Hurt & Hope: Innovative approach to suicide prevention saving Canterbury lives
Suicide was a hot election issue. How does Canterbury's post-quake environment compare with the rest of the country and do we have a specific suicide problem?
Maia Wilson* acts like a typical 13-year-old. She rolls her eyes at her younger cousins chasing each other nearby, has a shy smile and breaks into little dances as she walks across the room.
But when the rowdy cousins leave the room and the interview starts, her eyes get darker and she becomes serious beyond her years.
After a family member sexually assaulted her last year, she wanted to die.
"I didn't want to be in this world anymore. I was over this world."
Maia lives in Christchurch, but her battle with suicidal thoughts has nothing to do with the 2010 and 2011 earthquakes.
The help she received, however, is the product of the new way schools, charities and mental health services have been working together in the post-quake environment.
Suicide is a national problem, with the number of people taking their own lives on the rise.
Canterbury's suicide rate is higher than the national average, but much lower than other regions, including the West Coast, Wairarapa and Northland.
However, suicide attempts have increased at a higher rate in the region compared to national levels, with a 60 per cent increase over the last five years compared to a 52 per cent increase nationwide.
Comparing pre- and post-quake figures, the number of suicide call-outs to police almost doubled from 2009 to this year.
Police around the country have said they don't receive specialist training to deal with severely mentally unwell people.
Canterbury is better equipped with six psychiatric nurses working with police 24 hours a day.
'I WAS SCARED OF HOW IT'D AFFECT OTHERS'
Maia told her family about the assault, but kept quiet about her suicidal thoughts.
"I didn't want to talk to some stranger about my problems. I was telling myself I was fine, but I was going downhill."
She testified against her offender in court earlier this year, but the case was dismissed because there was not enough evidence, she says.
"That's when I hit rock bottom."
Maia felt like she had not expressed herself well enough in court and being treated as a liar was hard on her.
"At that time I didn't know how I felt. I was upset and angry. I had all those emotions running through me. All the emotions and I didn't know how I felt about them.
"I had so many negative thoughts in my head from then on. I hid it from everyone, but those thoughts were always running through my mind: 'I'm not good enough. I shouldn't be here'."
As she contemplated ways to die, she was not scared for herself.
"I was more scared of how it would affect others."
But when one of Maia's friends died by suspected suicide about a month ago, witnessing the devastating impact of her death pushed the teenager to reach for help.
Opening up to her school counsellor was "one of the hardest things" and she felt proud she found the courage to do it.
"I didn't want to admit that I was feeling this way, but after I talked about what was going on in my head, I felt lighter."
The counsellor rang Maia's sister, who asked suicide prevention worker Zion Tauamiti for help.
Tauamiti works for He Waka Tapu, a Christchurch non-profit offering health and social services for Māori, including a Ministry of Health contract to target Māori suicide prevention.
Maia knew Tauamiti from his regular visits to her school and his involvement in her community. Talking to him was like talking to a friend.
"He gave me the understanding that things are not all my fault and that things are going to get better.
"I felt like I believed him more."
She was then referred to the specialist child and family mental health service and is working on getting better with a counsellor.
"I still have really off days. I still think about suicide; it's still in my mind, but not always. I can think to myself 'It's going to get better'."
Tauamiti is like a magnet for children.
In Aranui's Haeata Community Campus, one of the 12 schools he visits weekly as part of his suicide prevention work, students come over to his cafeteria table to give him a hug, a pat on the shoulder or show him a drawing. He seems to know everyone.
"In the clinical world, it's not accepted to give hugs," he says.
But Tauamiti is not a clinician and his approach seems to work. In the three years he has worked in suicide prevention, he has seen children and teenagers struggling with sexual abuse, earthquake trauma, self-harm, bullying and poverty.
Youth from Christchurch's eastern suburbs, where Tauamiti does most of his work, reported the highest levels of depression, anxiety and self-harm and the lowest self-esteem in the country in a Prime Minister's Youth Mental Health Project report.
The city's statistics were "consistently different" to the rest of the country, the study found, with just under half of the young people surveyed experiencing three or more traumatic events in their lifetime.
Youth self-harm rates in Christchurch are the highest in the country at 28 per cent.
Despite all this, there have not been any suicides in the 12 primary and secondary schools he has visited regularly since 2014.
"The guy's a gift. He's so rare," says Tauamiti's boss, He Waka Tapu chief executive Dallas Hibbs.
"Zion is seen by hundreds, if not thousands, of young people in the east as a trusted adult – they feel like they can talk to him when they hit a dark spot."
Hibbs calls Tauamiti "Mr Hug".
"He is like an uncle, a big brother … He looks like a heap of the people he's talking to. He says having strong existing relationships in the community is more important than qualifications when it comes to suicide prevention, especially with Māori and Pasifika youth.
"It takes time for the community to trust someone."
Haeata community campus director of learning Melanie Taite-Pitama agrees.
"Zion is such a great ambassador for the community. Kids love him … Him being of Pasifika background really brings it home with our Pasifika students. We're really lucky to have him"
THE SMALL OF WELLBEING
How does suicide prevention work in a primary school?
"Obviously, I'm not going to give them a presentation," Tauamiti says.
It's more about being a positive role model and keeping a close connection with the children. It's groundwork and it takes time, commitment and listening.
"If you are the embodiment of wellbeing and incorporate it in all areas of your life … everywhere you go that's what people see you as. Whatever you come up with has that smell of wellbeing."
