23 April 2002
The Ministry of Health says new figures released today showing a decline in suicide deaths in 1999 are encouraging but
New Zealand's suicide rate is still too high.
Provisional 1999 suicide statistics for all ages show 514 people died by suicide in 1999, compared with 577 in 1998 and
561 in 1997. The 1999 total is the lowest since 1994 (512), said Ministry spokesperson Maria Cotter.
"It's encouraging to know these rates can come down but the figures are still too high," Ms Cotter said.
"Every suicide is a personal tragedy and devastates families, friends, colleagues and communities. While the decrease in
suicide is encouraging, we must all try to create an environment where people are supported enough to value their own
lives."
Suicide deaths have reduced among both Mäori and non-Mäori. The overall rate of suicide among Mäori was the same as for
non-Mäori in 1999.
Preventing suicide and suicide attempts across all age groups is a priority under the New Zealand Health Strategy. It
involves cooperative efforts from Government, service providers, communities and families.
"Suicide is not only an issue for the health system, it's an issue for New Zealand society. Although there is no one
cause and no single way to address the issue of suicide, Government and the community need to continue working together
to reduce and prevent suicide," said Ms Cotter.
"These latest figures still make New Zealand's youth suicide rate the highest among selected OECD countries, although
international comparisons are difficult as countries have different reporting methods," said Ms Cotter.
Youth suicide rates are still significantly higher among Mäori than non-Mäori.
The New Zealand Youth Suicide Prevention Strategy involves a wide range of initiatives aimed at reducing youth suicide,
with a specific focus on addressing suicide among taitamariki (Mäori youth).
This strategy, launched in 1998, is now led by the Ministry of Youth Affairs and involves a number of government
agencies. Many initiatives under the strategy impact on all age groups. These include expansion of mental health
services, primary health care, mental health and emergency department guidelines. Another important focus is the
prevention, recognition and management of depression across all age groups.
The 1999 statistics are currently only provisional as there are a small number of outstanding deaths awaiting a
coroner's finding.
"Suicide statistics take some time to collate as it is important to assign an accurate cause of death to the majority of
deaths before the figures are released. We expect the youth suicide statistics for 2000 to be available around mid
year."
The provisional 1999 suicide statistics are available from the New Zealand Health Information web site:
www.nzhis.govt.nz
ENDS
For more information contact: Zoe Priestley Media Advisor ph: 04-496-2483 or 025-277 5411
http://www.moh.govt.nz/media.html
Julie Allan Senior Communications Advisor Ministry of Youth Affairs ph: 04-914-4866 http://www.youthaffairs.govt.nz
The Ministry of Health has published a resource to help with the reporting and portrayal of suicide in the media. For
copies of Suicide and the Media - The reporting and portrayal of suicide in the media, a resource contact Wickliffe
Press on 0800 226 440 or see the Ministry's website under publications www.moh.govt.nz
Other contacts on suicide/suicide prevention:
Dr Peter Watson Specialist Adolescent Physician Centre for Youth Health ph: (09) 279-5110 or 021-863-426
Dr Annette Beautrais Principal Investigator Canterbury Suicide Project Christchurch School of Medicine ph: (03) 372-0408
Keri Lawson-Te Aho Researcher Suicide among Mäori ph: 025-207-1955
BACKGROUND
Suicide Facts Provisional 1999 Statistics (all ages)
For graphs to illustrate suicide statistics and more detailed information, see the NZHIS website www.nzhis.govt.nz
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-------------------------------------------------------------------------- --| |Key Points | | | |The total number of
suicides has reduced to 514 from 577 in 1998 and 561 in 1997. This is the lowest total number since 1994 (512) and the
lowest | |rate since 1993. | | | |Total suicide deaths and rates have reduced among males in recent years, but there has
been a slight increase in numbers and rates among females. | | | |In 1999 a total of 120 young people aged 15?24 years
died by suicide, compared with 140 in 1998, and 142 in 1997. Youth still have higher rates of | |suicide than other age
groups. | | | |Suicide deaths have reduced among both Mäori and non-Mäori. In 1999 the rate of suicide among both Mäori
and non-Mäori was almost identical (12.0 to| |12.2 per 100,000). However, Mäori continue to have higher rates of suicide
among youth. | | | |The hospitalisation rate for suicide attempt and self inflicted injury in 1999/2000 has increased
slightly for the total population compared to | |1998/1999 and 1997/1998 (but is identical to the 1995/1996 rate).
