13 May 2020 | Suicide Mortality Review Committee
As a nation, Aotearoa New Zealand is facing uncertain times. This is an unprecedented environment of social and physical isolation, change in routine and financial pressures, and it is both challenging and can be detrimental to our wellbeing.
While our sense of collective cohesion as we united against COVID-19 may have had positive effects on the mental health of some, we know others have struggled. Most people are resilient to traumatic events, but for those already dealing with mental health difficulties and challenging life circumstances, the COVID-19 response may have been particularly tough. Therefore, responses to this pandemic need to be tailored to meet the needs of different groups.
There has been speculation here and overseas that COVID-19 has ‘caused’ some deaths by suicide. Suicide is the endpoint of a complex series of factors; it does not have a single cause. Taking time to understand the context of a person’s life is critical to supporting effective suicide prevention initiatives.
Data on the impact of economic downturns on population harm from the global financial crisis and austerity measures in the UK indicates that financial challenges do not necessarily result in poor outcomes.
The current crisis has highlighted gaps in existing suicide prevention activities. A number of agencies have reported COVID-19-related increases in help-seeking from helplines, refuges and food banks. Extra support has been given to respond to service demand, however, the sustainability of this demand and resourcing needs to be monitored.
From previous global pandemics and financial crises, we have learned there are many things we can do to support community and individual mental wellbeing. These include developing macro-economic policies to keep incomes as stable as possible to avoid poverty increasing and to promote food and housing security. We can also support people to return to work, through interventions such as job clubs.
We know we need a sustained focus on accessible, good-quality welfare and health services, and to make quality clinical resources available to all to support mental health. Easily available online and telephone support, as well as – not at the expense of – face-to-face services will reduce distress.
Deaths during and after other pandemic crises have been driven by the effects of social and economic changes as well as existing inequities. We must therefore acknowledge and plan for people in our communities to be inequitably affected by this pandemic. The health inequities that existed pre-COVID-19 still remain and still need to be addressed.
As mana whenua, Māori must be placed at the centre of all responses. Te Tiriti o Waitangi must be honoured. The Human Rights Commission observed, from the United Nations’ Expert Mechanism on the Rights of Indigenous Peoples, that COVID-19 is likely to exacerbate discrimination.
We must address inequity in our communities and actively prevent racism toward other ethnicities and immigrants.
When there is public discussion on the mental health impacts of COVID-19 and sharing of stories of distress and suicide, we need to act responsibility. Media interest in the potential harm of the pandemic can outweigh the reporting of constructive work, and the planning and community responses underway. Because some individuals are more vulnerable at the moment, it is important that reporting and public dialogue does not circulate unsubstantiated information and data without context.
The potential for self-harm is present, but we must not unthinkingly link this to COVID-19 and anticipation of economic impacts. These things are simply not ‘our fate’. We can create an environment that protects and nurtures people, and enables community resilience.
Health consequences are likely to peak later than the COVID-19 virus threat; however, previous experience, evidence and the Government’s national strategies give us a good foundation for preventing harm.
In uncertain times we must work on issues we can control and plan on dealing with those issues we can’t, maintain constructive discussions and support each other.
The role of this committee is to monitor and analyse suicide and associated morbidity. With COVID-19, this will relate to connectedness and physical and social isolation, infringements on human rights, the ongoing impacts of colonialism and structural discrimination, racism, unemployment, increasing poverty and changes to the way education is delivered and received.
We are also interested in the responses and unintended consequences of the health care and welfare systems. To prevent unnecessary suffering, we must give attention to these future issues now.
An effective response by the Government, agencies and the public to this pandemic will be built on access to high-quality, timely data and information that places equity at its centre. The Suicide Mortality Review Committee is contributing to the ongoing and longer-term impact of the COVID-19 response through monitoring and understanding what is happening with suicide rates, prioritising Māori mana motuhake and equity, providing analysis and proposing system changes to reduce future, preventable, deaths.