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AUT University Presentation Effective Suicide Prevention and Intervention

AUT University Presentation Effective Suicide Prevention and Intervention

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Page 1: AUT University Presentation Effective Suicide Prevention and Intervention

AUT University Presentation

Effective Suicide Prevention

and Intervention

Page 2: AUT University Presentation Effective Suicide Prevention and Intervention

Outline

1. About SPINZ

2. Latest suicide statistics

3. What are the risk factors for suicide

4. What are the warning signs for suicide?

5. What are the protective factors against suicide?

6. What is being done for suicide prevention?

Page 3: AUT University Presentation Effective Suicide Prevention and Intervention

Outline

7. What is effective in preventing suicide?

8. What is not effective in preventing suicide?

9. Prevention models and interventions

10.Future considerations

Page 4: AUT University Presentation Effective Suicide Prevention and Intervention

The importance of self-care

• Suicide can be an emotional topic

• We are all likely affected in some way

• Important to notice what’s going on for us, and seek support if we need to

Page 5: AUT University Presentation Effective Suicide Prevention and Intervention

1. About SPINZ

Page 6: AUT University Presentation Effective Suicide Prevention and Intervention

What we do

• Part of the• Provides a Resource and Information Service• Produces resources and pamphlets• Provides information for specific audiences via its

website www.spinz.org.nz• Gives presentations/workshops• Runs events • Works closely with media

Page 7: AUT University Presentation Effective Suicide Prevention and Intervention

Our website

Page 8: AUT University Presentation Effective Suicide Prevention and Intervention

Information for

Page 9: AUT University Presentation Effective Suicide Prevention and Intervention

2. Latest suicide statistics

Page 10: AUT University Presentation Effective Suicide Prevention and Intervention

Overview

• 483 people died by suicide in NZ in 2007• This equates to 11.0 deaths per 100,000

population

• 370 were male, 113 were female• This equates to a ratio of 3.6:1

Page 11: AUT University Presentation Effective Suicide Prevention and Intervention

Overview

Groups with the highest rates of suicide:• males• younger male adults (20-39 years)• Māori• people living in the most deprived areas

• But, the rate of attempted suicide is twice as high for women than for men

Page 12: AUT University Presentation Effective Suicide Prevention and Intervention

Age distribution

Page 13: AUT University Presentation Effective Suicide Prevention and Intervention

Youth suicide

• Of the 483 deaths, 94 were in the 15-24 age group

• 71 were male, a rate of 22.9 per 100,000 population

• 23 were female, a rate of 7.6 per 100,000• The male rate was around three times the

female rate

Page 14: AUT University Presentation Effective Suicide Prevention and Intervention

Youth suicide over time

Page 15: AUT University Presentation Effective Suicide Prevention and Intervention

3. What are the risk factors for suicide?

Page 16: AUT University Presentation Effective Suicide Prevention and Intervention

Risk factors

• The biggest risk factor is experiencing depression or another mental health disorder

• A history of self-harm or previous attempts• Having been affected by a suicide death• Exposure to trauma, such as violence, abuse

or bullying• Family factors, such as neglect, parental

conflict, parental substance abuse, family violence

Page 17: AUT University Presentation Effective Suicide Prevention and Intervention

Risk factors

• Social isolation and lack of support• Socioeconomic disadvantage• Cultural breakdown, and loss of cultural

identity, land, and language• Stressful or negative life events, such as major

losses, disappointments or humiliations – these are often the ‘trigger’ event

Page 18: AUT University Presentation Effective Suicide Prevention and Intervention

Risk factors

• The more risk factors a person has, the greater their risk of attempting suicide

• These risk factors may contribute to suicidal behaviours directly, or indirectly by influencing individual susceptibility to mental disorders

Page 19: AUT University Presentation Effective Suicide Prevention and Intervention

4. What are the warning signs for suicide?

Page 20: AUT University Presentation Effective Suicide Prevention and Intervention

Warning signs webcast

Page 21: AUT University Presentation Effective Suicide Prevention and Intervention