Zion uses music to help children connect with their culture and feel good about themselves.
He wrote several songs for schools he works with based on their core values. He then teaches the song to the children and has them perform it on camera. It gives them something to be proud of.
Being Samoan helps Tauamiti have an instant connection with Pasifika children.
"You really have to be someone who sits at the back and listens. For our people you actually have to earn the right to speak into their lives."
He checks children feel warm, loved and safe in their homes. If not, he helps them connect with the right service. He says he is "just another person on the production line of wellbeing".
When young people come to him with suicidal thoughts, he tries to find out what they are trying to escape and then helps them find the help they need.
"People want to stop the pain, not end their life.
"When you look at the statistics of suicide it can be disheartening, but if you continue to do the work, if you put it in your back pocket … this should be more an incentive to work harder or better together or smarter."
The Prime Minister's chief science adviser, Sir Peter Gluckman, published a research paper on youth suicide in July that concluded youth suicide was "more than a mental health issue".
It recommended promoting resilience to emotional stress and building self-control skills in early childhood and primary school years, and "ensuring that there are competent and adequate adult and peer support systems in secondary schools."
Tauamiti's approach seems to match that.
RIGHT PEOPLE DOING THE RIGHT WORK
Canterbury suicide prevention coordinator David Cairns worries about suicide statistics every day.
"We've just got to do what we've got to do to reduce [the suicide rate]. It's terrible," he says.
But he disagrees with comedian and campaigner Mike King's suggestion that everyone working in suicide prevention should be fired because they were failing at their jobs.
"Fire everyone and replace them with what? The work that we're doing is evidence-based. We have the right people in the field and they're doing the right work."
There is no magic fix to suicide.
"It's going to take a societal change," he says.
Provisional statistics released earlier this month found 606 Kiwis died by suicide in the 2016-17 year – up from 579 the previous year.
The suicide rate per 100,000 people was 12.64, up from 12.33 the previous year, but similar to 12.65 recorded in 2010-11.
Canterbury's rate was higher than the national average at 14.52, but much lower than the West Coast (30.8), Wairarapa (27.5) and Northland (21).
Cairns has been overseeing the region's suicide prevention and postvention (supporting whānau who have lost a loved one to suicide) strategy since 2009.
Right after the February 2011 quake, the suicide rate dramatically decreased in the region, he says, which was to be expected. It has since climbed back up, which is also consistent with international post-disaster research.
It's about helping the community help themselves, he says.
"We don't go and tell the community what to do. We go into the community and ask: 'How can we help?'."
Most of the work happens "quietly behind the scenes", especially in postvention.
After the suicide of a school student suicide, Cairns works with several agencies to monitor individuals who might need help and refers them to the right service if necessary.
"The death of a young person has a really profound effect on the community. On average, a school in Canterbury has a suicide every 10 years, so when it happens it's a shock."
SUICIDE ATTEMPTS ON THE RISE
Canterbury's top cop, Superintendent John Price, is touching wood.
Since the introduction of six mental health nurses in the police watch house – where detainees first arrive after they are arrested – there have not been any suicide in the cells.
In the 18 months before the programme began in 2008, three people took their life in the cells.
Christchurch's police watch house is the only one in the country with a 24-hour programme of this sort. The mental health team assesses 20 per cent of detainees and provides mental health training to police staff who can call them in crisis situations.
"We want to avoid bringing in people who are not well," Price says.
The programme is the fruit of the "wonderful relationship" between police and the CDHB, which funds it for about $750,000 a year.
Christchurch police arrest an average of 800 people a month, around 640 of whom are intoxicated or have alcohol, drug, or mental health problems.
Police have been forced to adapt to the high mental health need nationwide, but even more so in Canterbury, Price says.
The number of police suicide call-outs around the country has risen by 52 per cent over the last five years, from about 14,000 in 2012-13 to 21,000 in 2016-17.
In Canterbury, the attempted suicide call-outs have increased by 60 per cent in the same period, from about 2200 in 2012-13 to 3500 in 2016-17.
Comparing pre- and post-quake figures, the number of suicide call-outs to police almost doubled from about 1700 in 2009 to 3500 in 2016-17.
The post-quake increase in suicide attempts has been hard on staff, Price says. They also have to deal with more suicide clean-ups.
A second welfare officer – someone to provide staff support on site – was added to the Canterbury team post-quake.
"I have a mantra that we must care for each other so we can care for our community … If we've got mental health going on in the community it will be reflected in your workforce," he says.
"The nature of policing is there is a lot of stress and anxiety. You've got to look after your people."
* Name changed to protect her identity.
WHERE TO GET HELP
Lifeline: 0800 543 354 - Provides 24 hour telephone counselling
Youthline: 0800 376 633 or free text 234 - Provides 24 hour telephone and text counselling services for young people
Samaritans: 0800 726 666 - Provides 24 hour telephone counselling.
Tautoko: 0508 828 865 - provides support, information and resources to people at risk of suicide, and their family, whānau and friends.
Whatsup: 0800 942 8787 (noon to 11pm)
Kidsline: 0800 543 754 (4pm - 6pm weekdays)
The Lowdown: thelowdown.co.nz - website for young people aged 12 to 19.
National Depression Initiative - depression.org.nz (for adults), 0800 111 757 - 24 hour service
If it is an emergency or you feel you or someone you know is at risk, please call 111
For information about suicide prevention, see www.mentalhealth.org.nz/suicideprevention.