Hospitalisation rates for youth (15-24 years) in 1999/2000 have also increased | |slightly on 1998/1999 but are lower
than the 1995/1996 rate. | | | |There is some variation in regional suicide rates for the total population but there is
no apparent trend. There is more variation among youth rates| |but still no emergent regional trends. | | | |The New
Zealand Health Strategy has identified reducing suicide and suicide attempts across all ages as a priority health
objective. | | | |Suicide prevention requires a range of interventions across a number of settings and the cooperation
of Government, service providers, communities | |and families. |
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What is the most recent data available on suicide? Provisional 1999 all ages statistics are available on the New Zealand
Health Information web site: www.nzhis.govt.nz These figures are still considered provisional because there are a small
number of deaths that are subject to coroners' findings, for which a cause of death has not yet been assigned. For this
reason we are unable to say they are final. Data becomes official once it is published by the New Zealand Health
Information Service (NZHIS).
How is a death deemed to be a suicide? Only a coroner can classify a death to be a suicide. A coroner will inquire into
all suspicious deaths and make the decision after they have all the facts. In some cases the inquest will be heard over
a year after the death, particularly if there are other factors surrounding the death which need to be investigated
first.
SUICIDE - ALL AGES
How many people died by suicide in 1999? A total of 514 people died by suicide, compared with 577 in 1998, and 561 in
1997. 383 males died by suicide, compared with 445 in 1998, and 440 in 1997. 131 females died by suicide, compared with
132 in 1998, and 121 in 1997.
What is the rate of suicide in New Zealand? The suicide rate for the total population was 12.5 per 100,000 in 1999,
compared to 12.1 per 100,000 in 1990. This is the lowest rate since 1993. The rate of suicide for males was 18.9 per
100,000 in 1999, compared with 19.7 per 100,000 in 1990. The rate of suicide for females was 6.4 per 100,000 in 1999,
compared to 4.7 per 100,000 in 1990.
Suicides by age group In 1999 the highest rates of suicide were among males 20-39 years (20-24 ? 41.2 per 100,000, 25-29
- 41.5 per 100,000, 30-34 ? 36.0 per 100,000 and 35-39 - 29.1 per 100,000). Among females 15-19 year olds (14.5 per
100,000) and 20-24 year olds (14.0 per 100,000) have the highest rates.
How many Mäori died by suicide in 1999? In 1999, 77 Mäori died by suicide, compared to 112 in 1998 and 103 in 1997. In
1999, 57 Mäori males died by suicide compared to 87 in 1998, 77 in 1997. In 1999, 20 Mäori females died by suicide
compared to 25 in 1998, 26 in 1997. The rate of suicide for Mäori was 12.0 per 100,000, compared to the non-Mäori rate
of 12.2 per 100,000. In 1999, the rate of suicide for Mäori males was 18.2 per 100, 000, compared to the non-Mäori rate
of 18.4 per 100,000. In 1999, the rate of suicide for Mäori females was 6.1 per 100, 000, compared to the non-Mäori rate
of 6.2 per 100,000.
How many Pacific people died by suicide in 1999? In 1999 14 Pacific people died by suicide (8 males and 6 females),
compared to 24 deaths in 1998.
How has the classification of ethnicity changed? And can we still compare ethnicity data across years? In September
1995, the method used for recording ethnicity for all mortality changed from a system of biological concept (50 percent
or more ancestry) to one of self-identification. This was to match with census changes, and is considered to be a more
reliable method. The changes have had a major impact on the relative rates of all mortality for Mäori and non-Mäori.
Ethnicity data can now only be compared as far as 1996. This is the case for all ethnic specific mortality data.
Why do more males die by suicide than females? The all ages gender ratio for suicide in New Zealand is 3:1 male suicides
to every female suicide. The youth suicide (15-24 years) ratio is 2:1 males suicides to every female suicide. Research
suggests that the difference in male and female suicide may be associated with choice of methods. Females, however, make
more non-fatal suicide attempts.
SUICIDE ? YOUTH (15-24 years)
How many young people (15-24 years) died by suicide in 1999? In 1999 a total of 120 young people aged 15?24 years died
by suicide, compared with 140 in 1998, and 142 in 1997. Of these 120 young people, 83 were male and 37 were female.
What is the rate of youth suicide (15-24 years) in New Zealand? The total rate of youth suicide in 1999 was 22.6 per
100,000 compared to 22.5 per 100,000 in 1990. The rate of youth suicide for males (aged 15?24) in 1999 was 30.6 per
100,000, compared with 38.0 per 100,000 in 1990. The rate of youth suicide for females (aged 15?24) in 1999 was 14.2 per
100,000, compared with 6.7 per 100,000 in 1990.