Warning Signs

• Threatening to hurt or kill themselves• Talking or writing about death, dying or suicide• Expressing feelings of hopelessness• Looking for ways to kill themselves e.g. looking

for pills, weapons or other means

Page 22: AUT University Presentation Effective Suicide Prevention and Intervention

Warning Signs

• Being unusually ‘down’, ‘low’, ‘angry’ or ‘depressed’

• Acting recklessly• Withdrawing from family and friends• Increased alcohol or drug use• Giving away possessions

Page 23: AUT University Presentation Effective Suicide Prevention and Intervention

5. What are the protective factors against suicide?

Page 24: AUT University Presentation Effective Suicide Prevention and Intervention

Protective factors

• Strong identity• Connectedness• Resilience – agency, relatedness,

reflectiveness, communication• Wellbeing, flourishing

• Not obvious suicide prevention activities but these do contribute to suicide prevention

Page 25: AUT University Presentation Effective Suicide Prevention and Intervention

Wellbeing and flourishing

Page 26: AUT University Presentation Effective Suicide Prevention and Intervention

6. What is being done for suicide prevention?

Page 27: AUT University Presentation Effective Suicide Prevention and Intervention

The NZ Suicide Prevention Strategy 2006-2012

• This strategy replaced the New Zealand Youth Suicide Prevention Strategy, which was published in 1998

Page 28: AUT University Presentation Effective Suicide Prevention and Intervention

Goals of The New Zealand Suicide Prevention Strategy1. Promote mental health and wellbeing, and prevent

mental health problems2. Improve the care of people experiencing mental

disorders3. Improve the care of people who make suicide attempts4. Reduce access to the means of suicide5. Promote the safe reporting of suicidal behaviour by the

media6. Support families/whanau, friends and others affected by

a suicide or suicide attempt7. Expand the evidence about rates, causes and effective

interventions

Page 29: AUT University Presentation Effective Suicide Prevention and Intervention

The New Zealand Suicide Prevention Action Plan, 2008-2012

• Included the Evidence for Action and the Summary for Action, published 2008

• A one-year report on Action Plan has been done, published September 2009

Page 30: AUT University Presentation Effective Suicide Prevention and Intervention

7. What is effective in preventing suicide?

Page 31: AUT University Presentation Effective Suicide Prevention and Intervention

The evidence-base

• The evidence-base is used to inform the NZSPS and Action Plan

• Important that all suicide prevention policy and practice is based on good evidence

• Want to make sure interventions and prevention activities are going to be effective, and don’t cause harm, or are ineffective, thus a waste of resource

Page 32: AUT University Presentation Effective Suicide Prevention and Intervention

Activities with strong evidence of efficacy

• Education of GPs and other health professionals

• Restriction of suicide methods• Gatekeeper education

Page 33: AUT University Presentation Effective Suicide Prevention and Intervention

Activities with promising evidence of efficacy• Public awareness of depression• Hotlines, internet-based tools

and texting• Support for those bereaved by

suicide• Psychological therapies• Pharmacological interventions• Responsible and informed

media coverage

Page 34: AUT University Presentation Effective Suicide Prevention and Intervention

Barriers to effective suicide prevention (Beautrais, 2009)

• Power of advocacy and lobbying• Power of rhetoric and emotion• Power of anecdotal evidence

• Working solely from instinct, good intentions, or personal experience is not sufficient – suicide prevention activities must be based on evidence of effectiveness and safety.

Page 35: AUT University Presentation Effective Suicide Prevention and Intervention

8. What is not effective in preventing suicide?

Page 36: AUT University Presentation Effective Suicide Prevention and Intervention

Activities with evidence of harm

• School-based suicide awareness programmes

• Generic public health messages raising awareness of suicide

• No-harm and no-suicide contracts

• Recovered or repressed memory therapies

Page 37: AUT University Presentation Effective Suicide Prevention and Intervention

Raising awareness of suicide

• Works really well for other social issues: family violence, drink driving, alcohol abuse, depression

• But, when it comes to raising awareness of suicide, there is insufficient evidence to support its safety - it could have unintended consequences that increase the risk of suicide among those who are already vulnerable

Page 38: AUT University Presentation Effective Suicide Prevention and Intervention

Raising awareness of suicide

• Can happen by inadvertently normalising suicide, or by creating a solution modelling effect

