Sorrows of society: Tackling the Aotearoa suicide crisis

This week is Mental Health Awareness Week, so brace yourselves; I’m tackling a heavy subject.

Earlier this month, mental health minister Matt Doocey launched a draft suicide prevention plan, calling New Zealand youth suicide rates “unacceptably high”. With the previous plan expiring at the end of the year, this one will be for 2025–29. It is out for consultation but includes inarguable priorities, such as growing the workforce, improving access to suicide prevention and postvention support, strengthening focus on prevention and early intervention and improving data collection.

New Zealand has one of the worst youth suicide rates in the OECD, with Māori, Rainbow youth and those in poverty at higher risk than the rest of the population. Young Māori men living in deprived areas are the most at risk of suicide, but the groups with increased rates – Māori, Pacific, mental health service users, males, rural communities, Rainbow youth, men in the construction industry, agriculture, forestry and fishing industry workers, young people involved with Oranga Tamariki, young disabled people, pregnant women and new mothers – span across the population demographics and mean that most of us will know someone who has considered, attempted or died by suicide, whether we know about it or not.

Unfortunately, youth suicide rates are rising in the post-COVID world. There’s much work to be done, and Mr Doocey hopes the “smaller set of focused actions with clear milestones and lead agencies” in his plan will make a difference and ensure accountability.

I couldn’t easily find statistics on suicide in general practice in New Zealand, but we know it’s happening

The draft plan outlines almost $18 million in Vote Health spending on suicide prevention and postvention services. And Mr Doocey says government targets and investment in initiatives like Gumboot Friday and the Mental Health and Addiction Community Sector Innovation Fund will contribute to preventing suicide.

The latter two have come under criticism – first, Gumboot Friday came under fire after it was given $24 million in Budget 2024 without a contestable procurement process, and questions were raised over the charity’s leaders’ close ties with the National Party. Then, in August, the Mental Health and Addiction Community Sector Innovation Fund’s eligibility criteria was branded “completely inequitable and unfair” with “impossible prerequisites”, locking small charities out of the running for a slice of the $10 million fund.

Labour’s mental health spokesperson Ingrid Leary spoke out against both, but Rainbow mental health organisation OutLine Aotearoa chief executive Emmaline Pickering-Martin was powerful in her criticism of the fund, saying it was “a horrific way to hold us all hostage within the sector”.

These moves will not have endeared the minister to the sector, although he seems genuinely to care about mental health and suicide. However, some would argue the Government’s policies may not help to ease the mental health challenges for those who are struggling. We know poverty, financial insecurity and housing are risk factors for suicide. And times are tough right now. The cost-of-living crisis is hitting people hard, businesses are struggling or closing, cost pressures are rising and access to services – including health – is getting harder. We’ve had changes to disability support, public sector job cuts and budget restraints. Add in ramped-up rhetoric over Te Tiriti and the use of te reo in public life, divisive political rhetoric around race and the trans community, and you can see how some people might feel lost or in despair right now.

General practice isn’t free from that either – many working in primary care are small business owners with increasing expenses and workloads, have a client base who may or may not be able to afford to pay for services, and there is no word on how the funding problem will be solved.

I couldn’t easily find statistics on suicide in general practice in New Zealand, but we know it’s happening. In Australia, there’s been a call to collect data on health-worker suicides to address it better. However, research across the Ditch
suggests female doctors take their own lives at 2.27 times the rate of the general population and male doctors at 1.41 times. The Royal Australian College of General Practitioners vice president, associate professor Michael Clements says the regional Queensland town where he lives and practises has lost five doctors to suicide in two years.

In an article on the RACGP website, Dr Clements says: “We as health professionals train and learn how to support our patients, but our colleagues often can present as a bit of a mystery to us.”

In small communities, such deaths are felt by everybody.

This year’s Mental Health Awareness Week theme is community and how important it is in getting through tough times. The general practice community is small and resilient, but times are tough, so make sure to lean into that community and don’t be afraid to ask for help if you need it. You can also check out the services at the bottom of this page.

Support is much more widely available these days – there are a number of organisations and programmes operating in schools, workplaces and the wider community, often demographic or industry-specific – and the stigma around mental health and suicidal ideation is lifting, particularly among younger generations who are much more likely to talk openly about, and prioritise, their mental health.

But we also know it can be tough to access mental health services, and like most of healthcare, there’s a lack of mental health staff.

A clear suicide prevention plan is the first step in addressing New Zealand’s dire suicide statistics.

Awareness campaigns, community support, growing a specialty workforce, addressing socio-economic factors, and good data collection are all part of the multifaceted approach needed to tackle this issue. That means funding but also addressing the big picture stuff – like poverty, housing, education, the cost of living and tackling discrimination in all its forms. Mr Doocey says his overarching vision is a future where there is no suicide in New Zealand – he acknowledges it won’t happen overnight but says his plan will move the country closer to this goal. Let’s hope so.

Mental Health Awareness Week runs from 23 to 29 September. Consultation for the draft suicide prevention plan is open until 5pm on Friday, 1 November. Look after yourselves.