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SPINZ suicide attempt

VIEWS: 6 PAGES: 51

									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?
Outline

7. What is effective in preventing suicide?
8. What is not effective in preventing suicide?
9. Prevention models and interventions
10. Future considerations
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
1. About SPINZ
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
Our website
Information for
2. Latest suicide statistics
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
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
Age distribution
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
Youth suicide over time
3. What are the risk
factors for suicide?
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
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
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
4. What are the warning
signs for suicide?
Warning signs webcast
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
Warning Signs

• Being unusually ‘down’, ‘low’, ‘angry’ or
  ‘depressed’
• Acting recklessly
• Withdrawing from family and friends
• Increased alcohol or drug use
• Giving away possessions
5. What are the protective
factors against suicide?
Protective factors

• Strong identity
• Connectedness
• Resilience – agency, relatedness,
  reflectiveness, communication
• Wellbeing, flourishing

• Not obvious suicide prevention activities but
  these do contribute to suicide prevention
Wellbeing and flourishing
6. What is being done for
suicide prevention?
The NZ Suicide Prevention Strategy
2006-2012

• This strategy
  replaced the New
  Zealand Youth
  Suicide Prevention
  Strategy, which was
  published in 1998
Goals of The New Zealand Suicide
Prevention Strategy
1. Promote mental health and wellbeing, and prevent
   mental health problems
2. Improve the care of people experiencing mental
   disorders
3. Improve the care of people who make suicide attempts
4. Reduce access to the means of suicide
5. Promote the safe reporting of suicidal behaviour by the
   media
6. Support families/whanau, friends and others affected by
   a suicide or suicide attempt
7. Expand the evidence about rates, causes and effective
   interventions
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
7. What is effective in
preventing suicide?
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
Activities with strong evidence of
efficacy

• Education of GPs and other
  health professionals
• Restriction of suicide methods
• Gatekeeper education
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
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.
8. What is not effective
in preventing suicide?
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
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
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
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
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
9. Prevention models
and interventions
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
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
Health care oriented strategies

Covered by Goal 2, 3, 6
of 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
Health care oriented strategies for
youth
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
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
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
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
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
contact

Ph 09 300 7035
info@spinz.org.nz

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

Working to reduce suicide by providing high quality information

2010

								
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