• Instead, a safer way to address suicide is focusing on raising awareness of depression, and promoting help-seeking

• Not all suicide prevention activities need to be marketed as such to make a difference, an example being the National Depression Initiative

Page 39: AUT University Presentation Effective Suicide Prevention and Intervention

Talking more about suicide

• The best way to address the topic is often by focusing on talking more about suicide prevention, not suicide

• This avoids previously mentioned issues of awareness-raising and normalisation of suicide

• Also an opportunity to talk more about risk and protective factors, warning signs, and the importance of help-seeking

Page 40: AUT University Presentation Effective Suicide Prevention and Intervention

Talking more about suicide after a suicide death

• This issue often comes up around addressing the school after the death of a student

• Talking to a large group of young people about the suicide of a classmate can increase the risk of those already vulnerable

• Asking someone one-to-one if they’re thinking about suicide does not increase the risk of them dying by suicide

Page 41: AUT University Presentation Effective Suicide Prevention and Intervention

9. Prevention models and interventions

Page 42: AUT University Presentation Effective Suicide Prevention and Intervention

Prevention models

There are several prevention models in health:• The Primary, Secondary, Tertiary (PST)

prevention model• The Universal, Selective, Indicated (USI)

prevention model• The ecological model (micro, meso,

macro)/social ecological model• Traditionally suicide prevention has focused

on the PST model

Page 43: AUT University Presentation Effective Suicide Prevention and Intervention

Prevention models

• No specific model is explicitly named in the NZSPS or Action Plan

• Instead, it includes some health care oriented strategies (broadly, individual/tertiary/micro interventions), as targeted initiatives for people who are most at risk of suicide…

• And some public health oriented strategies (broadly, universal/primary/macro interventions), to create a society that promotes mental health and wellbeing

Page 44: AUT University Presentation Effective Suicide Prevention and Intervention

Health care oriented strategies

Covered by Goal 2, 3, 6of the NZSPS:

2. Improve the care of people experiencing mental disorders

• NDI – Depression Helpline, The Journal programme, Depression and Lowdown websites and text and email support

Page 45: AUT University Presentation Effective Suicide Prevention and Intervention

Health care oriented strategies for youth

Page 46: AUT University Presentation Effective Suicide Prevention and Intervention

Health care oriented strategies

Covered by Goal 2, 3, 6 of the NZSPS:

3. Improve the care of people who make suicide attempts

• Whakawhanaungatanga: The Self Harm and Suicide Prevention Collaborative

Page 47: AUT University Presentation Effective Suicide Prevention and Intervention

Health care oriented strategies

Covered by Goal 2, 3, 6 of the NZSPS:

6. Support families/whanau, friends and others affected by a suicide or suicide attempt

• Postvention Support Service (Initial Response Service, Community Postvention Response Service) and Traumatic Incident support in schools

Page 48: AUT University Presentation Effective Suicide Prevention and Intervention

Public health oriented strategies

Covered by Goal 1, 4, 5,

(7) of the NZSPS:

1. Promote mental health and wellbeing, and prevent mental health problems

• Development of programmes across Govt agencies: Campaign for Action on Family Violence, ALAC Culture Change Campaign, LMLM Campaigns

Page 49: AUT University Presentation Effective Suicide Prevention and Intervention

Public health oriented strategies

Covered by Goal 1, 4, 5, (7) of the NZSPS :

4. Reduce access to the means of suicide

• Interventions around hanging, carbon monoxide poisoning, firearms, self-poisoning, jumping

Page 50: AUT University Presentation Effective Suicide Prevention and Intervention

Public health oriented strategies

Covered by Goal 1, 4, 5, (7) of the NZSPS :

5. Promote the safe reporting of suicidal behaviour by the media

• Promoting collaboration between media and suicide prevention professionals and researchers, monitoring the internet

Page 51: AUT University Presentation Effective Suicide Prevention and Intervention

contact

Ph 09 300 [email protected]

SPINZ (Suicide Prevention Information New Zealand)a part of the Mental Health Foundation of New Zealandwww.spinz.org.nz

Working to reduce suicide by providing high quality information

2010