How many Mäori youth (15-24 years) died by suicide in 1999? In 1999, 33 Mäori young people (15-24 years) died by suicide
(23 males, 10 females), compared to 43 in 1998, and 36 in 1997. In 1999, the rate of suicide for Mäori youth was 30.6
per 100,000, compared to the non-Mäori rate of 20.5 per 100,000. In 1999, the rate of suicide for young Mäori males was
42.4 per 100, 000, compared to the non-Mäori rate of 27.7 per 100,000. In 1999, the rate of suicide for young Mäori
females was 18.7 per 100, 000, compared to the non-Mäori rate of 13.1 per 100,000.
Is the overall rate of youth suicide still increasing? No. The youth suicide rate has now decreased for four consecutive
years. The 1999 numbers and rates are the lowest for many years. Total youth suicide deaths are the lowest since 1987
and the total rate is the lowest since 1991. Youth suicide numbers and rates have dropped for both Mäori and non-Mäori.
There was a slight increase for females (due to an increase among non-Mäori females). Because suicide is, in statistical
terms, an uncommon event and rates vary from year to year, it is better to look at the total pattern of suicide rates
over several years.
SUICIDE ATTEMPT
How many people attempted suicide (1999/2000 from mid year to mid year)
All ages The rate of hospitalisation for 1999/2000 was 95.7 per 100,00, compared to 92.9 per 100,000 in 1998/1999, and
94.8 per 100,000 in 1997. In 1999/2000, there were a total of 3767 hospitalisations for self-inflicted injury compared
to 3631 in 1998/1999. The rate of hospitalisation in 1999/2000 was the same as 1995/1996 (five years ago). In 1999/2000
there were 1389 male hospitalisations (rate of 70.4 per 100,000) compared to 1427 hospitalisations in 1998/1999 (rate of
73.1 per 100,000). In 1999/2000 there were 2378 female hospitalisations (rate of 121.2 per 100,000), up from 2204 in
1998/1999 (rate of 112.3 per 100,000). Among Mäori in 1999/2000 there were a total of 556 hospitalisations at a rate of
89.5 per 100,000 (213 male at a rate of 70.4 per 100,000, and 343 female at a rate of 108.0 per 100,000). More females
are hospitalised for attempted suicide than males. This is mainly due to females more often choosing methods such as
self-poisoning, which generally are less-fatal, but still serious enough to require hospitalisation.
Youth (15-24 years)
Youth have the highest hospitalisation rates. The hospitalisation rate for young people (15-24 years) in 1999/2000 is
198.5 per 100,000 (1054 hospitalisations) compared to 195.2 per 100,000 in 1998/1999 (1047 hospitalisations) and 215.8
per 100,000 in 1997/1998 (1172 hospitalisations). The hospitalisation rate in 1995/1996 was 238.4 per 100,000 (five
years ago). In 1999/2000 there were 356 male hospitalisations (rate of 131.4 per 100,000) compared to 402
hospitalisations (rate of 147.4 per 100,000) in 1998/1999. In 1999/2000 there were 698 female hospitalisations (rate of
268.3 per 100,000) compared to 645 hospitalisations (rate of 244.6 per 100,000) in 1998/1999. In 1999/2000, the
hospitalisation rate for Mäori females was 224.4 per 100,000, lower than the non-Mäori female rate of 279.6 per 100,000.
For Mäori males the hospitalisation rate was 158.6 per 100,000, higher than the non-Mäori male rate of 124.6 per
100,000).
Are there problems with the accuracy of suicide attempt data? Yes. It is important to be cautious about the
interpretation of suicide attempt data. We don't have accurate data on all suicide attempts because records are only
kept on those who are admitted to hospital as inpatients or daypatients. Data are not collected on people treated in
Accident and Emergency as outpatients, people treated by GPs, and those who do not seek medical treatment. Also,
changing treatment methods make comparisons across years difficult. For example, improving treatments for overdoses has
meant more people can be treated on an outpatient basis, and will not appear in hospitalisation suicide attempt figures.
The suicide attempt data (above) are for self-inflicted injury and may include cases of deliberate self-harm where the
intent was not death. Hospitalisation figures include people who are admitted more than once during that year, and also
include those who died while in hospital.
What is the relationship between suicide and attempted suicide? People who have already made one suicide attempt are at
greater risk of dying by suicide, so it is important that such people get effective follow-up support and treatment.
