through the gaps.

Another big lesson is we need programmes that are run by the communities in which people live their lives. National approaches are good for setting a standard, but only a community knows what goes on in a community, and it’s about resourcing those community-led approaches.

For example, in South Australia we’ve got 35 Life Networks for suicide prevention. Each one is different. We’ve got an Aboriginal Life Network in the central deserts, and they work with their community on solutions that they know work for Aboriginal people. We’ve got Life Networks with farmers affected by the drought. The Life Network model doesn’t take a huge amount of money, but it can equate to a large impact

I come back to the fact that you have to understand the numbers before you can deal with the severity of the problem. In New Zealand, we’ve got 20 District Health Boards across the country, which is way too many for a country the size of New Zealand, and within that DHB model we know that Māori are disadvantaged. That’s the evidence under Wai 2575 claim before the Waitangi Tribunal.

But there seems to be an institutional resistance to allowing Māori to develop their own strategies, implement them and work on them.

Take the draft strategy for suicide prevention put forward by Sir Mason Durie and others, which was to have a stand-alone suicide prevention approach designed by Māori for Māori, managed by Māori and administered by Māori. What happened to it? Why aren’t Māori MPs pushing that approach?

 

Where to get help

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What’s Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)

Kidsline (ages 5-18): 0800 543 754 (24/7)

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

If it is an emergency and you feel like you or someone else is at risk, call 111.

 

© E-Tangata, 2019