The NZ Herald’s recent special feature on teen suicide in Northland was a reminder, should anyone need it, of the tragic cost of suicide in New Zealand. It’s time we all started treating suicide as the national emergency it is, writes Dr Jess Berentson-Shaw.
What do I want for my children and what do I think a good life for them looks like? It’s simple: I want them to do and be well. Of course wellness means many things to many people. For me – and most parents, I would suggest – wellness in part means a life in which our children find purpose, feel satisfied, and at times (hopefully many times) experience joy. When they experience inevitable challenges and disappointments they will have the tools to manage their feelings, but also be able to get the help they need if they find they cannot. As their parent I want to be and do well for them also. To be resilient, to find joy where it lies, and to be able to manage the ebbs and flows of my own life.
But that’s all easier said than done. What we – me, my children, you, your children – need to achieve it is meaningful encouragement and investment from the wider society. Because individuals working alone, coping alone, who are not treated as an important part of a larger whole, will struggle to consistently be well: wellbeing is achieved through strong connections and systems.
We have a major problem in this country with suicide and self-harm
Young people, filled with enthusiasm and potential, are killing themselves at a rate that is more than tragic, greater than shameful: it is ripping the heart out of our communities. We have the worst rate of youth suicide in the OECD.
Older people, people with so much experience and support to offer the young, are killing themselves too, and leaving us with great holes in the fabric of our society.
Too many people are struggling under the grey and unbearably heavy burden of hopelessness, and it has created a torrent of heartbreak. But it is a torrent we are trying to hold back with our hands, and much like standing under a waterfall and holding up our arms to stop the flow, it is simply not going to work.
We MUST consider the social conditions associated with mental wellbeing
We know that the number of children and young people accessing mental health services has been steadily rising for some years. Whether this is due to the better identification of disorders or their higher occurrence is unclear. However we can see that self-harm and suicide rates (one indicator of mental unwellness) have remained steadily high for at least 10 years, at a rate of between 16 and 20 young people per 100,000.
Suicide is the leading cause of death in young people in New Zealand (shared with vehicle injuries), but the burden of death falls disproportionately on lower income communities, with self-harm and suicide rates all significantly higher for poorer children. The Child and Youth Mortality Review Committee reports that around 60 of every 100,000 children from the poorest communities in New Zealand die each year (from all causes, not just suicide) compared to 20 of every 100,000 from the wealthy communities.
Parents’ mental health matters too
The attachment and bond a child has with parents and caregivers is an essential factor in a child’s development. Having a primary caregiver who is mentally well matters. When we are unhappy we find it harder to connect with our children or to make our relationships go as smoothly as we would like, and this does impact on children’s well-being and development if it goes on too long.
It is estimated that post-natal depression occurs at a rate of between 10% and 20% of mothers, although it is a notoriously under-reported and misunderstood mental health issue. Fathers also experience depression after children’s births. More generally the rate of diagnosed mental health disorders in adults in New Zealand is 16.3% and the rate of psychological distress is 6.3%. There are over a million children in New Zealand and many of these adults reporting mental distress will be parents.
The Ministry of Health tells us mental health disorders and psychological distress occur at a much higher rate in the poorest adults. Psychological distress for example occurs at 2.6 times the rate in adults on the lowest incomes.
We need to get a lot more serious about what being poor does to families and children’s mental wellbeing.
It’s the poverty (specifically the stress)
I have previously discussed that the evidence shows it is poverty itself that is at the heart of why lower income children and parents experience greater levels of mental distress. In the book Pennies From Heaven, I describe research showing that being poor affects parents and their children’s wellbeing through increased stress. Stress affects the way parents interact with children, it affects their family relationships, and the brain development of children themselves – all of which impacts on parents’ and children’s mental wellbeing. Over time the impacts of this stress can lead to mental health disorders (substance abuse for example) which serve to further bind families to their circumstances.
There are many individual psychological and pharmacological treatments that do work to improve the lives of those who have become unwell. We should fund these properly and stop waiting until people become so unwell that they cannot respond optimally to treatment. But what we really need to do is focus on building mental health in our communities as a first approach, because failing to do so is expensive, and hard, and leads to tragic consequences.
On that note, investing properly in Māori and Pacific-led research and community initiatives in mental wellness (however these groups define that) is critical. Whānau ora is showing significant benefits for the whānau and communities involved. We need more of these types of initiatives for different vulnerable populations. What’s more, the people developing them need to be trusted and enabled to innovate and experiment, to show just how powerful models of intervention that are grounded in self determination can be.
People in government must make better decisions based on what actually works
What we know from international experiments is when low income parents receive unconditional cash both parents’ and children’s mental health improves. In 80% of the highest quality studies available across the world unconditional cash improved children’s mental wellbeing and behaviour, and in 100% of such studies it improved maternal mental health.
Why does providing sufficient resources without strings attached improve mental health? Because it gives families a trampoline to bounce off: it empowers them to do their best parenting and live their lives in a positive way that works for them and their children. It is exactly how superannuation works, and how the old family benefit worked too. We did not wait for people to fall.
People in government tell us “we need to talk about suicide”. Great! We can totally do that. But what they need to do is choose better policies; ones that account for how the structures and systems in society work to either protect or tear away people’s mental wellbeing. People in government should not wait until the trickle of mental health issues becomes a waterfall and then tell us to stand underneath and try and hold back the flow. That is what is really letting our kids down and it does not need to be this way. Those who we have elected to represent our children and us can choose to fix this.
Dr Jess Berentson-Shaw is Head of Research at the Morgan Foundation public policy think tank. She is the author of the new book Pennies From Heaven: Why cash works best to ensure all children thrive.
For more information about suicide prevention, see www.mentalhealth.org.nz/suicideprevention
Where to get help:
Lifeline – 0800 543 354
Suicide Crisis Helpline (open 24/7) – 0508 828 865 (0508 TAUTOKO)
Depression Helpline – 0800 111 757 – this service is staffed 24/7 by trained counsellors
Samaritans – 0800 726 666
Youthline (open 24/7) – 0800 376 633. Text 234 for free between 8am and midnight, or email firstname.lastname@example.org.
0800 WHATSUP (0800 9428 787) – Open between 1pm and 10pm on weekdays and from 3pm to 10pm on weekends. Online chat is available from 7pm to 10pm every day at www.whatsup.co.nz.
Healthline – 0800 611 116
For more information about support and services available to you, contact the Mental Health Foundation’s free Resource and Information Service on 09 623 4812 during office hours or email email@example.com
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