New Zealand continues to face stubbornly high suicide rates, says the Minister for Mental Health Matt Doocey. “Last year, 617 people died by suspected suicide. Behind that number are grieving families, friends, colleagues, and communities.”
Anthony O’Brien, Associate Professor in Mental Health Nursing at the University of Waikato says “There could be more recognition of the role of primary health care. It was surprising that the Access and Choice Programme was not included in current health-led suicide prevention supports.
“Also absent is the role of school nurses who in addition to providing support for students experiencing distress could be mobilised as school-based champions of suicide prevention,” he says.
“What sets this plan [The Suicide Prevention Action Plan] apart from the last is the actions in the plan are now focused on delivery with clear milestones, completion dates, and importantly an accountable agency,” says the Minister.
“Given the commitment to measurable outcomes it would have been good to see some recognition of a suicide research strategy,” says O’Brien although “it is good to see recognition of how various workforces can respond to suicidal thinking and support for those bereaved by suicide.”
New Zealand’s suicide statistics remain a source of national shame, says Registered Clinical Psychologist Jacqui Maguire.
“The Government’s new Suicide Prevention Action Plan signals good intent, but without meaningful detail, it is difficult to assess its true impact.
“The plan sounds promising on paper. However, without a clear picture of who is delivering what, and how services will be integrated, it is hard to see how this plan will drive the scale of change New Zealand urgently needs to meaningfully reduce suicide,” she says.
“The most obvious gap in the plan is workforce development. Peer support and coordination roles are valuable, but the plan does not outline the training and retention of psychologists, social workers and mental health nurses who are needed to meet demand.
“Across both public and NGO services, workforce shortages, not just budget, are a real constraint. If we do not have qualified professionals, we cannot deliver the required scale of care.”
Minister Doocey counters that “we know one of the biggest barriers to support is our workforce. The plan includes initiatives that will grow our workforce, such as by expanding suicide prevention training and strengthening existing resources to better equip workforces, communities and families.
“We want people to receive care in the community instead of resorting to an emergency department, that is why by the end of next June, we will have rolled out six crisis recovery cafés that will provide more options for people experiencing distress.
“However, for those who are presenting to emergency departments in mental distress, by the end of December we will establish peer support roles in eight emergency departments for people presenting with mental health and addiction needs.”
There is limited recognition in the plan of the increased risk of suicide among people who are not employed, despite the report identifying social determinants contributing to suicide risk, says O”Brien.
“There is some tension between the action areas of the plan, and other areas of policy. Some actions require no funding but have the potential to limit suicide risk.
“For example, the role of alcohol is highlighted, but curbs on alcohol advertising are not suggested. There is no plan to act on the role of social media in fuelling suicide risk.
Doocey says there are 21 health-led new actions and 13 cross-agency new actions in the plan. “The actions overall aim is to improve access to suicide prevention and ‘postvention’ supports, grow a workforce that is able to support those at risk of, or affected by suicide and strengthen our focus on prevention and early intervention.
“Some key actions include, by the end of this year, establishing a new suicide prevention community fund. This will provide targeted support that is focused on populations experiencing higher rates of suicidal distress.
Macguire believes the plan could be bolder and more detailed and cites examples of just what is needed:
- Every emergency department should have skilled, trained support not just the eight regions outlined. Peer support is already being trialled, including in Wellington ED, but suicide risk exists nationwide.
- The alcohol and suicide link is acknowledged, but there is no clear policy action mentioned. For example, will the Plan tackle outlet density or alcohol pricing?
- We need to ensure therapy is accessible to all. The current model excludes many middle-income earners, who fall outside subsidy thresholds and cannot afford private care. Unless you are under 25 and covered by PIKI, access can be incredibly limited. That is neither equitable nor sustainable.
- The plan also speaks to hope, wellbeing and prevention yet makes little reference to the deeper drivers of suicide such as loneliness, housing stress, cultural disconnection and income insecurity. If we want significant suicide reduction, these issues are central.
“While the plan refers to data and information sharing, it does not address the kind of infrastructure needed to enable real-time, coordinated care, says Maguire. Particularly between crisis services and mental health teams. Without this, continuity of care will likely remain fragmented.”
Implementation of the action plan will be supported by existing suicide prevention investment of $20 million per year, plus allocation of an additional $16 million per year to improve access to mental health and suicide prevention supports through initiatives identified in the plan.
“There is hope and a way forward. Suicide is preventable and we have a duty as a Government, and as a country, to do more to ensure all New Zealanders have the access and support they need to heal and go on to live the life they deserve,” says Doocey.