REGIONAL COMPARISONS
Key points (total population): Although there is variation at the District Health Board level, no overall trend in
suicide rates is apparent. Bay of Plenty, Whanganui, West Coast and Canterbury District Health Boards have suicide rates
significantly higher than the national rate. No District Health Board has suicide rates significantly lower than the
national rate.
Key points (Youth): While the magnitude of regional variation amongst youth suicide rates is greater, the number of
District Health Boards reaching levels of significance is less than for the total population. The lower levels of
significance are due to the smaller populations involved in calculating youth suicide rates. Bay of Plenty and Whanganui
District Health Board have significantly higher youth suicide rates while only Auckland District Health Board had a
significantly lower youth suicide rate than the national rate.
General points: Whanganui and Bay of Plenty have significantly higher suicide rates for both youth and the general
population.
INTERNATIONAL COMPARISONS
How does New Zealand's suicide rate compare internationally? In comparison with selected OECD countries New Zealand's
1999 suicide rates are high, particularly among youth. In 1999, New Zealand's all age suicide rates for males and
females were the fourth highest among selected OECD countries. For youth aged 15-24 years New Zealand has the highest
rates of suicide for both males and females among selected OECD countries. Suicide trends appear to differ across
cultures, for example, while New Zealand has a high rate of young male suicide, China has a high rate for females. The
increase in youth suicide over the last 20 years appears to be a global trend, particularly amongst developed countries.
BACKGROUND INFORMATION ON SUICIDE
What causes people to want to take their own life? Because each person is unique, there is no single reason why people
choose to end their life. However, from research we know that there are several factors that may contribute to a person
engaging in suicidal behaviour. Mental disorder, most commonly depression, appears to be the most important risk factor
for suicide and suicide attempts. Research from the Canterbury Suicide Project has found that young people who have died
by suicide or who have made a serious suicide attempt often have shared circumstances, such as: they have some
underlying psychological distress or mental illness they display some recognisable mental health or adjustment
difficulty prior to the suicide attempt immediately prior to the suicide attempt they may face a severe stress or life
crisis that often centres around the breakdown of an emotional or supportive relationship they tend to come from
disturbed or unhappy family and childhood backgrounds they tend to come from socially and educationally disadvantaged
backgrounds. Research from this study also found that approximately 90 percent of people who die by suicide or make
suicide attempts will have one or more recognisable psychiatric disorders at the time. The most common are: depression;
substance-use disorders (alcohol, cannabis and other drug abuse); and significant behavioural problems.
Are there protective factors for suicide? Research is continuing to investigate the range of factors that may have the
capacity to protect people who might otherwise be at risk of suicide. Suggested protective factors include good coping
skills and problem-solving behaviours, positive beliefs and values, feelings of self-esteem and belonging, connections
to family or school, secure cultural identity, supportive family/whänau, hapü and iwi, responsibility for children,
social support, and holding attitudes against suicide.
Where can people go for help? If you are concerned about someone who may be suicidal or is very distressed you can
approach the following people for advice: family doctor (GP) or practice nurse community mental health service Marae
based health clinics Mäori community health workers counsellor (including school guidance counsellor) or Mäori
health/counselling services phone counselling services such as Lifeline, Samaritans or Youthline.
If the situation is critical try to ensure the person is safe and contact your nearest hospital emergency department or
psychiatric emergency team.
How can suicide be prevented? Just as there is no one reason which brings someone to take their own life, there is no
one answer. Rather, a range of initiatives need to be in place across a number of settings supported by Government,
service providers, communities and families. Such interventions are generally aimed at promoting protective factors and
reducing risk factors for suicide.
Key components of suicide prevention
In the absence of conclusive scientific evidence on all aspects of suicide prevention, there is strong agreement
internationally of the key components for suicide prevention. The main themes from reports and strategies on suicide
prevention, both in New Zealand and internationally, state the need for a comprehensive and intersectoral approach. This
approach should use multiple strategies that: address multiple risk and protective factors involve sustained action over
a long period involve local, regional and national action involve action across several sectors (e.g. health, education,
police, corrections, child, youth and family etc) have a wide view of prevention as requiring interventions to occur at
a range of levels including the environment, whole population, specific population groups (eg, Mäori, youth, Pacific
peoples, males) and individuals at risk (preferably in the context of the family/whanau) include a focus on improving
data, research and evaluation.
