Mental illness is notoriously linked with shame, secrecy and isolation. Society is making moves to correct this stigma and encourage people to get help. But what happens when you're already isolated and excluded from society? When you've been disowned by your family? And when you can't even stay home in bed because you have no home or bed? The homeless population in Rotorua is growing and so too are those feeling like there's no solution to their troubles. Cira Olivier reports.
One in five suspected suicides in Rotorua in the past 15 months were homeless, the highest in a decade.
"I'm over losing these people because they're so desperate and they just give up," Love Soup co-founder Gina Peiffer said.
Provisional figures released to the Rotorua Daily Post found three of the 15 people who were suspected to have killed themselves between January 2018 and March 2019 had "no fixed abode".
Two of these were a man and a woman between 25 and 29-years-old and the other a man between 70 and 74.
This was up from zero each year since 2009.
The Government Inquiry into Mental Health and Addiction report last year found a relationship between poor mental health and threats to affordable and safe housing.
Homelessness was found to be a harm to wellbeing, along with other risk factors to wellbeing like alcohol, drug abuse and violence.
Peiffer said suicide and the threat of it was becoming increasingly prevalent in the homeless community and she had seen the fallout firsthand.
Love Soup was built around the needs of the homeless, housing families and "streeties", hosting dinners and distributing food rescue parcels around the Bay of Plenty.
They now have up to 10 new families a day seeking help.
They are currently supporting a woman whose partner was suspected to have committed suicide this year, something none of them saw coming.
"I didn't know how bad the anxiety and depression had gotten," Peiffer said.
"They are incredibly vulnerable. Homelessness screws with your head and everything you thought you knew."
Peiffer also spoke of a mother of four who had told her she had taken out a life insurance policy to make sure her children would be looked after.
"Because she thinks they're better off without her," Peiffer, who had been keeping close tabs on the woman, said.
The young mother had four 90-notices with landlords deciding to sell their homes, putting a black mark on her name, despite the reasons being out of her control, she said.
Peiffer said it got too overwhelming for some, who were forced to get used to living on the streets.
"We need to keep a glimmer of hope for them . . . the light at the end of a bloody dark tunnel."
Her husband, Elmer, said mental health issues among the homeless had become increasingly noticeable since Rotorua's housing crisis began.
"They're not used to being out on the streets, they're not street savvy, they don't want to be there," he said.
He said being put out on the streets brought on intense fears - from not knowing where they would stay, if they would lose their children, or if they would eat.
A formerly homeless man, who spoke on the condition of anonymity, said substance abuse was high among the homeless, many of whom used it to deal with depression.
He was housed by Love Soup after two years of living in a toilet block and said many people became addicted due to their mental illness and struggled when housed as they were unable to afford their habit on top of their rent.
Visions of a Helping Hand founder Tiny Deane said two children housed at the women's shelterhad attempted suicide within the last two months.
He said he was surprised the suspected suicide figures among the homeless community were not higher.
"In five years time I can see it getting out of control."
Deane saw drug and alcohol abuse daily, something which came into the vicious cycle as a symptom of mental illness, not a cause.
He had a growing waiting list, now at seven families, hoping to get into the women's shelter.
He said there were triple the number of registered homeless at the night shelter from the 72 when he opened last year and a "huge turn around" of 150 visitors each week.
Deane likened being homeless to being hit by a truck - "every homeless person needs intensive care".
"A lot don't have hope if not given the intensive care," he said.
This included housing, mental health support, addiction support and coaching in how to behave in society.
Rotorua social worker Eddy Hodge has offered support at the night shelter for the past year and saw self-harm and drug and alcohol abuse in the homeless community.
He said depression of the people he worked with was for a range of reasons: from homelessness, traumatic past experiences or alienation from their family for being homeless.
"Some can't see an end, they can't see any goals, they're just stuck . . . you try and unstick them but some see no way out."
Lakes DHB service manager for mental health and addiction services Michael Bland said The Mental Health Mortality and Morbidity Committee had not been aware of any strong link between homelessness and the cases that were reviewed by the members.
Bland said the 15 deaths, not confirmed as suicide, were examined by the committee and eight had a current or historical association with the mental health and addictions service.
Ministry of Social Development (MSD) regional commissioner Mike Bryant said the department tried to connect people with agencies best placed to help, such as health services, Lifeline or Samaritan if made aware of a specific mental health need or issue.
"Our priority is the wellbeing of the people we're trying to help and we're really concerned about this."
He said MSD staff had processes of compassion and care if someone made a threat of self-harm or suicide and also reported threats to the police who could do a wellness check.
They could also immediately help eligible people with somewhere to stay short-term, like a motel or boarding house, paid for by an Emergency Housing Special Needs Grant.
Research by the University of Otago - not yet published but reviewed by the Government - found that chronically homeless people have high mental health needs.
Budget 2019 announced $197 million over four years for Housing First which would fund 1044 new places.
Housing First, the Government's solution to homelessness, was officially launched in Rotorua on April 30.
The Housing First programme understood it was easier for people to address their issues once they had a home.
Waiariki MP Tāmati Coffey said the suspected suicides showed a "crossroads between two crisis points in our community" of housing and mental health.
He said the iwi-led Housing First homeless service would provide help to those in need in a multitude of ways to turn their lives around and stay sustainably housed.
Coffey said the $1.9 billion Wellbeing Budget investment by the Government into mental health, though long overdue, would work to combat suicide.
"There is much more mahi to do. However, by working in partnership with iwi, local government, social services, whānau and the community, we can change the story for New Zealanders in need within the Waiariki."
WHERE TO GET HELP
Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youthline: 0800 376 633 ?Kidsline: 0800 543 754 (available 24/7) ?Whatsup: 0800 942 8787 (1pm to 11pm)
Depression helpline: 0800 111 757 (available 24/7)
If it is an emergency and you feel like you or someone else is at risk, call 111.