Essay on the Four Elements of the Navy Suicide Prevention Program

Lifeline Aotearoa: Youth suicide is an urgent health issue in New Zealand (NZ), particularly for young Māori aged 15-19, in which suicide is 250% higher than their non-Māori counterparts. Literature shows that combining culturally appropriate mental health promotion and suicide responsiveness in adults is more likely to be effective in preventing suicide.  Suicide is a serious public health issue resulting in approximately 800,000 annual deaths globally, which are preventable given timely, evidence-based intervention. In NZ, suicide is the leading cause of death in 15-19 year-olds, at a rate of 15.6 people per 100,000.  The root causes of suicide are complex and multifaceted, with effects impacting beyond the individual into their communities. 

Risk factors include self-harm, depression, poor self-efficacy, and coping skills, bullying, lack of social support, and insecure identity. Wider social issues also contribute to suicide risk such as poverty, abuse, social media messages, mental health service inaccessibility, discrimination, and stigmatization of help-seeking. Vulnerable groups that experience intersectional layers of risk factors, such as indigenous populations, have higher rates of suicide. The cost of suicide on health systems internationally is approximately $1.4 billion with 19,218 healthy life years lost.   In New Zealand, previous responses to reducing the rate of suicide are outlined in The New Zealand Suicide Prevention Strategy 2006–2016, which collates the work of researchers, community organizations, health and social service providers, and multiple government agencies. It explores the potential benefits of expanding the range and accessibility of support for at-risk individuals, families, and communities. Lifeline Aotearoa has been helping New Zealanders in crisis for over 50 years. 

This program provides specialist counseling, corporate and volunteer training, online support for workplaces, and coordinates suicide prevention and postvention activities in the Wellington districts. The mission is to reduce distress and save lives by providing safe, accessible, effective, professional, and innovative services. We work specifically to increase awareness and understanding of suicide prevention in New Zealand and reduce the associated stigma and work with others to make a positive contribution to the health and social sector. Over 10,000 calls per month from people of all ages and ethnicities who are struggling with a wide range of issues including relationship and work problems, mental health, grief, abuse, bullying, and loneliness. They help an average of 6 people a day at high risk of suicide. Calls to our helplines are free, confidential, and available 24 hours a day, seven days a week. They receive no government funding for these helplines and rely on public donations. Lifeline is part of Presbyterian Support Northern, a non-government organization in the health and social service sector. Lifeline’s Vision: People have someone who will listen, to turn to when in distress. 

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Lifeline’s Mission: Reducing distress and saving lives by providing trusted, effective, interactive, and professional 24/7 helplines collaborating with others to provide accessible and effective crisis services having supervised and compassionate volunteers making a positive contribution to the health and social service sector Suicide Prevention Program: Te Au is my suicide prevention program of Aotearoa is to promote Maori whanau and communities through culturally appropriate training and activities. Our main aim of this program is to reduce the suicide rate. Te Au is part of Te Rau Ora and makes up the Māori platform of Waka Hourua: The Māori and Pacific Suicide Prevention National Programme, who we are accountable and align our values (Te Au, 2019b). As well as key stakeholders: 24/7 YouthWork, local Iwi, Otumoetai Intermediate, MMC, and the local community.   Te Au is partnering with 24/7 YouthWork to establish Kaupapa Māori youth hubs, called Hāpai House, in Otumoetai Intermediate and MMC. This partner with the existing relationship 24/7 YouthWork has with Otumoetai Intermediate and extends this into MMC.  Pre-Planning and Team Formation:  Recruitment and Establishing roles and expectations of the core team: One project manager and Two Rangatahi Tautoko from Te Au. Eight 24/7 YouthWorkers. Initial project plan i.e. general aims/objectives/activity outlines/stakeholder consideration.   

Stakeholder Consultation:  Te Au and 24/7 YouthWork organizational relationship established. Both are informed of our activities and have the opportunity to advise changes or supply additional resources. Contact whānau, iwi/hapū, local Māori health providers, and local communities through introductory hui to ensure they are fully informed, consent, and are involved in planning, and decision-making. The partnership was initiated with schools to inform them of the project, gain input, and determine resources/infrastructure. Consult with student representatives on their needs in relation to Hāpai house.   

Planning:  Assemble input of the various stakeholders to determine the overall project plan: Logistics of working in schools. What Hāpai House ‘looks’ like, will ‘do’, and aims to ‘achieve’. Conduct sessions:  Train Rangatahi Tautoko and YouthWorkers - How to: run activities, hui, engage with rangatahi and their whānau, notice behavior patterns in rangatahi, and implement early suicide intervention strategies. Conduct suicide prevention (gatekeeper) wānanga for youth workers, whānau, and school staff facilitated by Te Au.   

Implementation:  Trained Rangatahi Tautoko to establish and promote Hāpai House in schools, running after-school activities and whānau hui. Safe space that students can come to - kai, support, empowerment activities, life skills, reflection, relaxation. Youth development approach to foster hauora: Provide and foster skills, environment, and connections to increase resilience, that protects against suicide and uplifts mana. The strategy notes how successful programs emphasize empowerment and resilience building, including Whānau Ora, and Better Public Services, which focus on both risk and protective factors. It also noted how previous interventions have often lacked important opportunities for face-to-face interaction, such as one-off large group presentations or helplines, as both have received effectiveness critiques. The strategy found that ‘one-size-fits-all’ interventions increase suicide inequities in minorities, thus it is important to tailor interventions. School-based programs that foster long-term support systems are more effective at reducing rangitahi suicide rates, and more accessible for students than community-based locations. Furthermore, access barrier gaps need addressing, from classrooms to counseling spaces. Interventions that use a combination of gatekeeper training in adults, plus individual-focused, strengths-based, and custom-designed methods were found to be more effective in Māori youth suicide prevention.

Reference:

1. Alcohol. (2019). Retrieved 4 October 2019, from https://www.hpa.org.nz/programme/alcohol
2. Suicide Prevention in New Zealand. (2019). Retrieved 6 October 2019, from https://www.health.govt.nz/our-work/mental-health-and-addictions/suicide-prevention-new-zealand