Intervention themes
There is general agreement that a comprehensive approach to suicide prevention needs interventions to address the
following eight themes: mental health promotion including strengthening social cohesion and providing supportive
environments effective, accessible and responsive services for people with mental disorders or suicidal behaviours
(including prevention, recognition and treatment of depression) training and skill development on suicide risk
assessment and management a managed approach to media and publicity about suicide reducing access to the means of
suicide management and support for families and friends following suicide.
What are some examples of where we can focus suicide prevention initiatives? The prevention, recognition and treatment
of depression. Promote positive mental health in families, schools, workplaces and the community. Promote awareness of
mental health issues at the community level. Improve services (both mental health, emergency and general health
services). Support initiatives to reduce the stigma of mental illness (e.g. Like Minds, Like Mine campaign). Increase
public understanding of what to do if someone is suicidal. Improve the support and treatment of those who have already
attempted suicide, and their families and friends. Implement measures to restrict access to the means of suicide.
Provide guidance to the media about the reporting and publicity of suicide to minimise the potential of imitative
suicides. Improve our knowledge and information systems so we can better target suicide prevention strategies for the
best outcomes. Support communities, families and whänau to provide emotionally safe and nurturing environments for all
people, particularly children and young people. Expand family support and early intervention services to help keep
children and young people safe and healthy.
A toolkit has been developed to provide guidance to District Health Boards on the most effective ways in which they can
work to reduce the rate of suicide and suicide attempts in their region: www.moh.govt.nz
What is the New Zealand Youth Suicide Prevention Strategy? In March 1998, the Government released The New Zealand Youth
Suicide Prevention Strategy. This Strategy provides a framework for understanding what suicide prevention is, and
signals the steps a range of government agencies, communities, service providers, Mäori whänau, hapü and iwi must take
to reduce suicide. Through the Strategy, all suicide prevention initiatives should become increasingly coordinated and
any service gaps identified and addressed. The Strategy has two components. In Our Hands is the general population
strategy. Kia Piki te Ora o te Taitamariki takes an approach based on whänau, hapü, iwi and Mäori community development
and encourages mainstream services to be more responsive to Mäori. >From 2001 the Ministry of Youth Affairs has the
leadership role for promoting, coordinating and communicating the implementation of the strategy. A Ministerial and
Inter-Agency Committee have also been formed to oversee the government-level implementation of the Strategy.
The 2002 implementation plan will be available from May 2002 from the Ministry of Youth Affairs: Ph (04) 471-2158,
Website: www.youthaffairs.govt.nz
Help Lines and Services
Refer to page 32 of the telephone book
Help Lines · Youthline · Lifeline · Samaritans
Services for emergencies · Psychiatric emergency services · Community mental health services · General practitioner ·
Emergency department of the local hospital
General support services · Community mental health services · General practitioner · Lesbian and gay support counselling
services · Iwi and other Mäori health/counselling services · Sexual abuse counselling services · Family counselling
services · Alcohol and drug services · Other specialist counselling service such as bereavement services, family
counsellors, whanau support services, refugee support services etc.) · Victim support · Samaritans/Lifeline/Youthline ·
School counsellor · Specialist Education Services
General information for the public on mental health · The Mental Health Foundation of New Zealand, Ph (09) 630-8573,
Website: www.mentalhealth.org.nz
Anyone seriously concerned about an individual's immediate safety should: · remain with them until appropriate support
arrives · remove any obvious means of suicide (guns, medication, cars, knives, rope etc) · contact the nearest hospital
or psychiatric emergency service.
Statistics:
For technical queries about provisional data contact the New Zealand Health Information Service. Website:
www.nzhis.govt.nz Ph (04) 922-1800, fax:(04) 922 1897, E-mail: inquiries@nzhis.govt.nz
New Zealand Youth Suicide Prevention Strategy
To find out more about the New Zealand Youth Suicide Prevention Strategy contact: Debbie Edwards, National Coordinator,
Ministry of Youth Affairs: Ph (04) 914-4863
A stocktake of initiatives that address youth suicide prevention will be available from May 2002 on the Ministry of
Youth Affairs website: www.youthaffairs.govt.nz
For New Zealand Youth Suicide Prevention Strategy documents contact Wickliffe Ph 0800 226 440. E-mail pubs@moh.govt.nz
SPINZ (Suicide Prevention Information New Zealand)
For general information for the public about youth suicide and youth suicide prevention contact SPINZ: website:
www.spinz.org.nz, contact: Leora Hirsh Ph (09) 638-7364, fax (09) 630-7190, E-mail: info@spinz.org.nz