Supervision 'big issue' in suicide prevention

A simple system overhaul could prevent suicides, a Bay of Plenty coroner believes.
Responding to shock figures showing 60 Western Bay people committed suicide between July 2007 and July 2010, Coroner Dr Wallace Bain said there was a "huge opportunity" to reduce rates.
What was needed was more supervision of suicidal people and an effective system to keep them on medication, he said.
"People just don't do that kind of thing when they're on their meds. How to supervise them is the big issue."
A registered pharmacist, Dr Bain suggested a programme similar to that for methadone patients, where suicidal people on medication would be required to visit their pharmacy to obtain their daily prescription.
If the patient failed to show up one day, a "red flag" would activate and a social worker would visit his or her home.
"There's been a huge amount of suicide, generally over my 20 years, and I've seen it time and time again how it could have been prevented.
"It's quite distressing to see when it would be quite easy to fix it."
Dr Bain said likely factors in the 60 Western Bay suicides were relationship breakdowns, histories of depression and, particularly in the black 2008/2009 period - when there were 30 cases in the district - financial hardship.
Tauranga Hospital mental health clinical director Dr Sue Mackersey said it was likely the economic climate contributed to the jump in cases in 2008-2009, although cases were usually "multifactorial".
She said the group aged 45 to 49 had proven particularly "problematic", recording high suicide rates as it moved through up the age groups.
"This cohort has also been over-represented in suicide statistics nationally."
While factors among suicides in older people usually included mental illness, significant relationship loss or other factors built up over a period of time, youth suicide was a different case altogether, she said.
"Often with young people, there's not many warning signs and they will be in a significant amount of pain. They don't yet have that emotional regulation that comes with age."
In recent years the Bay of Plenty District Health Board had run a quality improvement project to ensure people presenting to the hospital at risk of suicide were referred on to the appropriate services.
Bruce Wall, the chairman of Samaritans of New Zealand, said the number of people calling during the recession period had been relatively static but there had been a spike due to the increase in GST this month.
"We ask every caller whether they are feeling suicidal. The number of our callers who say they are suicidal increases during the mid-winter period," Mr Wall said.
"On average, around 4 per cent of our callers say they are suicidal and this is in response to a Samaritans volunteer asking them that question."
On Thursday, the DHB opened its upgraded child adolescent mental health unit Voyagers, based in Whakatane.
Mrs Mackersey spoke about youth suicide among other talks during the day, which was timed to mark Mental Health Awareness Week.
More information about the awareness week and mental health can be found at the website, www.mentalhealth.org.nz
HOW YOU CAN HELP
People having thoughts and feelings about suicide should be taken very seriously, says Suicide Prevention Information New Zealand. The group recommends:
* Try to make their environment safe from any means of harm.
* If the person is feeling unsafe, or you think they are at high risk, don't leave them alone.
* You could ask someone else to be with them when you need to leave or need time out.
* If they're feeling more settled they might appreciate some time alone - however, don't leave them alone for long periods of time.
* Be willing to listen, without judgment. Allow the person opportunities to talk honestly with you.
Most suicides committed by males
Forty-four of the 60 people who committed suicide in the Western Bay of Plenty between July 2007 and July 2010 were male, figures provided by the Chief Coroner's Office show.
Most of those males committed suicide in 2008/2009, when there were 23 cases, while there were eight male suicides in 2007/2008 and 13 in the past financial year.
The most common age group recorded across the three-year period was 45 to 49, with eight cases, followed by 20 to 24-year-olds, with seven cases, and 15 to 19-year-olds, 35 to 39-year-olds, 40 to 44-year olds and 50 to 54-year-olds, with six cases across each group.
Figures showed 38 of the deaths were recorded in Tauranga, 10 in Mount Maunganui, six in Te Puke, four in Katikati and two in Omokoroa.
In the youngest age group, 10 to 14, there had been three cases, while across the oldest age group, 85 to 90, there had been two cases.
Of the total 60 cases, 45 were closed and the remaining 15 were listed as active.