An increased focus on ‘talking about it’ will only help if we’re honest with ourselves and each other about what is driving self-inflicted deaths in this country, writes Carla na Nagara.

There has always been debate about whether talking about suicide is responsible or constructive. And since the Covid-19 alert level response started in March, there’s been a marked increase in speculation and rumours about the number of suspected suicides across the country.  

This is not entirely surprising, given the increasing rate of reporting on suicide over recent years in all forms of media – articles reporting suspected suicides, coroners’ findings and the experiences of those bereaved by suicide; social media support and chat groups; movies and podcasts dealing with suicide.

Unfortunately, talking about suicide – and referencing numbers – will not help us to prevent suicide in New Zealand, and it can have the opposite effect. All this “talking about it” has not led to a decrease in our suicide rate. 

We live in a world where it has become increasingly common to talk openly about issues to help raise awareness and normalise them. Usually, this is a good thing.  It helps people understand the struggles of others and destigmatises issues. This is certainly true for conversations about mental health and wellbeing.

However, international evidence tells us normalising talking about suicide is not helpful. In fact, it can cause harm.  

We need to be clear about what we are talking about, and why. Our current “talking about it” is stuck in the traditional framing of suicide being a mental health problem to be solved by mental health services. However, while people who die by suicide are almost always acutely distressed, they are not necessarily mentally ill. In addition to improving our emotional competence and tolerance for the mental health challenges of others, we must commit to being honest with ourselves and each other about what is driving self-inflicted deaths in this country.

In the traditional approach, suicide prevention focuses on supporting someone in distress. This is important, but supporting people who need help cannot be the exclusive focus of our suicide prevention efforts if we are to lower what is acknowledged as being an unacceptably and persistently high suicide rate. 

The only way talking about suicide will have a positive result is if it contributes to understanding and prevention. To do this, we need to be brave enough to talk about what contributes to suicide, and to take the steps to address those things.

Things such as traumatic childhood experiences, domestic violence and sexual abuse, poverty, racism, bullying, loneliness, the myth of the stoic Kiwi bloke, the breakdown of families and communities and our drinking culture.

These things don’t cause suicide. They impact healthy development from birth and they impact wellbeing. They contribute to distress and in the absence of protection from strong, healthy, connected whānau, families and communities, can lead to suicide. Unless we confront this and are prepared to do something about it, our suicide rate will not come down.

It is not a problem we can consign to mental health services to fix – they are just one part of the solution. What drives distress are the things we don’t like to talk about – things such as the prevalence of psychological, physical and sexual violence across our society, inequity, racism, intergenerational poverty and the impacts of colonisation.

Not only do we need to name these things, we need to face up to their impacts, and we need to own these issues. After all, they are all around us, affecting us all in some way every day.

As a society we have not been ready to own these issues, much less to acknowledge their relationship with our suicide rate. It is much easier for us to consider suicide a problem to be solved solely by services, because the alternative is to accept that we have serious issues of inequity and human rights to address. 

That we haven’t done this well is reflected in our suicide rates, and for as long as we are happy to tolerate the casual dismissal of concern about these issues, we will not be ready to hear, much less talk about, the things that really need to be said.

Carla na Nagara is the director of the Ministry of Health’s Suicide Prevention Office

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