A new report from the Ministry of Health shows a steep rise since 2009 in death by suicide of Māori aged 25 to 44 years. The Suicide Mortality Review Committee (SuMRC) looks at the latest suicide figures, what is driving them, and what must be done urgently to address them.
Provisional suicide figures for the 2016 year from the Ministry of Health show suicide rates for Māori 25 to 44 doubled from 2009 to 2016, from 29.4 to 55.4/100,000 for males and from 9.0 to 16.1/100,000 for females. These rates are intolerable. They are far greater than the rates for non-Māori in this age range and show persistent inequities for Māori.
For the total population, the Ministry of Health’s reported suicide number and rate has fluctuated slightly over the 10-year period 2007 to 2016 but remains relatively stable. Sadly, in the 2016 year we lost 553 people by suicide, with a rate of 11.3 (deaths per 100,000 people). Any loss is one too many and unacceptable. Losses to suicides in Pasifika and Asian communities have not changed significantly.
Chair of the Suicide Mortality Review Committee, Prof Rob Kydd knows the analyses of the diversity of experiences behind these numbers is complex. What we must remember is that not all of those who we lost by suicide had depression or a mental illness, and that many people who have depression or a mental illness continue to live well, so long as the right support and resources are in place.
The drivers behind suicide include a broad range of social and economic determinants of health. For Māori, the trauma of colonisation is not simply something that happened in the past, the consequences continue to affect people today and are linked to structural and psycho-social challenges.
The SuMRC’s 2016 report, Ngā Rāhui Hau Kura, found that determinants of health relevant to suicide outcomes included higher unemployment, lower educational achievement, and that young Māori who died by suicide were more likely than non-Māori to live in areas of high deprivation.
The impact of entrapment in poverty needs to be acknowledged across government as a significant contributor to poor mental and physical wellbeing outcomes which inequitably and unfairly impact on Māori. Reducing poverty is critical to reducing suicide in Māori.
The Wai 2575 Tribunal Panel has found the Crown has breached its Treaty of Waitangi obligations, with this contributing to persistently poorer health outcomes for Māori. All sectors across government must respond in a coordinated systemic way, and in partnership with Māori.
The system is being challenged to act now in tackling the issues driving suicide, and to respect the importance of cultural identity, connectedness, the solutions lying in te ao Māori, as well as tino rangatiratanga and self-determination.
In communities, agencies, and within whānau, people continue to work passionately to drive the changes needed to prevent deaths from suicide. This includes those who support friends and whānau after a suicide of a loved one.
While communities around Aotearoa have always held knowledge about what is needed to address their issues, it is increasingly being stated that effective solutions lie within communities. Communities, regional and urban, hold practical and applied knowledge of what works and how, but they require better support with resource and funding, and capacity.
The SuMRC is working with the Child Youth Mortality Review Committee and the Ngā Pou Arawhenua Māori advisory group to understand rangatahi (young) Māori deaths by suicide, including capturing learnings from successful rangatahi-centred programmes around the regions. The SuMRC also has investigations underway into deaths by suicide in the Asian and Pasifika communities, and of people from sexually and gender diverse minorities and is promoting the voice of lived experience in these areas.
The SuMRC acknowledges that behind these numbers are a much larger number of people who grieve these losses and are profoundly impacted by them. While loss to suicide will continue to generate much discussion and debate, we must not forget their friends, whānau, colleagues affected, who will also need our ongoing support. Supporting these people is the key component driving suicide post-vention work which must grow to be a critical part of the solution to suicide prevention.
Author: Carlene McLean, senior specialist advisor, Suicide Mortality Review Committee