Suicide Prevention Dr Peter Watson Clinical Director Counties Manukau Mental Health & Addictions Date: Created by:Dr Peter Watson

Why are we interested in suicide prevention? “ We are not seeing any shift in what is an unfortunate statistic.” Judge Marshall – Chief Coroner

NZ All Age Mortality

Why is it so hard to prevent suicide? Low incidence of about 1/10,000 per year Very common risk factors Poor risk prediction Heterogeneity Cultural context Fear

Starting points….. We need to counteract the trivilisation and sensationalization of suicide by developing a sense of community and responsibility Realise there are no experts

What is suicide prevention about? Suicide and suicidal behaviours –Many suicides are first attempts with no contact with services –Challenges the focus of our efforts –Which self harm behaviours are suicidal vs non- suicidal –Suicide attempters accounts

Suicide prevention is not… It is not just about detecting those at risk…. “It is not a dash of teen screen and a splash of QPR” Richard McKeon - Head of SAMHSA adolescent suicide prevention programme

How might we achieve this? Clarity about the goal A long term comprehensive strategy with targets Broad and consistent leadership Collaborative actions and learnings Consistent and repeated measurement

2 areas of focus Mental health and addiction services Communities (inclusive of geographic, ethnic, faith based, schools, primary care, other government agencies and non-government organisations)

Mental health and addiction services Risk of death by suicide among those who are MH&A service users approx 20x that of the general population and account for 30-40% of all suicide deaths Quality and safety = zero suicide movement

CMH MH&A Provider Arm‘Big Dot’ By 2019 there will be 25% fewer suicide deaths in Counties-Manukau

CMH MH&A Provider Arm Suicide Prevention Action group focusing on: –Owning the target –Sharing information and data –Systematic approach to SIR recommendations –Review and updating our ED guidelines and responses –Clinician awareness and training

Provisional suicides by DHB

CMH Suspected Suicides

Community SP initiatives responding to communities' identified needs change selected policies and practice that promote mental wellbeing and resilience increasing awareness and knowledge change social norms increasing early help seeking

What can we all do now….. Sector leadership Public engagement Media engagement Sharing stories Relentless focus on learning and doing better

Finally….Suicide Prevention needs to be values driven Inspiring hope, meaning and purpose Preserving dignity, counter stigma, stereotypes, discrimination Support people, families and communities so that everyone experiences a life worth living